Scielo RSS <![CDATA[Curationis]]> http://www.scielo.org.za/rss.php?pid=2223-627920150002&lang=en vol. 38 num. 2 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Allopathic and traditional health practitioners' collaboration</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200001&lng=en&nrm=iso&tlng=en BACKGROUND: Professional collaboration between traditional and allopathic health practitioners in South Africa is proposed in the Traditional Health Practitioners Act and could benefit and complement healthcare delivery. OBJECTIVES: To explore and describe the collaborative relationship between allopathic and traditional health practitioners regarding the legalisation of traditional healing, and these health practitioners' views of their collaborative and professional relationship, as role-players in the healthcare delivery landscape in South Africa. METHODS: A qualitative design was followed. The research population comprised 28 participants representing three groups: allopathic health practitioners (n = 10), traditional healers (n = 14), and traditional healers who are also allopathic health practitioners (n = 4). Purposive and snowball sampling was used. Data collection involved unstructured interviews, a focus group interview and modified participant observation. RESULTS: Results indicate both allopathic and traditional health practitioners experienced negative attitudes towards each other. Mutual understanding (in the form of changing attitudes and communication) was considered crucial to effective collaboration between these two health systems. Participants made suggestions regarding capacity building. CONCLUSIONS: Considering realities of staff shortages and the disease burden in South Africa, facilitating collaboration between allopathic and traditional health practitioners is recommended. Recommendations could be used to develop strategies for facilitating professional collaboration between traditional and allopathic health practitioners in order to complement healthcare delivery. <![CDATA[<b>Perceptions of nursing students regarding responsible use of social media in the Eastern Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200002&lng=en&nrm=iso&tlng=en BACKGROUND: Social media have become a popular communication system that has transformed communication from the traditional to the Web-based model. Because social media use has no limitations to place and time, it is now used extensively at clinical facilities. Social media use is becoming a popular activity amongst students at Nursing Education Institutions (NEI) in South Africa. However, lack of accountability and unethical use of social media by nursing students in South Africa has been reported. OBJECTIVES: The aim of the study was to explore and describe the perceptions of nursing students regarding responsible use of social media METHODS: A qualitative, descriptive, explorative and contextual research design was used to explore and describe the perceptions of nursing students regarding the responsible use of social media. Twelve nursing students registered for the undergraduate nursing degree were purposely selected and interviewed individually using a semi-structured interview method. RESULTS: The results of this research study demonstrate that nursing students use social media irresponsibly. Nursing students experience blurred boundaries between personal and professional lines and lack accountability when using social media. CONCLUSION: The extensive use of social media in the clinical environment, by healthcare students, requires a joint effort by Nursing Education Institutions and healthcare facilities to ensure that social media are used in an ethically acceptable manner. The implementation of the recommendations of this research study could positively influence legally and ethically acceptable use of social media at healthcare facilities. <![CDATA[<b>Undergraduate nurses reflections on Whatsapp use in improving primary health care education</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200003&lng=en&nrm=iso&tlng=en BACKGROUND: The global use of mobile devices with their connectivity capacity, and integrated with the affordances of social media networks, provides a resource-rich platform for innovative student-directed learning experiences. OBJECTIVE: The objective of this study was to review the experiences of undergraduate nurses on the improvement of primary health care education at a School of Nursing at a University in the Western Cape, South Africa, through the incorporation of a social media application, WhatsApp. METHOD: A qualitative, exploratory, descriptive, and contextual design was used to explore and describe data collected from a purposive sample of 21 undergraduate nursing students. The study population was engaged in a WhatsApp discussion group to enhance their integration of theory and clinical practice of the health assessment competency of the Primary Health Care Module. Participants submitted electronic reflections on their experiences in the WhatsApp discussion group via email on completion of the study. Thematic analysis of the qualitative data collected was done according to Tesch's (1990) steps of descriptive data analysis in order to identify the major themes in the study. The electronic reflections were analysed to explore their rich, reflective data. RESULTS: Seven themes were identified that included: positive experiences using the WhatsApp group; the usefulness of WhatsApp for integrating theory and clinical practice; the availability of resources for test preparation; opportunity for clarification; anonymity; exclusion of students as a result of the lack of an appropriate device, and the application caused the battery of the device to run flat quickly. CONCLUSION: The results of the experiences of students in the WhatsApp discussion group could be used to inform the use of social media applications in teaching and learning, with the purpose of enhancing the integration of the theory and clinical practice. <![CDATA[<b>Experiences of homosexual patients' access to primary health care services in Umlazi, KwaZulu-Natal</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200004&lng=en&nrm=iso&tlng=en BACKGROUND: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate health care. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk AIM OF THE STUDY: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province of KwaZulu-Natal (KZN METHOD: A qualitative, exploratory, descriptive study was conducted which was contextual in nature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis RESULTS: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel CONCLUSION: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes. <![CDATA[<b>Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200005&lng=en&nrm=iso&tlng=en BACKGROUND: Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge OBJECTIVE: To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme METHOD: The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) and individual interviews to identify themes RESULTS: Themes identified from the students' FGDs and individual interviews included: mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices CONCLUSION: The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices. <![CDATA[<b>Clinical learning experiences of male nursing students in a Bachelor of Nursing programme: Strategies to overcome challenges</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200006&lng=en&nrm=iso&tlng=en BACKGROUND: Male nursing students are faced with more challenges in the clinical setting than their female counterparts. The ways in which male nurses are viewed and received by nursing staff and patients have an impact on how they perceive themselves and their role in the profession. These perceptions of self have a significant impact on their self-esteem. This study was conducted to explore the clinical learning experiences of male nursing students at a university during their placement in clinical settings in the Western Cape Province, and how these experiences impacted on their self-esteem OBJECTIVES: To describe the learning experiences of male nursing students during placement in clinical settings, and how these impact on their self-esteem METHOD: A qualitative, exploratory study was conducted. Purposive sampling was used to select participants. Three focus group (FG) discussions, consisting of six participants per group, were used to collect data. Data analysis was conducted by means of Coliazzi's (1978) seven steps method of qualitative analysis STUDY FINDINGS: The following three major themes were identified: experiences that related to the constraints in the learning environment, the impact on the self-esteem, and the social support of students working in a female-dominated profession CONCLUSION: Male nurses should be supported in nursing training, as the rate at which males enter the profession is increasing. <![CDATA[<b>Expectations of youth victims of violence regarding health care professionals leading them to wellness in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200007&lng=en&nrm=iso&tlng=en BACKGROUND: Many youth victims of violence report for treatment at the health care facilities in the Western Cape Province of South Africa. It was unclear what the youth expected regarding how they could be led towards wellness by health care professionals following an incident of violence (R1.1) OBJECTIVES: This study sought to explore and describe the expectations of the youth victims of violence with regards to health care professionals (R1.2) leading them to wellness in a selected rural community METHOD: A qualitative, exploratory, descriptive and contextual design was used. Nine focus group discussions were conducted with 58 (23 males, 35 females) purposefully selected youth victims of violence between the ages of 15 and 19. Data analysis was done through open coding. Ethics clearance was received from the University Ethics Committee prior to the study being conducted RESULTS: Findings indicated that the youth victims of violence expect the health care professionals (professional nurses, doctors and social workers) working in their community to act as role models, demonstrate a professional attitude, provide health education, provide confidential counselling services, and establish school and community outreach programmes CONCLUSION: This study provides evidence that youth victims of violence have important expectations from health care professionals concerning their wellness. Hence, health care professionals should focus on designing and implementing interventions targeting these expectations. <![CDATA[<b>Perceptions of female teenagers in the Tshwane District on the use of contraceptives in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200008&lng=en&nrm=iso&tlng=en BACKGROUND: Perceptions of female teenagers in the Tshwane District contribute to the non-use and or discontinued use of contraceptives as evidenced by increased levels of unplanned pregnancies. OBJECTIVE: The objective of this study was to explore and describe the perceptions of female teenagers in the Tshwane District on the use of contraceptives. METHODS: A qualitative, explorative, descriptive approach was followed in this study. The population comprised of pregnant female teenagers who were purposively selected. Data were collected using unstructured individual interviews on a face-to-face encounter in a natural setting. Data were analysed using the discourse method of data analysis. RESULTS: The following perceptions on the use of contraceptives emerged: Perceptions on the use of contraceptives, emotions, contraceptive effects, social pressure and education on contraceptives. Teenagers' perceptions were predominantly negative with unfounded fears. Though the teenagers were aware of the importance of the use of contraceptives, motivation to pursue contraception was lacking. Teenagers verbalised to be uncommitted as well. CONCLUSION: Various perceptions of female teenagers in the Tshwane District on the use of contraceptives were explored and described. It was noted that all the teenagers interviewed had great remorse and feelings of guilt regarding their behaviour of not using contraceptives. Their need for re-education was cited and seen as motivational enough to encourage the use of contraceptives at primary health care settings. Therefore, the study recommended that health education programmes should be restructured to effectively influence the female teenagers' perceptions positively and to promote the use of contraceptives. <![CDATA[<b>Use of the step-up action research model to improve trauma-related nursing educational practice</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200009&lng=en&nrm=iso&tlng=en BACKGROUND: A lack of authentic learning opportunities influence the quality of emergency training of nursing students. The purpose of this article is to describe how the step-up action research model was used to improve the quality of trauma-related educational practice of undergraduate nursing students OBJECTIVES: To reduce deaths caused by trauma, healthcare workers should be competent to provide emergency care and collaborate effectively with one another METHOD: A simulated mass casualty incident, structured to support the integration of theory into practice, became a more rigorous action research activity which focused on the quality improvement of the mass casualty incident RESULTS: The results indicated improved student learning; partnership appreciation; improved student coping mechanisms, and increased student exposure. Quality emergency training thus results in better real-life collaboration in emergency contexts CONCLUSION: The step-up action research model proved to be a collaborative and flexible process. To improve the quality and rigour of educational programmes it is therefore recommended that the step-up action research model be routinely used in the execution of educational practices. <![CDATA[<b>Learning end-of-life care within a constructivist model: Undergraduate nursing students' experiences</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200010&lng=en&nrm=iso&tlng=en BACKGROUND: Although nursing education aims to equip nursing students to provide care to dying patients and their families, nurses often feel ill-prepared to cope with the emotional labour involved in end-of-life care. OBJECTIVES: The aim of the study was to explore and describe nursing students' experiences of end-of-life care through experiential learning within a constructivist educational model. METHOD: A qualitative, descriptive design was used. As part of introducing experiential learning, innovative educational practices were initiated during a second year level undergraduate nursing module on end-of-life care. Qualitative data on second-year nursing students' experiences were collected through written reflections and analysed using open coding. RESULTS: The themes that emerged revealed participants' sensory and emotional experiences during the learning opportunities. Participants reflected on what they learnt and clarified their values related to death and dying. They indicated how they would apply the new meanings constructed in clinical practice. CONCLUSION: A constructivist educational model of experiential learning holds potential to enhance value clarification and nursing students' sensory and emotional awareness of death and dying. Experiential learning is recommended to develop nursing students' competency in providing end-of-life care. <![CDATA[<b>Access to information and decision making on teenage pregnancy prevention by females in Tshwane</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200011&lng=en&nrm=iso&tlng=en BACKGROUND: The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. OBJECTIVE: To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa. METHOD: In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semi-structured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens. RESULTS: Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information. CONCLUSION: Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy. <![CDATA[<b>Experiences of registered nurses with regard to accessing health information at the point-of-care via mobile computing devices</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200012&lng=en&nrm=iso&tlng=en BACKGROUND: The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients OBJECTIVES: This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs METHOD: A qualitative, exploratory, descriptive and contextual design was used. Ten in-depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded, transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study RESULTS: Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop, and improve, their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public, for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device CONCLUSION: The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing. <![CDATA[<b>Adult learning: What nurse educators need to know about mature students</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200013&lng=en&nrm=iso&tlng=en BACKGROUND: Most nurse educators regard students who enter postgraduate studies as adult learners capable of self-direction and independent learner behaviour. Therefore, a mismatch between the nurse educator's expectation of adult learners and actual adult learner conduct may result in disappointment and even frustration for both educator and learner PURPOSE: This article is a report of a secondary analysis of data that were collected to explore the high-fidelity simulation learning experiences of a group of postgraduate nursing students. The secondary analysis was done to determine whether adult learners who bring professional knowledge and experience to a postgraduate learning environment displayed adult learner conduct as proposed by educational theorist Malcolm Knowles METHOD: Using a qualitative descriptive research design, data were gathered from 18 postgraduate nursing students who participated in high-fidelity simulation in a nursing school at a higher education institution in South Africa. The nominal group technique was used to collect the students' ideas about improving their simulation learning experiences. A secondary qualitative analysis of the primary nominal group data was done FINDINGS: Data either confirmed or belied adult learner behaviour. Although the findings suggested self-directed and independent learner behaviour, they also revealed behaviour evident of dependence on the educator CONCLUSION: Mature students have well established ways of thinking and doing that may hinder learning. Educators have to support adult learners in developing effective learning techniques in order to maximise the benefits of their experience and knowledge by fostering independence and self-direction <![CDATA[<b>Accessibility and availability of the Female Condom2: Healthcare provider's perspective</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200014&lng=en&nrm=iso&tlng=en BACKGROUND: Despite the acceptability of the Female Condom2 (FC2) as a contraceptive method by some women, it remains inaccessible and unavailable to the majority of women because of affordability, training, distribution and marketing strategies. The FC2 affords women dual protection and the option to negotiate safe sex OBJECTIVE: This paper explores and describes the perspective of the healthcare providers regarding accessibility and availability of the FC2 as a contraceptive method in the Tshwane district METHOD: The study used an explorative, descriptive, and qualitative design. Data were collected from 26 healthcare providers who were purposively selected. In-depth face-to-face interviews were conducted with these healthcare providers in the Tshwane district. Tesch's method of open coding was used for data analysis RESULTS: Two main themes emerged, namely, the availability of the FC2 and the knowledge of the healthcare providers. The findings of this study indicated that the availability of the FC2 remains a challenge because of factors such as lack of affordability, inefficient procurement and lack of distribution measures. The condoms are also not available at strategic points so as to ensure accessibility. Insufficient knowledge amongst healthcare providers was described as a barrier which affects the quality of training of the service users CONCLUSIONS: It is evident that the FC2 is not yet available in all healthcare settings, therefore strategies to safeguard accessibility and availability of the FC2 as a contraceptive method are recommended. <![CDATA[<b>The impact of an indigenous proverb on women's mental health: A phenomenological approach</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200015&lng=en&nrm=iso&tlng=en BACKGROUND: Proverbs and idioms represent cultural and societal beliefs and values inherited from the forefathers. An example is lebitla la mosadi ke bogadi. Over many decades African people have used such ancient instructions to counsel women to be resilient in their marriages thus impacting on their mental health OBJECTIVE: The purpose of this article was to explore and describe that proverb and its impact on women's mental health METHOD: Hermeneutic phenomenology was used to explore and describe the proverb and its impact on indigenous women's mental health. The population included married, divorced, widowed and single women who were attending social clubs or networks in the cities of Tshwane and Johannesburg. Snowball and purposive sampling was used to select 57 participants. Five face-to-face interviews and eight focus groups interviews were conducted. Colaizzi's data analysis method was used to analyse data RESULTS: Oppression and stigmatisation of women and their families and harmful effects that may result in death were identified as having an impact on women's mental health. Some women shared that they were oppressed in many ways. In addition, they feared stigmatisation should they wish to divorce. They constantly lived in fear of being harmed or killed by their spouses CONCLUSION: There was a need for nurses to develop awareness regarding cultural issues so that women are better served in primary healthcare settings. Women who are suspected of experiencing abuse, should be screened for abuse so that they can be assisted accordingly. <![CDATA[<b>Assessing the use of contraceptives by female undergraduate students in a selected higher educational institution in Gauteng</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200016&lng=en&nrm=iso&tlng=en BACKGROUND: Unplanned pregnancies amongst students at higher education institutions are a major concern worldwide, including South Africa. Apart from various social and psychological challenges, unplanned pregnancies affect students' objectives of achieving academic success. Research undertaken in the United States of America (USA) indicates that around 80% of female students in institutions of higher education between ages 18 and 24 are sexually active OBJECTIVES: To assess and describe the use of contraceptives by undergraduate female students in a selected higher educational institution in Gauteng METHOD: A cross-sectional, descriptive, quantitative design was used. A total of 400 female undergraduate students were requested to respond to a self-administered questionnaire. Stratified random sampling was used to select the participants. They were selected systematically from two campuses. Data were entered using an excel sheet at the Department of Statistics, and analysed using the Statistical Analysis Software programme, (SAS version 9.3), of the Department of Statistics' higher educational institutions RESULTS: A total of 74% females indicated they were sexually active, 79% of whom reported using contraceptives. The most common used methods were oral contraceptives at 38%, and 25% for male condoms. The most commonly known methods were condoms at 84%, and the oral contraceptive at 68%. The knowledge of condom use to prevent sexually transmitted diseases was high at 91% CONCLUSION: Inadequate knowledge and awareness on some contraceptive methods was found. Thus, educational programmes to increase students' knowledge on the use of all contraceptive methods are urgently needed. <![CDATA[<b>Bridging the gap between self-directed learning of nurse educators and effective student support</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200017&lng=en&nrm=iso&tlng=en BACKGROUND: Self-directed learning requires the ability to identify one's own learning needs, develop and implement a plan to gain knowledge and to monitor one's own progress. A lifelong learning approach cannot be forced, since it is in essence an internally driven process. Nurse educators can, however, act as role models to empower their students to become independent learners by modelling their own self-directed learning and applying a number of techniques in supporting their students in becoming ready for self-directed learning OBJECTIVES: The aim of the article is to describe the manifestations and implications of the gap between self-directed learning readiness of nurse educators and educational trends in supporting students METHOD: An instrumental case study design was used to gain insight into the manifestations and implications of self-directed learning of nurse educators. Based on the authentic foci of various critical incidents and literature, data were collected and constructed into a fictitious case. The authors then deductively analysed the case by using the literature on self-directed learning readiness as departure point. Four constructs of self-directed learning were identified, namely internal motivation, planning and implementation, self-monitoring and interpersonal communication. Supportive strategies were identified from the available literature RESULTS: Nine responses by nurse educators based on the fictitious case were analysed. Analysis showed that readiness for self-directed learning in terms of the identified constructs was interrelated and not mutually exclusive of one other CONCLUSION: The success of lifelong learning is the ability to engage in self-directed learning which requires openness to learning opportunities, good self-concept, taking initiative and illustrating independence in learning. Conscientiousness, an informed acceptance of a responsibility for one's own learning and creativity, is vital to one's future orientation towards goal-directed learning. Knowledge and understanding of one's own and students' self-directed learning abilities are critical for nurse educators. In the nursing profession, it has been shown that self-directed learning by the nurse educators has a direct relationship towards the development of a lifelong learning approach by their students. Supporting students towards becoming self-directed learners throughout their professional life, in turn, will impact directly on the quality of nursing and midwifery practice. <![CDATA[<b>Parents perceptions of stress in a neonatal intensive care unit in Rwanda</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200018&lng=en&nrm=iso&tlng=en BACKGROUND: Having a newborn infant hospitalised in the neonatal intensive care unit (NICU) is an unexpected and stressful event for a family. A number of potential stressors to which family members of patients in these units may be exposed have been identified, although no studies about this issue have been conducted in Rwanda AIM: The aim of this study was to describe and analyse parental perception of stress that resulted from having their infant admitted to a NICU in Kigali, Rwanda METHOD: A quantitative survey was used to describe and analyse parents' perceptions of stress when they had an infant admitted to a NICU. The Parental Stress Scale: Neonatal Intensive Care Unit was used to measure the level of stress that those parents experienced RESULTS: The results indicated that parents experienced stress from having their infants cared for in a NICU. The most stressful events were the appearance and behaviour of the baby with a mean score of 4.02, whilst the subscale items related to sights and sounds were found to be the least significant source of stress for parents with a mean score of 2.51. In addition, the current study found that parents' age, educational level, occupation, and infant birth weight were associated with parental stress CONCLUSION: The study established that a range of factors was responsible for parental stress when a baby was cared for in a NICU. Identification of these factors could enable health professionals from a hospital in Kigali, Rwanda, to facilitate parents' adjusting and coping. <![CDATA[<b>Reflections on clinical practice whilst developing a portfolio of evidence: Perceptions of undergraduate nursing students in the Western Cape, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200019&lng=en&nrm=iso&tlng=en BACKGROUND: In order to develop clinical judgement, nurses should be encouraged to become analytical and critical thinkers. Development of a portfolio of evidence (PoE) of reflection on clinical experiences is one of the strategies that can be used to enhance analytical and critical thinking amongst nursing students. Students' perceptions of the process are important in order to encourage their reflective practice. PoE compilation at a school of nursing at a university in the Western Cape includes evidence of students' clinical learning which they present in a portfolio. The students are expected to reflect on their clinical learning experiences and include these reflections in their portfolios OBJECTIVE: To describe the perceptions of fourth-year nursing students regarding reflective practice whilst compiling their PoEs METHOD: A qualitative design was used to explore the perceptions of registered fourth-year nursing students with regard to their reflective practice whilst compiling their PoEs. Purposive sampling was used for selection of participants. Three focus group discussions were held, each consisting of six to eight participants. Data saturation was reached during the third meeting. Tesch's method of data analysis was used RESULTS: Findings revealed that reflection enabled the learners to gain experience and identify challenges related to the expected events and tasks carried out at the hospitals and in the classroom whilst developing their PoE CONCLUSION: The compilation of a PoE was a good teaching and learning strategy, and the skills, experience and knowledge that the participants in this study acquired boosted their self-esteem, confidence and critical thinking. Reflection also assisted in self-directed learning. <![CDATA[<b>Nurse educators' experiences of case-based education in a South African nursing programme</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200020&lng=en&nrm=iso&tlng=en BACKGROUND: A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE) approach was adopted for the delivery of the Bachelor of Nursing programme in 2005 AIM: The aim of the study was to explore nurse educators' experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape METHODS: A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data RESULTS: Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening CONCLUSION: It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach. <![CDATA[<b>Using mobile phones and social media to facilitate education and support for rural-based midwives in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200021&lng=en&nrm=iso&tlng=en BACKGROUND: Empirical studies show the value of mobile phones as effective educational tools to support learning in the nursing profession, predominantly in high income countries PROBLEM STATEMENT: The rapidly increasing prevalence of mobile phone technology in Africa nourishes hopes that these tools could be equally effective in lowly resourced contexts, specifically in efforts to achieve the health-related Millennium Development goals. The purpose of this study was to investigate the perception and use of mobile phones as educational and professional tools by nurses in lowly resourced settings METHODOLOGY: A quantitative survey using self-administered questionnaires was conducted of rural advanced midwives RESULTS: Fifty-six nurses (49.6%) from the 113 rural-based midwives attending an advanced midwifery training programme at the University of KwaZulu-Natal, South Africa, filled in a questionnaire. The results showed that, whilst nurses regarded their technology competences as low and although they received very little official support from their educational and professional institutions, the majority frequently used mobile functions and applications to support their work and learning processes. They perceived mobile devices with their voice, text, and email functions as important tools for the educational and professional activities of searching for information and engaging with facilitators and peers from work and study contexts. To a lesser extent, the use of social networks, such as WhatsApp and Facebook, were also reported CONCLUSION AND RECOMMENDATION: It is concluded that educational institutions should support the appropriate use of mobile phones more systematically; particularly in relation to the development of mobile network literacy skills <![CDATA[<b>Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200022&lng=en&nrm=iso&tlng=en BACKGROUND: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care OBJECTIVES: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision METHOD: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses. Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection RESULTS: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented CONCLUSION: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems <![CDATA[<b>The perceptions of African women regarding natural menopause in Mamelodi, Tshwane district</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200023&lng=en&nrm=iso&tlng=en BACKGROUND: The majority of South African aging population are women, who spend late adulthood experiencing natural menopause. Despite the government spending billions of rand on different services for ageing women, menopausal challenges to African women still receive little attention OBJECTIVES: The aim of the study was to explore and describe the perceptions of African women regarding natural menopause, in order to propose recommendations for health and social support systems for women in Mamelodi, Tshwane district METHOD: A qualitative, exploratory, descriptive and contextual design was used to conduct the study. The population of the study consisted of menopausal women, between the ages 45 and 60 years or more, visiting the clinics for collection of chronic medication and other health assessment. Individual face-to-face interviews were conducted, using a semi-structured interview guide to collect data. Tesch's method of qualitative data analysis was used in the study RESULTS: The main theme that emerged from the study was 'attitude toward menopause', which was supported by cultural beliefs and experience. The African menopausal women expressed the importance of health support systems that will meet their needs within their context CONCLUSION: Women's health programs and educational health information at facilities should include menopausal education to promote and improve health of all African menopausal women during their adulthood. There is a need to establish a women's health support group network within communities to share menopausal experiences with peers. The training and education curriculum of healthcare providers should include detailed menopause in order to provide comprehensive, congruent care. <![CDATA[<b>Indigenous practices of pregnant women at Dilokong hospital in Limpopo province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200024&lng=en&nrm=iso&tlng=en BACKGROUND: Indigenous practices (IPs) are experiences generated by people who are living in a specific regional context and cultural group. IPs are shaped by cultural traits that are passed from one generation to the next. IPs practices are rooted and embedded in society and, therefore, the practices become part of the people's lifestyle. It is difficult to try and change these practices as people have adhered to them throughout their entire lives. The believe system plays a major role in health care seeking behaviour of individuals because they are informed by the IPs that are observed in their environment OBJECTIVES: To explore and describe the IPs of pregnant women at Dilokong hospital in Limpopo province METHOD: A qualitative, descriptive, explorative and contextual research design was used for the participants to describe the IPs used by pregnant women. Data were collected through unstructured one-on-one interviews RESULTS: The following four themes with sub-themes emerged from the data: IPs based on ancestral knowledge; IPs based on spiritual diviners versus church principles; restricted practices versus instructions followed during pregnancy; and labour and IPs during labour and delivery CONCLUSION: IPs are regarded as an honourable health intervention by traditional health practitioners (THPs), families and pregnant women. IPs like cords around women's waists are still observed during physical examinations. However, there is a reduction of prescribed indigenous oral medication used to accelerate labour because of their potential toxicity. <![CDATA[<b>Validation of the integration of HIV and AIDS related nursing competencies into the undergraduate nursing curriculum in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200025&lng=en&nrm=iso&tlng=en BACKGROUND: Being in its fourth decade, HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV, increasing health care access, and strengthening the health care system. South Africa has made the fight one of its top priorities, and has developed plans to increase the role of nurses in the management of HIV, demonstrating its willingness, commitment and progress in the fight against HIV OBJECTIVE: This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa METHODS: This study adopted a constructivist paradigm, using a qualitative approach, applying the design step of the process model of curriculum development, to validate the integration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum RESULTS: For each competency, outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum, as well as the feasibility and practicability of the integration CONCLUSION: Required resources for integration of HIV and AIDS related nursing competencies, such as human resources and nurse educators' continued personal development were identified, as well as barriers to integration, and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated. <![CDATA[<b>Experiences of nurses caring for mental health care users in an acute admission unit at a psychiatric hospital in the Western Cape Province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200026&lng=en&nrm=iso&tlng=en BACKGROUND: Caring for mental health care users (MHCUs) with mental illnesses is a major task that confronts nurses globally. It has been argued that caring for this group of patients is accompanied by unique challenges. Despite the available abundance of data about nursing patients suffering from mental illnesses, little is known about the lived experiences of nurses who care for MHCUs in acute admission units in the Western Cape province OBJECTIVES: This study's aim is to explore and describe the lived experiences of nurses who care for MHCUs in an acute admission unit at a psychiatric hospital in the Western Cape province METHODS: A qualitative, descriptive, phenomenological study was conducted. A purposive sampling procedure was applied which resulted in a sample that comprised eight nurses. In-depth, individual, semi-structured interviews were conducted with these eight participants. Interviews were audio-recorded and transcribed verbatim and the researcher utilised Collaizzi's method to analyse collected data RESULTS: Both positive and negative experiences were reported. Positive experiences were the recovery of patients, teamwork, and passion for caring. Negative experiences were the feelings of being unappreciated and unsupported by authorities. Physical assault by MHCUs, shortage of staff, increased workload and burnout was also reported CONCLUSIONS: In-service training about management of aggression needs to be provided, debriefing sessions to deal with burnout needs to be arranged, and research to quantify levels of burnout should be conducted. <![CDATA[<b>Students' voices on spiritual care at a Higher Education Institution in the Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792015000200027&lng=en&nrm=iso&tlng=en BACKGROUND: Nurses have a moral obligation to ensure holistic care of patients, inclusive of the spiritual dimension. However, there seems to be a void in the teaching and learning of spiritual care in nursing curricula. Despite the South African Nursing Council being in favour of holistic nursing, there are no measures in place to ensure implementation of spiritual care, hence its practice is not standardised in nursing education in South Africa Currently, the undergraduate nursing curriculum does not provide clear direction on how spiritual care in nursing should be integrated and the reason for this is not clear. It appears that the lack of professional regulation, difficulties in definition and the personalised nature of spiritual practice are partly responsible for the practice being barely enforced and scarcely practised by students in clinical placements. The aim of the study was to develop a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme. OBJECTIVES: The study objective was to describe and explore the students' experiencs of teaching-learning of spiritual care in the undergraduate nursing programme METHODS: A qualitative, explorative, descriptive and contextual design with purposive sampling was used. The sample consisted of undergraduate nursing students at a University in the Western Cape Province. Measures for trustworthiness were applied RESULTS: The findings indicated a need to provide support, a conducive learning environment and structure for teaching, learning and practice of spiritual care CONCLUSION: There is a need for formal education regarding spiritual care in nursing.