Curationis

Implementation of maternal guidelines for gravid teenagers with hypertensive disorders in KwaZulu-Natal

BACKGROUND: The worldwide phenomenon of teenage pregnancy among 13-9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy. OBJECTIVE: The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers. METHODS: As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics RESULTS: Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives. CONCLUSION: Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP). CONTRIBUTION: This study contributed to facilitating adherence to guidelines improving healthcare of teenagers in government facilities.

Perspectives of nursing students on challenges of e-learning during early stages of the COVID-19 pandemic

BACKGROUND: E-learning is becoming an important approach to teaching and learning in higher education institutions, including nursing training. Despite that, there are students who were never introduced to e-learning prior to the coronavirus disease 2019 (COVID-19) pandemic. Their challenges in relation to e-learning could differ from those of other students who had experienced the platform before, especially against the backdrop of the COVID-19 pandemic that brought an abrupt change in the approach to teaching, learning and assessment. OBJECTIVES: This study explored and described university nursing students' challenges in relation to e-learning during the early stages of the COVID-19 pandemic in a resource-constrained setting. METHOD: Qualitative exploratory and contextual design was used. The sample consisted of 17 participants who were conveniently selected, and data were collected by means of two focus groups and five individual interviews. Data analysis followed a qualitative content analysis process. RESULTS: The five categories emanated from analysis are e-learning mode not suitable for practical components, challenges related to assessment of learning, connectivity issues, e-learning is a lonely journey and computer illiteracy and limited skills for the use of e-learning CONCLUSION: Nursing students' challenges regarding e-learning during the early stages of the COVID-19 pandemic related to the learning of practical components, assessment, connectivity, a lack of interaction with peers and a lack of the skills required to operate e-learning tools. CONTRIBUTION: The findings have implications for international, regional and local contexts in helping to develop support systems and preparing students to use e-learning when it is introduced abruptly.

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality

BACKGROUND: Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse. OBJECTIVES: To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa. METHOD: A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process. RESULTS: Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse. CONCLUSION: The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province. CONTRIBUTION: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Do the parents of the youth abusing substances need to be supported? A literature review study

BACKGROUND: Substance abuse negatively affects the youth who use substances, their families and especially their parents. The use of substances impairs the health of the youth and is linked to an increase in noncommunicable diseases. Parents become stressed and they need help. Parents fail to carry out daily plans and routines because they are not sure what the substance abuser can do or what can happen to the substance abuser. When the parents' well-being is taken care of, they will be able to take care of their youth when they need help. Unfortunately, little is known about the psychosocial needs of the parents, especially when their child abuses substances. OBJECTIVES: This article aims to review the literature to explore the need for support for parents of youth abusing substances. METHOD: The study adopted the narrative literature review (NLR) methodology. Literature was retrieved from the following databases and search engines: electronic databases, search engines and hand searches. RESULTS: Substance abuse has been found to affect the youth abusing substances and their families negatively. The parents, being the most affected, need support. The involvement of health professionals can assist the parents in feeling supported. CONCLUSION: Parents need support programmes that will give support and strength to their existing abilities. CONTRIBUTION: Focusing on the support needs of the parents of youth abusing substances will help to ensure parents are supported and mentally healthy.

A professional nurse's understanding of quality nursing care in Limpopo province, South Africa

BACKGROUND: Quality has increasingly become a critical part of life in every aspect. Patients are today continuously looking for good quality services from health professionals. Professional nurses are expected to render quality care to fulfil the patients' healthcare needs. Poor nursing care has led to several litigations and the loss of patients' lives. It is essential to explore professional nurses' viewpoints regarding quality nursing care. OBJECTIVES: To explore and describe the understanding of professional nurses regarding quality care rendered to patients in the selected hospitals of Limpopo Province. METHOD: This study utilised a qualitative, exploratory-descriptive design. Individual semi-structured interviews were conducted for data collection. Participants comprised 35 professional nurses who were purposely selected. Data collected were audio-recorded and transcribed verbatim. Data were analysed using Tech's eight-step data coding process, which led to the emergence of themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability. RESULTS: Three themes emerged: professional nurses' descriptions, meanings, and expectations of quality nursing care. The findings highlight that quality nursing care means meeting patients' needs through advocacy, empathy, fulfilment of patients' needs, good interpersonal relationships and teamwork. Challenges experienced included the lack of resources and staff shortage. CONCLUSION: Hospital management needs to develop effective ways to support professional nurses in delivering quality nursing care. In discussion with the Department of Health (DoH), hospitals should be fully equipped with resources to render quality care to patients. Evaluation of service quality and patient satisfaction should be ongoing for improving the quality of patient care. CONTRIBUTION: The study reveals that professional nurses perceive quality nursing care differently. Moreover, it emphasises the importance of maintaining and promoting quality nursing care as the cornerstone of healthcare.

Objective structured clinical examination: Do first-year nursing students perceive it to be stressful?

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is widely accepted as an effective means of assessing clinical competence and nursing skills. There is, however, little existing knowledge on how first-year nursing students perceived stress during their first OSCE. OBJECTIVES: To determine the perception of stress; to identify the perceived factors causing stress; and to determine the perceived incidence of stress. METHOD: A descriptive, survey was conducted on a sample of 82 first-year nursing students using the Perceived Stress Scale (PPS). RESULTS: The results showed that more than half (n = 54) of students perceived stress at moderate levels. Students not having sufficient time to complete the OSCE was perceived as the main factor causing stress (mean = 22.04; standard deviation [s.d.] = 6.21). The correlation between perception of stress and perceived factors causing stress showed a significant weak positive linear correlation among the variables (r = 0.45; p < 0.05). CONCLUSION: The study findings are important as the data determining the first-year nursing students' perception of stress were collected immediately after their first OSCE, which may indicate that perception of stress was related to the actual event rather than the preparation for the OSCE. A follow-up qualitative research study should be conducted, preferably in the same setting, so that the students' experiences of stress during the first OSCE can be explored in depth. CONTRIBUTION: The OSCE environment is perceived as stressful for nursing students and will need careful support from academic and clinical teaching staff.

Bullying, shortage of staff and resources in workplace: Qualitative experience of newly qualified nurses

BACKGROUND: The results of the study conducted at Alfred Nzo Municipality revealed that newly qualified nurses were overwhelmed with the challenges surrounding the execution of their duties in healthcare facilities. The experienced staff largely ignored the newly appointed personnel, which led to emotional distress among the newly qualified nurses. OBJECTIVES: This study aimed to explore and describe the effects of bullying and the shortage of staff and resources in the workplace on newly qualified nurses and to evaluate the support offered to these nurses in the workplace. METHOD: A qualitative, explorative, descriptive and contextual design was used with semi-structured interviews to gather data that were analysed using Tesch's thematic analysis. RESULTS: The themes that emerged revealed that the participants felt bullied in the workplace, the shortage of staff and resources made the participants feel ineffective in their work environment, and the clinical exposure to different units and procedures added value to the participants' development in the workplace. CONCLUSION: The study revealed that bullying has adverse implications for newly qualified staff. The shortage of staff and resources made the newly qualified nurses feel ineffective and useless but their rotation through the wards added value to their development and confidence in their expertise. CONTRIBUTION: A conceptual framework serves as a guide to newly qualified professional nurses in guiding, protection and coaching in the workplace.

Psychometric properties of a clinical assessment tool in the postgraduate midwifery programme, Botswana

BACKGROUND: The psychometric properties of a clinical assessment tool used in the postgraduate midwifery programme in Botswana have not been evaluated. A lack of reliable and valid clinical assessment tools contributes to inconsistencies in clinical assessment in midwifery programmes. OBJECTIVES: This study aimed to evaluate the internal consistency and content validity of a clinical assessment tool used in the postgraduate midwifery programme in Botswana. METHOD: For internal consistency, we calculated the total-item correlation and Cronbach's alpha coefficient. For content validity, subject matter experts completed a checklist to evaluate the relevance and clarity of each competency in the clinical assessment tool. The checklist included questions with Likert-scale responses, indicating the level of agreement. RESULTS: The clinical assessment tool had a good reliability, with a Cronbach's alpha of 0.837. The corrected item total correlation values ranged from -0.043 to 0.880 and the Cronbach's alpha (if item deleted) ranged from 0.079 to 0.865. Overall content validity ratio was 0.95, and content validity index was 0.97. Item content validity indices ranged from 0.8 to 1.0. The overall scale content validity index was 0.97 and the scale content validity index using universal agreement was 0.75. CONCLUSION: The clinical assessment tool used in the postgraduate midwifery programme in Botswana has acceptable reliability. Most of the competencies included in the clinical assessment tool were relevant and clear. Certain competencies need to be reviewed to improve the reliability and validity of the clinical assessment tool. CONTRIBUTION: The clinical assessment tool currently used in the postgraduate midwifery programme in Botswana had acceptable internal consistency reliability and validity.

Challenges on sexual health communication with secondary school learners, Limpopo province

BACKGROUND: A conversation about sexuality is most likely to encourage healthy and positive sexual practices while reducing risky sexual behaviour among adolescents. Traditionally, sexuality is discussed in hushed tones in proverbs and is reserved for adults. On the other hand, adolescents must be well informed about their sexuality to assist them to make informed decisions about their sexual behaviour. OBJECTIVES: The study determined parents' views regarding challenges of sexual health communication among secondary school learners in the Limpopo province. METHOD: A qualitative, exploratory-descriptive and contextual approach was employed for the study. Fifty-six parents were purposively selected, resulting in five focus group discussions that had 8-12 members. One central question was asked, and based on the participants' responses, probing questions followed. Data were analysed using thematic analysis. Trustworthiness and ethical considerations were ensured. RESULTS: Three themes, namely communication concerns, role shifting in imparting sexuality education and poor parent-child relationships, and eight subthemes emerged from the data. CONCLUSION: This study identified that communication concerns influence parent-child dialogue on sexuality education. Therefore, there is a need to address factors hindering communication such as cultural barriers, role shifting in imparting sexuality education and poor parent-child relationships. This study suggests that parents should be empowered in dealing with children's sexuality. CONTRIBUTION: Parents should be equipped with reproductive knowledge to enable them to talk freely about sexuality with their children. This should be complemented with broader programmes aimed at promoting sexual health education within the traditional family institution

The roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal South Africa

BACKGROUND: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a crisis of massive economic, social, spiritual, as well as political magnitudes. Joint United Nations Programme on HIV/AIDS (UNAIDS) revealed that in 2018, there were 37.9 million individuals across the globe who lived with HIV and/or AIDS. The religion is an essential tool used by the pastors to help people living with HIV to come to terms with the illness. Therefore, it is imperative that religious leaders should be actively involved in the prevention of HIV epidemic among the youth. OBJECTIVES: The study objective was to explore and describe the roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal. METHOD: A qualitative descriptive phenomenology design was employed. Data were collected from 18 to 35 years old participants who were purposefully sampled. Unstructured interviews were conducted to collect data, which was determined by saturation and analysed using Colaizzi's method of data analysis. RESULTS: The study revealed five major themes, which consisted of churches' contribution to HIV prevention; health awareness; churches' involvement in sexual education; churches' partnership with stakeholders, human and financial resources. It became evident that churches' contribution to HIV and/or AIDS prevention is beneficial to the youth. CONCLUSION: The study's findings revealed that churches play a significant role in HIV prevention among youths. Programmes available in churches play an important role among the youth in curbing the HIV epidemic. CONTRIBUTION: The Department of Health should consider collaborating with church leaders to promote and prevent HIV and/or AIDS among youth.

Experiences of healthcare staff in forensic care facilities supporting sexual violence survivors, in Tshwane, South Africa

BACKGROUND: Sexual violence is a persisting global epidemic that is constantly increasing on a large scale. The rate of sexual violence in South Africa is one of the highest in the world; and it has been reported to appear socially normalised and acceptable. OBJECTIVES: The study aimed to explore and describe the experiences of healthcare staff working in forensic care centres (FCCs) in Tshwane, South Africa. METHOD: A qualitative approach was followed incorporating focus group interviews with a range of healthcare staff based in the two FCCs. Non-probability purposive sampling was done. Data analysis was informed by the Analytic Hierarchy Model which comprised of three steps: data management, descriptive accounts and developing explanatory accounts. RESULTS: Three main themes emerged as, (1) help them to do away with the idea of self-blame: everyday work; (2) barriers to the accessibility of care: seeking alternative traditional remedies (muti) from traditional healers and working in an unconducive environment and (3) compassionately sick at times: Emotional impact of forensic care work. CONCLUSION: The findings revealed that the healthcare staff are often working in difficult circumstances and that both professional and societal factors mediate against the provision of care and support for survivors. Greater attention is needed both in terms of service development and wider challenges to pervading societal norms surrounding violence against women. CONTRIBUTION: The study highlighted the need for training, improved management support and debriefing sessions.

Midwives' perceptions of and attitudes towards prevention of mother-to-child-transmission of HIV

BACKGROUND: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase. OBJECTIVES: To explore and describe midwives' perceptions and attitudes towards PMTCT of HIV services. METHOD: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services. RESULTS: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services. CONCLUSION: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved. CONTRIBUTION: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

Exploring quality standards implementation at a South African municipality's health facilities

BACKGROUND: Despite government initiatives to ensure the delivery of safe and high-quality care in health establishments, most health establishments in the City of Tshwane Metropolitan Municipality, South Africa were non-compliant with the National Core Standards. This study explored the experiences of quality assurance managers regarding quality standards implementation in these establishments OBJECTIVES: This study aimed to explore and describe factors affecting the implementation of quality standards at public health facilities based on quality assurance managers' lived experiences in the research setting METHOD: This qualitative study used phenomenological design by conducting individual in-depth interviews with nine purposively selected quality assurance managers in 2021. The collected data were analysed using Colaizzi's phenomenological analysis framework RESULTS: The study's findings revealed that the legislative framework and the policy environment were motivators for quality standard compliance among the participants. Furthermore, human resources, materials-related issues and poor infrastructure were found to be barriers to the implementation of quality standards in health facilities CONCLUSION: The explored and described barriers must be addressed to improve compliance with the National Core Standards at public health facilities in the City of Tshwane Metropolitan Municipality. In addition, capacity-building for quality assurance managers should be ongoing to ensure the highest quality implementation standards and to strengthen the enforcement of quality standard regulations CONTRIBUTION: The study's findings explored and described the factors that influence the implementation of quality standards. Addressing these factors could improve the quality of healthcare delivery in the research setting's health facilities

Caring for the careers: A psychosocial support model for healthcare workers during a pandemic

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has further placed additional stress on the already fragile and overstretched healthcare system in Zimbabwe. Most healthcare institutions reported staff shortages, inability to cope with the extra workload, burnout and the resultant psychological implications OBJECTIVES: This study aimed to develop a psychosocial support model that sustains a support structure that will contribute to an enabling work environment promoting efficiency and effectiveness in response to public health emergencies METHOD: Empirical findings from interpretive phenomenological analysis studies on healthcare workers' experiences during the COVID-19 in Zimbabwe formed the basis for model development. The model development in this study was informed by the work of Donabedian, Dickoff, James and Wiedenbach, Walker and Avant, Chinn, Kramer and Wilkes RESULTS: The developed model is described using the elements of Donabedian's framework (structure, process and outcome) and of Dickoff, James and Wiedenbach's (1968) practice theory elements (agents, recipients, context, process, dynamics and outcome) and within the national and international context of the COVID-19 pandemic CONCLUSION: The fragile and under-resourced healthcare system has psychosocial implications to the well-being of healthcare workers. The utilisation of this model is critical and facilitates the provision of an enabling and supportive environment that facilitates efficiency in response activities during pandemics CONTRIBUTION: This study provides a reference guide in the provision of psychosocial support for healthcare workers particularly during public health emergencies. There is paucity of evidence focusing on the well-being of healthcare workers during a crisis, hence the significance of this study

Barriers and enablers to scholarship for post basic nursing students in clinical service

BACKGROUND: Clinical scholarship is defined as an approach that enables evidence-based nursing and the development of best practices to meet the needs of clients efficiently and effectively. However, there are many barriers that impede its progress OBJECTIVE: This study aimed to identify the barriers and enablers to scholarship for post basic nursing students in clinical service areas METHOD: This multimethods study used a structured questionnaire followed by semi-structured individual interviews of post basic nursing students and their lecturers (nurse educators RESULTS: The 81 students who completed the questionnaire indicated a lack of support or funding assistance and mentoring, as well as no mechanisms to reward or recognise scholarship as top barriers to clinical scholarship. Top enablers were noticed as reward mechanisms in place, more protected time and availability of role models and mentoring. Twelve respondents engaged in the qualitative phase and three categories emerged from the data, namely (1) resource dependent, (2) 'what's the use of research', (3) making a change CONCLUSION: It has been shown that there is a need to adopt and promote a culture of clinical scholarship to ensure that the best available evidence is being utilised by nurses to effectively manage their patients; however, to support clinical scholarship, resources are needed CONTRIBUTION: This study highlighted the lack of funding and resources as being a major barrier to scholarship, together with an institutional culture that did not promote clinical scholarship. Providing protected time, mentoring and criteria for promotion and reward based on scholarship is viewed as enabling

Students' self-perception of empathy in caring

BACKGROUND: The attribute of empathy leads to more desired patient outcomes. A patient who experiences empathy from student nurses will feel important and cared for. It is vital to know how student nurses perceive themselves in terms of empathy in caring. Thus, self-reflection is a requirement on the part of student nurses in a caring relationship OBJECTIVES: This study aimed to determine student nurses' self-perceptions of empathy in caring and compare the third- and fourth-year student nurses' self-perceptions of empathy in caring METHOD: A quantitative, descriptive and comparative approach was employed in the study. The population was undergraduate student nurses in their third- and fourth-year level of study (n = 77), while 56 respondents participated in the study. Ethical approval was obtained prior to commencing with the study. Data were collected by way of the Consultation and Relational Empathy measure questionnaire that consisted of 10 items responded to by using the 5-point Likert scale. Data were analysed by means of descriptive statistics, inferential statistics and t-tests RESULTS: All the student nurses perceived themselves to have empathy in caring. There was no significant difference in perceptions of empathy in caring by the nurses in their third- and fourth-year level of study CONCLUSION: The results of the study provide insights for nursing education and training to shape and mould the empathy perceived by the student nurses. Future research could focus on the patients' perspective coupled with the student nurses' perspective to prevent bias CONTRIBUTION: This paper contributes by adding self perceptions of empathy by student nurses to support best practice in nursing

Self-reported incidents of violence towards nurses working in acute psychiatric units

BACKGROUND: Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with OBJECTIVES: This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa METHOD: A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse RESULTS: Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007 CONCLUSION: Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence CONTRIBUTION: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers

Social determinants of health in non-communicable diseases prevention policies in South Africa

BACKGROUND: The South African government has developed many policies for the prevention and control of non-communicable diseases. However, non-communicable diseases remain among the major causes of morbidity and mortality in South Africa. Although these diseases are linked to interaction of multiple risk factors, many of which are modifiable, they continue to cause much suffering particularly among the marginalised and people from the lower socio-economic status OBJECTIVES: The objective of this research was to explore and present the inclusion of social determinants of health in the policies meant for the prevention and control of non-communicable diseases in South Africa METHOD: The qualitative document analysis approach was used to conduct policy analysis of purposefully selected policies for prevention and control of cancers, obesity and mental and behavioural disorders in South Africa RESULTS: The analysis revealed that policies for prevention and control of cancers, obesity and mental and behavioural disorders included policy intervention activities that focused on five social determinants of health: (1) governance, (2) social policies, (3) public policies, (4) material circumstances and (5) health system CONCLUSION: Excluding most of the important social determinants of health in the policies for prevention and control of non-communicable diseases means that these policies would continue to fail in preventing these diseases from the root causes CONTRIBUTION: This article points out weaknesses in the policies meant for prevention and control of obesity, cancers and mental and behavioural disorders. This article further suggests policy improvement strategies that may be considered to effectively address these diseases

Experiences of nursing students during their mental health clinical training at a general hospital in Namibia

BACKGROUND: Clinical training is important because it constitutes more than half of the formal courses in nursing education. Accordingly, it is important for institutions of higher learning to continually explore the experiences of nursing students during their clinical placement. These experiences can be used to promote a positive clinical learning environment for students. However, the experiences of nursing students during their mental health clinical training in Namibia have not been extensively researched OBJECTIVES: The aim of this study was to explore and describe the experiences of nursing students during their mental health clinical training at a general hospital in Namibia METHOD: A qualitative, exploratory, descriptive and contextual research design was followed as the basis for conducting the study. A sample of 15 nursing students was conveniently selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes RESULTS: The following three themes emerged: collating theory and mental health practice experiences, facing challenges in clinical placements, and recommendations to ensure effective learning about mental health CONCLUSION: The use of a general hospital for clinical placements within an undergraduate nurse training course led to some concerns regarding the relevance and appropriateness of such experience within a nursing programme CONTRIBUTION: The findings have important implications for the training of undergraduate nursing students in general hospitals. It can be utilised to develop strategies to improve positive clinical practice placement and develop clinical skills for undergraduate nursing students in general hospitals

Cost of wound dressing: Implication for enrollment into the National Health Insurance scheme, Nigeria

BACKGROUND: Enrollment into the National Health Insurance scheme (NHIS) still poses a challenge in Nigeria despite the established Group, Individual and Family Social Health Insurance Programme (GIFSHIP) during the coronavirus disease 2019 (COVID-19) pandemic OBJECTIVES: This study examined the direct cost of wound dressing and enrollment into the health insurance scheme among hospitalised patients METHOD: A descriptive cross-sectional research design was utilised to investigate the cost of wound dressing and enrollment into health insurance scheme among hospitalised patients in three selected hospitals of South-West Nigeria. The study was conducted from March 2021 to June 2021, and 190 patients were recruited via an interviewer-administered questionnaire. Ethical approvals were obtained from the hospitals while COVID-19 preventive protocols and ethical principles of autonomy, confidentiality and non-maleficence were observed RESULTS: Majority of the respondents (91%) were not on any healthcare insurance scheme, only 4.2% were enrolled in NHIS while over 70% could not personally pay for their wound dressing. The minimum average cost of wound dressing materials per week and per acute care episode was ₦10 000.00 (Nigerian naira) and ₦50 000.00, respectively, while the minimum average cost for hospitalisation per week and per acute care episode was ₦18 000.00 and ₦130 000.00, respectively, ($1.00 equaled ₦600.00, June 2022 CONCLUSION: A lack of health insurance coverage is a precursor of 'out of pocket' payment. A political will is required to scale up enrollment of the indigenous population into the NHIS in Nigeria CONTRIBUTION: Many hospitalised patients are not enrolled in the NHIS and they are at a higher risk of catastrophic healthcare expenditure

Challenges experienced by nurse educators developing postgraduate nursing diploma curriculum programmes, Gauteng

BACKGROUND: Nursing education's positioning within higher education mandated public nursing education institutions to develop competent nurses to manage diverse disease profiles of the country. Nurse educators were tasked to develop a competency-based curriculum with emphasis on primary healthcare to help prepare nurses to be independent, leaders, researchers, and critical thinkers OBJECTIVES: To explore and describe the challenges experienced by nurse educators in Gauteng when developing the curriculum for the postgraduate nursing diploma programmes METHOD: An exploratory descriptive qualitative research design was used. Purposive sampling was followed to select the participants based on the inclusion criteria. Four focus group interviews were conducted, comprising of six participants each, leading to a sample of 30. Data collection were between March 2022 and April 2022. Thematic data analysis were performed following Tesch's eight steps of analysis RESULTS: Themes that emerged during data analysis were psychological and emotional impact, challenges with communication and interpersonal relations, nurse educators experienced transformation and empowerment, nurse educators encountered barriers that impacted on their allocated tasks, and, nurse educators demonstrated resilience with the curriculum development processes CONCLUSION: Participants reported positive and negative experiences they encountered during curriculum development. The findings revealed that nurse educators need support when involved in curriculum development, for instance, managerial, administrative, technological, financial, and most importantly capacitation, as this could enable them to work effectively without deterrents CONTRIBUTION: This study highlights the need to train and support nurse educators when developing a curriculum to equip them with the necessary competencies