Scielo RSS <![CDATA[Curationis]]> vol. 44 num. 1 lang. pt <![CDATA[SciELO Logo]]> <![CDATA[<b>Family members' lived experiences of non-compliance to psychiatric medication given to female adults living with depression</b>]]> BACKGROUND: Family members face the burden of adult females living with depression who do not comply with psychiatric medication. Discomfort, tension, anxiety, frustration, and related feelings of hopelessness and dysfunction were identified by family members. There have also been records of financial problems, physical ill-health, limitations on social and recreational opportunities and a general deterioration in their quality of life. There is a shortage of published literature and information on the reasons for non-compliance to psychiatric medications. The existing body of information needs to be strengthened and future approaches encouraged. The study aimed to improve compliance of adult females dealing with depression to psychiatric medical treatment and the effect it has on family members caring for adult females living with depression. OBJECTIVES: To describe family members' lived experiences of non-compliance to psychiatric medication by adult females living with depression. METHOD: A qualitative, exploratory, descriptive and contextual study design was used. A purposive sample of family members aged between 20 and 45 years was made. Data were collected by conducting eight in-depth, phenomenological interviews, and field notes were taken. The interviews focused on the central question: 'Tell me your experiences of living with your wife, mother, sister and daughter living with depression and not taking their medication as ordered by the doctor?' Tesch's method for data analysis was used, and an independent coder analysed the data and met with the researcher for a consensus discussion of the results. Measures to ensure trustworthiness were applied and ethical principles were adhered to. RESULTS: The three themes identified were: experienced psycho-social effects, experienced treatment refusal and experienced challenges in caring for adult females living with depression who are non-compliant to psychiatric medication. As a result, the absence of social help, disturbance of family working, shame, separation and troublesome conduct of the adult females who are non-compliant to psychiatric medication developed as principal subjects. CONCLUSIONS: The results demonstrated that family members experienced debilitation because they needed information about their relatives living with depression who are non-compliant to psychiatric medication. More information about the management of non-compliance of psychiatric medication was needed; a comprehensive awareness of the ramifications of the findings, treatment and care are required from mental health care professionals and service providers. <![CDATA[<b>A model for psychiatric nurses to facilitate the mental health of women living with borderline personality disorder</b>]]> BACKGROUND: Borderline personality disorder (BPD) is characterised by emotional dysregulation, feelings of worthlessness, impulsivity, suicidality and poor relationships. As a result of the challenges in the treatment of women living with BPD and the lack of skills from the psychiatric nurse, there was a need to develop a model for psychiatric nurses to facilitate the mental health of women living with BPD OBJECTIVES: To describe the process that was followed in developing, describing and evaluating a model that could be used as a framework of reference for psychiatric nurses to facilitate the mental health of women living with BPD METHOD: A theory-generative, qualitative, exploratory, descriptive and contextual study design was used to develop the model. The central concept of the model was derived from a previous study: 'The experiences of women living with borderline personality disorder'. The process entailed the identification of the central concept and other essential criteria, the classification of the central concepts and describing the relationships between the concepts RESULTS: The central concept was identified as 'facilitation of self-empowerment' of women living with BPD. The concepts 'facilitation' and 'self-empowerment' were defined and classified. The identified and defined central concepts were placed into interrelated statements. The model to facilitate self-empowerment of women living with BPD was developed, described and evaluated. The model has not been implemented CONCLUSION: The model provides a framework of reference for psychiatric nurses to facilitate self-empowerment of women living with BPD <![CDATA[<b>Perceptions of student accoucheurs regarding gender inequality in midwifery training at Free State maternal healthcare institutions</b>]]> BACKGROUND: Worldwide, gender inequality has been a dominating factor in the training of student accoucheurs in most maternal healthcare institutions. This poses challenges for the maternal healthcare institutions where student accoucheurs are placed for clinical practice as most women become reluctant or refuse to accept their services. Gender inequality has a negative impact on the training of student accoucheurs as most of them become demotivated which could lead to a high attrition rate. OBJECTIVES: This study explored and described the perceptions of student accoucheurs regarding gender inequality in midwifery training at the Free State maternal healthcare institutions. METHOD: An explorative and descriptive qualitative research design was undertaken. There were 40 student accoucheurs that formed 10 focus group discussions. Each focus group discussion had four participants. Tesch's eight-steps of data analysis was used to analyse data RESULTS: Three major themes emerged during data analysis: meeting the training requirements in midwifery, women's autonomy in a choice of healthcare provider versus student accoucheurs' autonomy to be trained in midwifery and staff establishment to render maternal healthcare. CONCLUSION: The participants perceived prejudice, rejection and resistance by women in maternity units as a contributing factor to gender inequality, which has a negative impact on their training in midwifery. The study recommends that health directorates, nurse managers and training institutions should consider revising maternal healthcare policies regarding the recruitment and placement of willing accoucheurs in maternity units in order to address gender inequality. <![CDATA[<b>Barriers to the management of children under five exposed to HIV in the rural areas of South Africa</b>]]> BACKGROUND: South Africa has made enormous progress in reducing mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), however, MTCT and AIDS related death persist among children particularly in the rural areas. Lack of adherence to health policies and guidelines implementation remain one of the contributory factors to poor management of HIV-exposed children. Hence, the need to deeply explore the complexity of the problems and understand the barriers to the management of HIV exposed children in the rural areas OBJECTIVES: To explore and synthesise the barriers to the management of children under 5 years old exposed to HIV in rural areas in South Africa METHOD: An integrative literature review was conducted. An electronic search was conducted on several databases. The researchers applied the Boolean ' AND'/'OR' in combination with phrases such as 'HIV infection*', 'HIV transmission', 'HIV-exposed infant*, child*, and neonate*' and 'South Africa*'. Included studies were limited to South Africa, and articles were written in English and published in peer-reviewed journals from 2005 to 2018. Both qualitative and quantitative studies between 2005 and 2018 were utilised RESULTS: The findings highlighted that healthcare institution-related barriers, healthcare provider-related barriers, patient-related barriers and Socio-economic-related barriers were the significant barriers to the management of HIV-exposed children in the rural areas CONCLUSION: Continuous engagement with all relevant stakeholders should remain a priority in protecting HIV-exposed children. It is evident that there exist gaps in the current implementation of prevention of mother-to-child transmission (PMTCT), especially in rural areas. Therefore, intervention strategies that could improve implementation of PMTCT policy guidelines for HIV-exposed children in rural areas are needed <![CDATA[<b>Educators' perceptions and views of problem-based learning through simulation</b>]]> BACKGROUND: The real-world problems and ever-changing challenges currently confronting the future of nursing education and healthcare require a problem-based learning approach using simulation strategy. This is exacerbated by the increasing burden of diseases such as tuberculosis, human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) and more recently the coronavirus disease 2019 (COVID-19) pandemic, as well as advancing technology and changing regulations and policies. Problem-based learning is a student-centred learning strategy, where students are presented with situations drawn from practice, which can be used to bridge the theory-practice gap. OBJECTIVES: To explore the perceptions and views of healthcare educators on how problem-based learning can be facilitated through simulation. METHOD: A qualitative, exploratory, descriptive and contextual research design was used. Thirteen educators from the Faculty of Health Sciences of the University of Johannesburg, with 5 years' teaching experience, were purposively selected from the Dean's office, the Nursing Department, emergency medical care and the departments of podiatry, somatology and radiography. The participants were selected based on their extensive knowledge of problem-based learning and the use of simulation. Data were collected through in-depth, individual, semi-structured interviews. Thematic analysis provided six themes and 13 related sub-themes. The article focuses on the perceptions and views of educators regarding problem-based learning through simulation. RESULTS: Problem-based learning through simulation allows students to work together in teams, which demonstrates a new modus operandi and renders a holistic approach to patient care. CONCLUSION: Problem-based learning through simulation should be utilised to encourage reflective knowledge exchange. Students from various departments can learn about new innovations, creativity and develop critical thinking when solving complex health-related problems <![CDATA[<b>A preceptorship model to facilitate clinical nursing education in health training institutions in Botswana</b>]]> BACKGROUND: Despite the wide use of preceptorship, there is evidence that preceptorship and the role of preceptor in clinical nursing education are not clearly understood or supported. OBJECTIVES: To develop a preceptorship model to facilitate clinical nursing education in Botswana. METHOD: The model development in this study followed the steps of theory generation as described by Chinn and Kramer. These four steps are concept analysis, relationship statements, description and critical reflection of the model. RESULTS: Four main themes emerged from the empirical study that formed the basis for key concepts and model development. The model has six components, namely, agent, recipient, context, procedure, dynamics and terminus. The description of the model is based on Chinn and Kramer. CONCLUSION: The need for a preceptorship model to facilitate preceptorship cannot be overemphasised in this regard. This model will guide the planning and implementation of preceptorship procedures by different stakeholders to improve its effectiveness in clinical nursing education. <![CDATA[<b>Operational nurse managers' perceptions on the competence of community service nurses in public settings in the Western Cape</b>]]> BACKGROUND: Community service nurses placed in the Western Cape Government public health facilities render essential healthcare to underserved populations. Anecdotal evidence from operational nurse managers indicated concerns that community service nurses may lack competence in basic required nursing competencies OBJECTIVES: To investigate operational nurse managers' perceptions of the competence of community service nurses in public health facilities in the Western Cape METHOD: A quantitative survey was conducted with an all-inclusive sample of 297 operational nurse managers in the Western Cape. A self-administered questionnaire with 65 questions with a 4-point rating scale was used to rate perceived competence of community service nurses across the South African Nursing Council (SANC) competencies. Descriptive and inferential statistics were calculated per competency domain RESULTS: The survey (response rate: 59%) showed that the operational nurse managers perceived the community service nurses to be competent in the clinical patient care domain and mostly either developing proficiency or proficient in the SANC competencies of legal framework and ethical practice, interprofessional relationships, leadership, quality management and management competency domains CONCLUSION: Community service nurses were found to be competent in the clinical patient care, possibly because of the integration of theory and practice focus of work-integrated learning in the programme. Education and practice supportive strategies for community service nurses should be developed to support the successful transition from students to community service nurses, especially around the development of research and critical thinking skills <![CDATA[<b>Experiences of undergraduate nursing students during clinical practice at health facilities in Western Cape, South Africa</b>]]> BACKGROUND: This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality. OBJECTIVES: To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa. METHOD: A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses' experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi's method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to. RESULTS: After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives. CONCLUSION: During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students. <![CDATA[<b>Descriptive survey of women's childbirth experiences in two state hospitals in KwaZulu-Natal</b>]]> BACKGROUND: Giving birth is one of the most important events in a woman's life and is a highly individualistic and unique experience. OBJECTIVES: The study aimed to describe women's childbirth experiences in two state hospitals in KwaZulu-Natal. METHOD: A non-experimental, quantitative, descriptive survey of low-risk mothers was conducted in two state hospitals by using the Childbirth Experience Questionnaire (CEQ). RESULTS: With a response rate of 96%, 201 questionnaires were completed and returned. The highest mean score of the four dimensions of the CEQ was for the dimension of Professional Support (3.1). The results of the individual dimension items scoring the highest positive response were: I felt that I handled the situation well (147; 74%) (Own Capacity); I felt very well cared for by my midwife (165; 82%) (Professional Support); 151 respondents (76%) scored the item My impression of the team's medical skill made me feel secure as the highest positive experience (Perceived Safety); and I felt I could have a say in the choice of pain relief (105; 52%) (Participation). The relationship between demographic variables (age, level of education, parity, antenatal clinic attendance, induction of labour, augmentation and duration of labour) and respondents' scores of the CEQ dimensions was calculated, and only the dimension of Perceived Safety and duration of labour (≥ 12 hours) were found to be significant (p = 0.026). CONCLUSION: From the women perspectives, the study results described childbirth experience as multi-dimensional experience and subjective. Both positive and negative experiences coexisted in all dimensions of the CEQ, with the dimension of Professional Support scoring the highest positive response. To maintain a positive birth experience, the study suggests that women should be involved and equipped with knowledge on the process of childbirth. <![CDATA[<b>Epidemiology of patient safety incidents in a long-term rehabilitative hospital in KwaZulu-Natal, South Africa (April 2011 to March 2016)</b>]]> BACKGROUND: Patient safety is a key priority of the National Department of Health. Despite the publication of legislation and other measures to address patient safety incidents (PSIs) there are a paucity of studies relating to patient safety at the different levels of hospitals OBJECTIVES: To determine the epidemiology (incidence, nature and root causes) of PSIs at a long-term rehabilitative hospital between April 2011 and March 2016 METHOD: Data were collected through a review and analysis of routinely collected hospital information on patient records and from the PSI register, as well as minutes of adverse health events meetings, quality assurance reports and patient complaints register RESULTS: A total or 4.12 PSIs per 10 000 inpatient days were reported. Approximately 52% of the adverse health events occurred in females with most of the adverse health events occurring in the 50-59 years category: 96% being reported during the day and 33% within the shift change. Pressure ulcers, falls, injury, hospital acquired infections and medication error were the most commonly reported PSIs. Patient factors were listed as the most common root cause for the PSIs CONCLUSION: The study shows a low reporting rate of PSIs whilst showing a diverse pattern of PSIs over a period of 5 years. There is a need for active change management in order to establish a blame-free culture and learning environment to improve reporting of PSI. A comprehensive quality improvement intervention addressing patients, their families and staff is essential to minimise PSI and its consequences <![CDATA[<b>The experience of professional nurses working with newly qualified nurses placed for community service in public health facilities in the City of Tshwane, South Africa</b>]]> BACKGROUND: The newly qualified nurses (NQNs) were mandated to work for one year as community service nurses before being registered. During the placement, NQNs were supposed to be supervised and supported by professional nurses. On the contrary, professional nurses expected NQNs to be hands-on and provide quality care on completion of their training. Expectations of professional nurses created misperceptions regarding the objectives of community service. Therefore, exploring their experience would identify skills gap that is needed to be addressed. OBJECTIVES: This study explored and described the experiences of professional nurses working with NQNs placed for community service in the City of Tshwane. METHOD: A qualitative exploratory design was conducted. Individual interviews were carried out with 22 professional nurses in various public healthcare settings, such as a hospital, a community health centre and a clinic. Informed consent was obtained from all the participants and confidentiality and anonymity were maintained throughout the interviews. Creswell's data analysis process was implemented. RESULTS: Two themes emerged from this study, namely, experience of participants with NQNs and professional nurses. Participants experienced NQNs as not being competent to work independently and had to deal with unprofessional behaviour of NQNs. Participants supported NQNs, even though they were not empowered as mentors to NQNs. CONCLUSION: Participants were disappointed that NQNs were not competent and confident to work independently. They expressed their frustrations in behaviours displayed by NQNs. However, participants acknowledged NQNs' individual differences and were supportive towards them even though they were not empowered for such responsibility. <![CDATA[<b>Feedback in clinical settings: Nursing students' perceptions at the district hospital in the southern part of Namibia</b>]]> BACKGROUND: Feedback was the backbone of educational interventions in clinical settings. However, it was generally misunderstood and demanding to convey out effectively. Nursing students were not confident and did not feel free to practise clinical skills during practical placements because of the nature of the feedback they received whilst in these placements. Moreover, they experienced feedback as a barrier to completing practical workbooks. OBJECTIVE: The purpose of this article was to report on a qualitative study, which explored nursing students' perceptions of the feedback they received in clinical settings, at a district hospital. METHOD: This study was conducted at a district hospital located in southern Namibia. An explorative qualitative design with an interpretivist perspective was followed. A total of 11 nursing students from two training institutions were recruited by purposive sampling and were interviewed individually. All interviews were audio recorded with a digital voice recorder followed by verbatim transcriptions, with the participants' permission. Thereafter, data were analysed manually by qualitative content analysis. RESULTS: Themes that emerged as findings of this study are feedback is perceived as a teaching and learning process in clinical settings; participants perceived the different nature of feedback in clinical settings; participants perceived personal and interpersonal implications of feedback and there were strategies to improve feedback in clinical settings. CONCLUSION: Nursing students appreciated the feedback they received in clinical settings, despite the challenges related to group feedback and the emotional reactions it provoked. Nursing students should be prepared to be more receptive to the feedback conveyed in clinical settings. <![CDATA[<b>Support model for nurses caring for people living with HIV and AIDS in the Limpopo province, South Africa</b>]]> BACKGROUND: Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) caregiving has created a foundation for stress and burnout amongst nurses as they are burdened by the increased workload of HIV and AIDS care. OBJECTIVES: This study aimed to develop a support model for nurses caring for people living with HIV and AIDS (PLWH). METHOD: The study employed concept analysis and the identified concept of interest within the caring context of HIV and AIDS was conceptualised using six elements of practice-oriented theory, namely, the context, agent, recipient, dynamic, procedure and purpose RESULTS: The framework consisted of six components: health service and legislative (context); nursing service managers (agents); nurses (recipients); decreasing power imbalance, participative and transformational leadership and trust (dynamics); initiation of support process through teamwork and mutual goal-setting, implementation and sustenance through reflections, monitoring and evaluation (process) and empowered nurses (outcome) CONCLUSION: Poor organisational support deteriorates the quality of nurses' lives on a personal level and imposes a direct economic cost on the employer by decreasing overall nursing workforce productivity. The conceptual framework could be a guide to support nurses in healthcare services regarding the management of HIV and AIDS in the workplace. <![CDATA[<b>Exploring the challenges in leadership roles experienced by nurse managers in a mining primary healthcare setting in South Africa</b>]]> BACKGROUND: The challenges in leadership roles hinder the rendering of quality primary healthcare service in the mines. Mining, the heart of the South African economy, requires good health to its personnel to carry out operations. However, nurse managers, the leaders in a mining primary healthcare setting experience difficulties in their leadership roles. OBJECTIVES: The aim of this study was to explore and describe the challenges in leadership roles experienced by nurse managers in a mining primary healthcare setting in South Africa. METHOD: The study was conducted in a mining primary healthcare setting in West Rand, Gauteng province, South Africa. A qualitative, exploratory, descriptive design that is contextual in nature, using a phenomenological approach, was adopted. Data from nurse managers in the mine were collected and data saturation was reached by the seventh participant. The study followed Giorgi's four stages of the phenomenological descriptive data analysis. An expert independent coder in qualitative research coded the data, and consensus on the findings was reached with the researcher. RESULTS: Three subthemes emerged from the study: mining management and unions interfere with nurse managers' leadership roles, incongruent mining primary healthcare policies and communication gap between nurse managers and mining management. CONCLUSION: The triangulation of nurse managers, mining management and unions requires a collective fusion to directly tackle the challenges in leadership roles in mining primary healthcare. <![CDATA[<b>Experiences of student nurses on role modelling of a therapeutic approach by registered nurses: Recommendations for improvement</b>]]> BACKGROUND: A therapeutic approach involves portraying the attributes of being polite towards fellow human beings and patients, respecting them irrespective of their circumstances and having sympathy and compassion for them. Knowledge of therapeutic approach is the initial step towards gaining patients' trust and developing student nurses' communication with patients; however, theoretical knowledge alone may not increase application in practice. Role modelling of a therapeutic approach increases patient care satisfaction and enables student nurses to therapeutically communicate with patients, colleagues and all other staff members. The most appropriate way for student nurses to learn what it means to portray therapeutic approach is seeing registered nurses' role modelling it. OBJECTIVES: To make recommendations for the enhancement of role modelling of therapeutic approach by registered nurses for student nurses at a regional public hospital. METHOD: A qualitative, exploratory, descriptive, phenomenological and contextual design was used. Three focus group interviews were conducted. Data were analysed using Giorgi's descriptive phenomenological method. Measures to ensure trustworthiness and ethical principles were applied throughout the research. RESULTS: One central theme with three main themes and related sub-themes indicated that student nurses had negative experiences on role modelling of therapeutic approach owing to registered nurses' non-therapeutic communication, lack of professionalism and ethical conduct as well as poor quality patient care. However, only the recommendations seeking to address the experiences of non-therapeutic communication which included negative attitudes of registered nurses towards patients, lack of provision of patient information, poor handling of patients' complaints as well as racial discrimination re-handling of patients' complaints will be highlighted. CONCLUSION: The majority of student nurses had negative experiences on role modelling of therapeutic approach by registered nurses. They needed registered nurses to improve their approach towards patients. It is expected that the implementation of the recommendations will enhance therapeutic approach to patients. <![CDATA[<b>Perceived predictors of quality of life in patients with end-stage renal disease on dialysis</b>]]> BACKGROUND: Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South Africa are cared for in public and private hospitals, with public health institutions characterised by several challenges. OBJECTIVE: To explore and analyse the perceived predictors of QOL in patients with ESRD in the three district hospitals that provide renal services in KwaZulu-Natal. METHODS: An exploratory, descriptive qualitative research approach based on grounded theory research design was used and three focus group discussions (FGDs) were conducted. The researcher recruited 18 participants, 6 in each focus group. Three phases of data analysis were followed: open coding, axial coding, and selective coding. RESULTS: Predictors of QOL that emerged were the geographic location of the patients, accessibility of haemodialysis centres, patients' adaptation and acceptance of the condition, self-management, support by family members and caregivers and availability of adequately trained nurses. CONCLUSION: Predictors of QOL in patients with ESRD are associated with an increased risk of morbidity and mortality resulting from dialysis. The broad range of dimensions of life is negatively affected and requires intervention by the renal team and policymakers to improve the QOL of patients <![CDATA[<b>Self-monitoring of blood pressure for preeclampsia patients: Knowledge and attitudes</b>]]> BACKGROUND: Preeclampsia is one of the causes of maternal deaths and is also responsible for complications such as premature births worldwide. In South Africa, hypertensive disorders cause 14% of all maternal deaths. Evidence indicates that it may be beneficial to empower women to monitor their blood pressure (BP) in the comfort of their homes. OBJECTIVES: The purpose of this study was to explore and describe preeclampsia patients' knowledge and attitudes towards the self-monitoring of their BP. METHOD: An exploratory, descriptive and contextual qualitative research study was conducted. Fourteen preeclampsia patients were purposively sampled and participated in the study. In-depth semi-structured interviews were used to collect data. Data were analysed using the thematic analytic approach. RESULTS: The knowledge and attitudes towards the self-monitoring of blood pressure (SMBP) were explored. Four themes emerged, namely understanding of hypertension disorders during pregnancy, openness on self-monitoring at home, its hindrances and benefits. The participants portrayed limited understanding and knowledge of preeclampsia, yet they had positive attitudes towards monitoring BP themselves and were open and willing to do self-monitoring at home. CONCLUSION: The use of SMBP may relieve overcrowding in public healthcare institutions. Encouraging patients to participate in self-monitoring could promote active participation and a positive outlook on their pregnancies. The unavailability and unaffordability of the equipment may pose a challenge to women with a low socioeconomic status. <![CDATA[<b>Role of the nurses in partnering with mothers to give oral medication to their hospitalised child: Modification and development of a contextualised evidence-based practice guideline</b>]]> BACKGROUND: In paediatric wards, children are often reluctant to receive medication from nurses and eventually it is given by the parents. It is a common practice for nurses to hand the medication to mothers to give to their children, However, it is an 'informal' practice and lacks evidence-based guidelines. OBJECTIVES: To develop a contextualised and adapted evidence-based guideline to support nurses to partner with mothers/carers so that they can safely give oral medication to their hospitalised child under the supervision of a competent nurse METHOD: Existing relevant guidelines were identified through searches of bibliographic databases and websites. The AGREE II: Appraisal of Guidelines for Research and Evaluation II instrument was used to appraise the quality of the identified sources. The process of guideline adaptation recommended by the South African Guidelines Excellence project was followed, and a list of adapted recommendations was developed, aligned with the legislative and regulatory frameworks for nursing in South Africa. Accessible end user documentation was developed. RESULTS: Six sources were screened and three sources were found to be eligible and were subjected to full appraisal. Two guidelines and one policy document were identified as suitable for adaptation. Expert consultation confirmed that the resulting adapted guideline was sound, easy to understand, and well presented for the target audience. CONCLUSION: This process successfully led to the development of a modified evidence-based practice guideline to enable nurses to partner with mothers/caregivers in safely giving oral medication to their hospitalised child in lower-resourced African settings. <![CDATA[<b>Sleep promotion for hospitalised children: Developing an evidence-based guideline for nurses</b>]]> BACKGROUND: Adequate sleep in hospitalised children is important for a variety of physiological and psychological processes associated with growth, development, and recovery from illness and injury. Hospitalisation often prioritises clinical care activities at the expense of age-appropriate sleep. Nurses and the wider healthcare team contribute to this paradox. However, through conscious practice and partnering with mothers, nurses are able to enact change and promote sleep. OBJECTIVES: To adopt, adapt or contextualise existing guidelines to develop an evidence-based practice guideline to promote sleep-friendly ward environments and routines facilitated by nurses, and in partnership with mothers. METHOD: A six-step methodology for guideline adaptation was followed, as recommended by the South African Guidelines Excellence project: (1) existing guidelines and protocols were identified and (2) appraised using the AGREE II instrument; (3) an evidence base was developed; (4) recommendations were modified, (5) assigned levels of evidence and grades of recommendation; and (6) end user guidance was developed. Expert consultation was sought throughout. RESULTS: Existing relevant guidance comprised 61 adult-centric recommendations. Modification of the evidence base led to six composited recommendations that facilitate sleep in hospitalised children: (1) prioritising patient safety; (2) collaborating with the mother or caregiver to promote sleep; (3) coordinating ward routine and (4) environment to improve sleep; (5) work with clinical and non-clinical staff; and (6) performing basic sleep assessments. Practice recommendations were aligned to the South African regulatory framework for nursing CONCLUSION: Hospitalisation is a time of physiological and psychological dysregulation for children, which is amplified by poor sleep in a hospital. Nurses have the opportunity to promote sleep during hospitalisation by implementing this African-centric guideline in partnership with mothers. <![CDATA[<b>Experiences and perceptions of birth companions supporting women in labour at a District Hospital in Limpopo, South Africa</b>]]> BACKGROUND: South Africa has included birth companions in its national guidelines for maternity care and the revised Maternity Case Record, in and effort to improve the quality and experience of care. However, reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward. OBJECTIVES: To document the experiences and perceptions of birth companions who supported women in labour in a rural hospital in Limpopo Province where a Respectful Maternity Care (RMC) project was piloted METHOD: An institution-based cross-sectional study design was employed. Purposive sampling was employed where all birth companions who supported a woman during labour and birth were included in the study. The experiences and perceptions of birth companions were captured using a birth companion feedback book during the period of 1st April to 30th August 2019. Thematic analysis was used to analyse the data. RESULTS: Seventy-one (71) of the 73 birth companions only had positive responses about the birthing experience and how both the birth companion and woman in labour were treated. Two birth companions were dissatisfied with the treatment provided by the midwife that supported the birth. CONCLUSION: It is important for healthcare providers to understand the far reaching emotional and psychological impact of their attitudes and behaviour on, not only women in labour but also on others who witness their (healthcare providers) behaviour. Mechanisms to obtain feedback from birth companions should be integrated into strategies to improve the quality and experience of care for women during childbirth. <![CDATA[<b>When online learning becomes compulsory: Student nurses' adoption of information communication technology in a private nursing education institution</b>]]> BACKGROUND: Integrating the use of information communication technology (ICT) in nursing curricula when preparing student nurses for the digital health future such as the sudden online learning as a result of the coronavirus disease 2019 (COVID-19) pandemic is vital. However, when student nurses in a South African private nursing education institution, struggled to complete obligatory online learning courses, nurse educators had to search for solutions. OBJECTIVES: To explore the barriers and enablers for ICT adoption by a diverse group of student nurses in a private nursing education institution in the Free State Province. METHOD: Following a qualitative, explorative, interpretive-descriptive design, student nurses were invited to participate. Based on all-inclusive, purposive sampling with inclusion criteria enabled selecting, a total of 17 participants who took part in three focus groups and written narratives. Transcribed interviews underwent thematic analysis with co-coder consensus. The study adhered to strategies to enhance trustworthiness. RESULTS: Students shared their views related to ICT and online learning within their theory and practice training. Student nurses held positive, negative and contrasting views of ICT adoption and online learning. Actions to master ICT adoption and online learning are highlighted. Information communication technology brings a challenging interdependence between nurses and technology. CONCLUSION: Integration of ICT into nursing programmes is important. The enablers and barriers to ICT are described. Expose students to different technologies, especially using smart phones to search for (academic/non-academic) information. The adoption of ICT should enhance the learning process and facilitate deep learning. Students preferred online learning for self-assessment and described how they tried to master ICT and online learning. Information communication technologies in the clinical setting highlight the challenged interdependence between nurses and technology. Context-specific recommendations are proposed. <![CDATA[<b>Women's experiences on the use of Implanon as a contraceptive method in a selected primary healthcare facility in KwaZulu-Natal</b>]]> BACKGROUND: The South African department of health recently introduced subdermal Implanon contraceptive implant with the aim to reduce teenage pregnancy and maternal mortality. First used in all public healthcare facilities across the country since early 2014, this method of contraception has been described as highly effective. However, some women have reported unbearable side effects, forcing them to remove the contraceptive implant early before its expiry date. Negligible emphasis has been placed on staff training and development to equip the nurses with new protocol and policies on Implanon. OBJECTIVES: The objective of this study was to explore experiences of women using Implanon as method of contraception at a selected primary healthcare facility in KwaZulu-Natal province of South Africa. METHODS: A qualitative, descriptive and exploratory study design was used. A purposive sampling technique was used and a sample of seven women aged between 15 and 50 years was selected for this study. Semi-structured interviews were used in the data collection process. The Tesch's method for data coding and data analysis was utilised. Necessary ethical measures were taken to ensure that the study is trustworthy. The study was conducted at Community Health Centre, KwaZulu-Natal between June 2017 and December 2018 RESULTS: The findings showed that some participants were still willing to continue using this method of contraception regardless of the unwanted side effects. Major side effects reported were heavy menstrual bleeding, pain and discomfort, weight loss, insomnia and decreased sexual interest, which resulted in most participants stopping the use of Implanon. CONCLUSION: Most of the participants' experience unwanted side effects because of poor screening, counselling and support. There is a clear demand to develop a screening tool and facilitate training of healthcare workers when initiating the use of Implanon. <![CDATA[<b>Experiences of cervical cancer screening in HIV-positive women in Zimbabwe</b>]]> BACKGROUND: The primary purpose of screening is to detect individuals in danger of cervical cancer so as to prevent further progression of the disease. Cervical cancer remains a global concern, as it ranks as the fourth most commonly diagnosed female malignancy worldwide. It is the commonest female cancer in Zimbabwe. Women living with human immunodeficiency virus (HIV) have a disproportionate risk of invasive cervical cancer, as they are 2-12 times more likely to develop pre-cancerous lesions. As a result of the increased risk, routine screenings are suggested. Few women are screened for cervical cancer in Zimbabwe. OBJECTIVES: This study aimed at describing the experiences of screening for cervical cancer and motivation behind screening. METHOD: The study employed a qualitative research approach. In-depth one to one interviews and focus group discussions were conducted using interview and focus group guides. The study was conducted at an opportunistic infections clinic in Mpilo Central Hospital. Data analysis was performed by using Giorgi's descriptive method of data analysis. RESULTS: The themes that emerged from data analysis were facilitators to screening for cervical cancer, community awareness of cervical cancer screening, free cervical cancer treatment and more screening centres and integrating cervical cancer screening with HIV care CONCLUSION: In-depth understanding of the factors that enable women to take part in cervical cancer screening is essential so that these factors can be strengthened to improve uptake of cervical cancer screening services. <![CDATA[<b>Interaction of culture and grief amongst women who terminated a pregnancy in adolescence: A narrative approach</b>]]> BACKGROUND: Culture plays a vital role in resolving grief in African communities. However, women who terminate a pregnancy in adolescence are typically not exposed to cultural rituals that could ease their grief. OBJECTIVES: The purpose of this article is to explore the interaction of culture and grief amongst women who terminated a pregnancy in adolescence. METHOD: A qualitative exploratory study was undertaken using a narrative approach. Unstructured interviews were conducted to solicit narratives from 11 women who terminated a pregnancy in adolescence. RESULTS: Data were analysed through narrative, thematic data analysis. Three themes emerged from the findings: delayed post-traumatic growth, low body esteem and an alteration in the development of maternal identity. CONCLUSION: The study intended to explore the interaction of culture and grief amongst women who terminated a pregnancy in adolescence. The researcher determined that women who had not honoured their culture because of the secrecy surrounding the termination of pregnancy had delayed healing and an altered self-image. <![CDATA[<b>The perceptions of newly qualified nurses on the guidance by preceptors towards becoming experts in nursing</b>]]> BACKGROUND: The new role as professional nurse can be a difficult transition for the new qualified nurses. During this time, factors such as not being well prepared, working without supervision and a lack of guidance can be the result of a difficult transition. OBJECTIVES: The purpose of this study is to assess the perceptions of newly qualified nurses on the guidance given by their preceptors towards becoming experts in practice at a Level II regional hospital in the Western Cape. METHOD: A non-experimental quantitative descriptive design was followed. Collection of data was done by means of a questionnaire, designed by the researcher, using a cross-sectional research method. Non-probability sampling produced a sample of 162 nurses comprising registered nurses (48.2%), enrolled nurses (32.7%), and enrolled nursing auxiliaries (19.1%). Statistical analysis was performed using the Statistical Analysis System (SAS), version 9.3. RESULTS: The results of the research study indicated that respondents had more positive experiences than negative ones. The respondents indicated that for the role and characteristics of the preceptor, expectations were met for knowledgeability, professionalism and contribution to team work. Furthermore, the results indicated that the respondents would recommend preceptorship. CONCLUSION: Preceptorship is one of the major interventions available to support newly qualified nurses by easing the transition from student to practicing nurse and reducing the theory-practice gap. The findings emphasised the importance of ongoing support programmes for nurses after obtaining a new qualification or/and being a new nurse. <![CDATA[<b>Strategies to facilitate effective caring for patients in primary health care clinics</b>]]> BACKGROUND: Caring is described as the innermost core of nursing which occurs in a relationship between the patient and the care provider. Although caring in nursing is associated with maintaining and strengthening of the patient's sense of dignity and being a person, there seems to be a gap between caring theories in nursing, healthcare policies and caring for patients by professional nurses in primary health care clinics. Developing strategies that will facilitate effective caring for patients by professional nurses in primary health care clinics within an ethical and mindful manner became an area of focus in this study. OBJECTIVES: To develop strategies to facilitate effective caring for patients by professional nurses in primary health care clinics in South Africa. METHOD: Strategies were developed based on the conceptual framework developed in Phase 2, which was derived from synthesis of the results of Phase 1 of the previously conducted study and supported by literature. The conceptual framework reflects the survey list of Dickoff, James and Wiedenbach's practice theory. RESULTS: Three strategies were developed: 1) facilitating maintaining of the empowering experiences; 2) facilitating addressing the disempowering experiences by professional nurses, and 3) facilitating addressing of the disempowering primary health care clinic systems CONCLUSION: The developed strategies, being the proposed actions, procedures and behaviours, could facilitate effective caring for patients by professional nurses in primary health care clinics.