Scielo RSS <![CDATA[Curationis]]> vol. 32 num. 3 lang. pt <![CDATA[SciELO Logo]]> <![CDATA[<b>Denosa Magic</b>]]> <![CDATA[<b>The lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution</b>]]> Caring for good people is difficult enough; to care for people who are either aggressive or violent is even more difficult. This is what psychiatric nurses working in the psychiatric institution in which research was done are exposed to on a daily basis. The aim of the research was to explore and describe the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews and naive sketches. Tesch 's (Creswell, 2004: 256) method of open coding and an independent coder were utilised for data analysis. This study shed some light on the lived experience by psychiatric nurses of aggression and violence from patients in a Gauteng psychiatric institution. The findings show that the level of violence and aggression to which psychiatric nurses are exposed is overwhelming and the consequences are alarming. The contributing factors to this violence and aggression are: the mental status and the conditions in which patients are admitted; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation among newlv appointed staff members. As a result, psychiatric nurses are emotionally, psychologically, and physically affected. They then respond with the following emotions and behaviour: fear, anger, frustration, despair, hopelessness and helplessness, substance abuse, absenteeism, retaliation and the development of an "I don't care " attitude. <![CDATA[<b>Adolescent mothers' non-utilisation of antenatal care services in Bulawayo, Zimbabwe</b>]]> Adolescent pregnancies are high risk obstetric occurrences. Antenatal care (ANC) provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. The purpose of the study was to identify factors influencing adolescents ' non-utilisation of ANC services in Bulawayo. The Health Belief Model (HBM) was used to contextualise the study. A quantitative, non-experimental, descriptive research design was adopted, using structured interviews to collect data. Purposive, non-probability sampling was used to conduct structured interviews with 80 adolescent mothers from the postnatal wards who had delivered their babies without attending ANC. Factors influencing these adolescent mothers' non-utilisation of ANC services included socio-economic issues, individuals' perceptions about ANC, limited knowledge about ANC, policies and structural barriers. However, these adolescents knew that delivering their babies with skilled attendance could enhance the outcomes for the mothers and babies, would help secure documents to facilitate the acquisition of their children 's birth certificates, and that obstetric complications required the services of skilled midwives/doctors. Policy-related issues, such as requiring national identity cards from pregnant adolescents (or from their spouses) prohibited some of them from utilising ANC services. There is a need to improve adolescents ' reproductive health outreach (including ANC) programmes and to offer free ANC services in Zimbabwe. Restrictive policies, such as the required identity cards of the pregnant adolescents (or their husbands), impacted negatively on the accessibility of ANC services and should be addressed as a matter of urgency in Bulawayo. <![CDATA[<b>Clinical skills required of ophthalmic nurse practitioners in tertiary level public hospitals in the Western Cape Province</b>]]> BACKGROUND: South Africa has a 32-year history of training ophthalmic nurse practitioners (ONPs). The role and required skills and competencies of ONPs are not well documented in the international literature and are also absent from South African publications, including South African Nursing Council publications. AIM: This study aims to inform curriculum development and human resource planning by reporting on the clinical skills expected of ONPs by members of multidisciplinary ophthalmology teams. METHOD: A limited survey was undertaken in the ophthalmology wards and outpatient departments of three tertiary level hospitals in the Western Cape Province. A researcher-designed structured self-completion questionnaire was distributed to 30 ophthalmology practitioners: doctors, nurses and technicians. Respondents were asked to indicate the expected clinical skills of ONPs. FINDINGS: All questionnaires were completed. All respondents favoured ONPs taking histories and performing emergency eye irrigations. There was less support for more complex procedures, such as B-scans. One-third of respondents did not expect ONPs to have skills in eight key areas, including examination of the anterior chamber angle for glaucoma. No statistically significant differences were found between responses of doctors and nurses, with one exception: more nurses (15/18) than doctors (4/10) had confidence in the ONP undertaking basic eye examinations for ocular motility (Fisher 's exact test, P=0.035). CONCLUSION: In the study settings, ONPs are not using their specialist skills to the full. Not all practitioners were receptive to ONPs using the skills that they had acquired during their postgraduate diploma, threatening the educational effectiveness of this initiative. <![CDATA[<b>An assessment of teaching strategies used by lecturers at a nursing college in Mpumalanga</b>]]> The need for the utilization of various teaching strategies by lecturers when facilitating learning cannot be overemphasized. The aim of this study was to establish if lecturers at a Nursing College in Mpumalanga were using teaching strategies that could facilitate the personal development of nursing learners. A quantitative approach was followed for this studv. The participants of the study were all lecturers at a Nursing College in Mpumalanga. Data was gathered by means of a questionnaire. Descriptive statistics were used to describe and summarize data regarding the type of teaching strategies used and the recommendations that could enhance the utilization of various teaching strategies. The data revealed that the teaching strategies mostly utilized required active participation of the learners namely: formal/informal writing of assignments; learner-led class presentation; group sessions; clinical case studies; role-playing and clinical rounds. Inclusion of certain strategies such as problem-based learning, structured accompaniment and computer literacy for learners could enhance the personal development of nursing learners. Although lecturers did use some of the teaching strategies that could enhance the personal development of nursing learners, staff development regarding the utilization of various teaching strategies was highlighted as an important factor to be considered. Other findings revealed that lack of resources have a negative influence on the utilization of various teaching strategies. <![CDATA[<b>Abortion care training framework for nurses within the context of higher education in the Western Cape</b>]]> The high morbidity and mortality rate due to illegal abortions in South Africa necessitated the implementation of abortion legislation in February 1997. Abortion legislation stipulates that registered nurses who had undergone the proposed abortion care training - certified nurses - may carry out abortions within the first 12 weeks of pregnancy. Currently it seems that an inadequate number of nurses are being trained in the Western Cape to provide pregnant women with counselling, to perform abortions and/or refer problem cases. No real attempts have since been made by higher education institutions in the Western Cape to offer abortion care training for nurses. This case study explores the situation of certified nurses and the context in which they provide abortion care in different regions of the Western Cape. The sampling included a random, stratified (non-proportional) number of designated state health care facilities in the Western Cape, a non-probability purposive sampling of nurses who provided abortion care, a non-probability convenience sample of women who had received abortion care, and a non-probability purposive sampling of final-year pre-registration nursing students. Data was generated by means of questionnaires, a checklist and semi-structured interviews. The main findings of this study indicate that the necessary infrastructure required for legal abortion is in place. However, the ongoing shortage of trained health care practitioners hampers abortion care services. Deficiencies were identified in the existing provincial protocol as some of the guidelines were either not in use or had become obsolete. Certified midwives who had been trained by the regional offices of the Department of Health: Western Cape were skilled in carrying out the abortion procedure, but other aspects of abortion care mainly carried out by other categories of nurses required more attention. This article suggests a training framework that should provide focus for the development of a formal programme or programmes for the training of nurses in abortion care at higher education institutions in the Western Cape. <![CDATA[<b>Managerial guidelines to support parents during the hospitalisation of their children in a private paediatric unit</b>]]> The purpose of this article is to describe managerial guidelines to support parents with the hospitalisation of their child in a private paediatric unit. The hospitalisation of a child is regarded as a major stressor for both parents and child. The role of the family in participating in a child's illness is slowly being recognised (Kibel & Wagstaff, 2001:544), but the South African government per se has not yet issued any formal reports on parental participation in the hospitalisation process. The study explored and described • the nursing care experiences of parents regarding the hospitalisation of their child in a paediatric unit; • managerial guidelines to support parents with their lived experiences of their child's hospitalisation in a paediatric unit. To achieve the purpose and the objectives of the research, an interpretive-phenomenological qualitative approach was used in the research design and methods. Research was conducted through unstructured individual interviews, narrative diaries and field notes and data were analysed through open-coding (Tesch, 1990). Parents were asked to respond to the question "How did you experience your child's hospitalisation in the paediatric ward", followed by probing when the responses of the parents were ambiguous. Purposive sampling was used to achieve saturation of data and seven parents were interviewed and fifteen parents completed narrative diaries. The model of Lincoln and Guba (1985) was used to ensure trustworthiness. Ethical considerations were maintained throughout the study and consent was obtained from the respondents. The recommendations of the research were that attention should be given to 1) empowering parents to participate in their child's care; 2) guiding nursing personnel to plan the discharge process; 3) including parents in the unit routine; 4) fostering a trusting relationship with parents; 5) promoting the communication of information; and 6) creating a therapeutic environment for parents. <![CDATA[<b>Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province</b>]]> Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy. <![CDATA[<b>Reflecting on 'meaningful research': A qualitative secondary analysis</b>]]> Reflection on meaning' and 'meaningful research ' led the researchers to further explore data obtained in an original study which aimed to develop a strategy to improve the contribution of nurses towards health research. The purpose of this further exploration, using a qualitative secondary analysis, was to explore and describe what important stakeholders in research, as well as nurses, see as meaningful research. It was expected that this analysis might contribute to refine the strategy and shed light on how research can be communicated to nurses as a more meaningful activity. The original data sets, namely 28 lists of open-ended questions and eight transcripts of focus group interviews, were analysed, using content analysis. The results show that there are similarities, but differing emphasis, between the viewpoints of the mentioned stakeholders and nurses. It is recommended that stakeholders in research, including nurses, need to establish and work in respectful, supportive, research capacity building partnerships when conducting research. Following this approach might lead to research being understood and experienced by nurses as a meaningful activity.