Search

Aim: The aim of the study was to investigate stereotypes of occupational gender roles about male nurses, as viewed from both emic and etic perspectives. Background: Male nurses are a minority group in health institutions. Stereotypes have been questioned regarding these males' occupational role and presence in the nursing profession. Design A qualitative description design was used. Methods: During 2016, semi‐structured interviews (N = 30) were conducted with male nurses (n = 10) (emic group), female nurses (n = 10) and discharged patients (n = 10) (etic groups) from four public hospitals. Results: Seven categories with respective themes and subthemes emerged. Three categories were captured for emic groups, namely, existing stereotypes, experiences of stereotyping and the influences of stereotypes on work performance. Four categories emerged for etic groups, namely, treatment preferences, types of stereotyping towards male nurses, origin of stereotypes and effects of stereotypes. Conclusion: Positive and negative stereotypes were reported by both emic and etic groups, with etic groups revealing more stereotypes. Effort should be made by both management in the practice environment and the media to counter the stereotyping of male nurses. SUMMARY STATEMENT: What is already known about this topic? Stereotyping of male occupational roles in the nursing profession has been questioned.Limited information is available on male occupational stereotypes in the nursing profession within low‐ and medium‐income countries such as South Africa. What this paper adds (research findings/key new information)? This paper describes perspectives with both an emic (male nurses) and etic (female nurses and discharged patients) focus on occupational stereotyping of males in the nursing profession.The findings indicated more stereotyping towards male nurses from etic groups compared with emic groups. The implications of this paper (how findings influence or can be used to change policy/practice/research/education): The media and the Departments of Education and Health should assist by creating public awareness on the importance of male nurses in the profession.Practice environments should support male nurses through in‐service training and open discussions between various categories of staff, to prevent stereotyping and sensitize staff on the impact of stereotyping on male nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Several studies explore and describe the role of family dynamics in dementia care.However, few focus specifically on the diversity of family relationships that influence family caregivers' experiences of providing care to a relative with dementia.The role of family caregivers engaging in unpaid care of relatives with dementia is becoming more and more critical as the numbers of people living with dementia increase across the globe.Family caregivers are a diverse group of people as there are different categories of kinship relations and thus cannot be viewed as a single collective.They are linked intricately to their family and social support systems, however, they often experience limited family support, and tensions between family members can be a major source of stress.Hence, health professionals need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers. What the paper adds to existing knowledge?: This study is unique in that it focuses on a range of family relationships in which a person with dementia finds themselves. It highlights that this network of complex connections influences the caregiving process.The study demonstrates the important role that siblings can play in sharing the caregiving load. However, this sharing is rarely balanced or fair and there is always someone in the family who carries the heaviest load.Communication between family members is frequently a challenge, with family members experiencing denial or an inability to understand the challenges encountered by the family caregiver.Most studies focus on the relationship between the family caregiver and the relative with dementia alone, rather than the family network of the family caregiver and how it influences the caregiving process.This study is unique as it focuses on family dynamics and the family network, particularly the range of family relationships in which family caregivers and their relative with dementia find themselves.Other studies tend to focus on a specific kinship category and the family network, such as an adult child, caring for their parent, but this study presents a wide variety of kinship categories to demonstrate the diversity of family caregiving contexts.The family caregivers in this study all highlighted the need or desire for effective support from the family network.Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. What are the implications for mental health nursing?: The findings suggest the need for communication (training and therapeutic) interventions between family caregivers and other family members (secondary caregivers). Mental health nurses are often well positioned to offer the family caregiver the option to undertake such an intervention.The findings emphasize the diversity of family caregiving situations and argue that mental health nurses can assess the nature of the care situations and work with families on how best to address the needs of the relative with dementia and the main caregiver.However, tensions frequently exist between family members, some of which existed prior to the relative acquiring dementia and other tensions as a consequence of the relative acquiring dementia. Mental health nurses could assist as a mediator between family members in order to assist families to become more cohesive. Introduction: This article explores the diverse nature of family caregivers, focusing on the different categories of kinship relations. Family caregivers are linked intricately to their families, but often experience limited family support, causing stress and tension between family members. Aim: The article aims to explore the family relationships of family members caring for relatives with dementia in order to provide an insight into the role of such relationships on the caregiver relative with dementia dyad. Method: A phenomenological, exploratory‐descriptive design was used. Eight participants took part and data were obtained using collages and semi‐structured interviews. Results: A range of family relationship patterns was highlighted including sibling involvement in the caregiving process; spousal involvement in supporting a caregiver of a parent; and spousal involvement in caring for their spouse. Discussion: The family caregivers highlighted the need or desire for effective support from the family network. Challenges of communication between family members and the caregiver were also evident and were framed within the existing family dynamic of each family. Implications for Practice: Mental health nurses need to deepen their understanding of family relationships to enable them to provide effective advocacy and clinical support to family caregivers and assist families to become more cohesive. [ABSTRACT FROM AUTHOR]

Accessible summary: What is already known about the topic?: Newly qualified nurses often feel overwhelmed by the challenges of the work environment and struggle to transition into healthcare work environments.Nurses require opportunities during the transition period to develop both competence and confidence in their ability to practise independently. What the paper adds to existing knowledge?: Newly qualified mental health nurses experience fear during their adaptation period, especially when they perceive mental healthcare users as dangerous and the working environment as risky, with little concern for their safety.Nurses new to the mental health environment learn from accepting responsibility, taking on challenges and making adjustments, in order to develop confidence as mental healthcare professionals. What are the implications for practice?: Nursing management should ensure a safe and supportive mental healthcare environment. The potential for and consequences of negative stereotyping of patients among mental health nurses should be acknowledged and addressed as it may hinder the smooth adaptation of newly qualified nurses.Although stressful experiences can help mental health nurses to develop confidence and skills to manage future demanding situations, newly qualified nurses need to be given appropriate support and debriefing to ensure challenging situations do not "go the wrong way" and decrease confidence levels. Introduction: Much has been written about the experiences of newly qualified nurses in their first year of employment, yet not much has been heard from the perspectives of newly qualified nurses working in mental health facilities. Aim: To explore and describe the adaptation process of newly qualified nurses working in public mental health facilities in South Africa. Method: Following a qualitative descriptive design, 11 newly qualified nurses in their first 6–18 months of employment were purposively selected from three public mental health facilities in South Africa. Data collected through unstructured individual interviews were thematically analysed. Results: Four themes emerged from the analysis: fear related to the mental healthcare environment; self‐doubt upon meeting the expectations of the inter‐professional team; ways to adjust to the challenges; and confidence as mental healthcare professionals. Discussion: During the adaptation process newly qualified nurses working in mental health facilities need support to overcome their initial fears and develop self‐confidence in both managerial and therapeutic realms. Implications for practice: Management of mental healthcare facilities needs to be cognisant of the importance of creating a supportive and safe environment that discourages negative stereotyping of patients and fosters newly qualified nurses' adaptation. [ABSTRACT FROM AUTHOR]

Accessible summary The purpose of this study was to describe the role of inclusiveness in lessening the pain of parents death in adolescents orphaned by AIDS., Data were derived from 15 AIDS orphans between the ages of 14 and 18 years., The method used was focus groups with discourse analysis using four themes: grieving patterns, coping strategies, experience with loss and expectations., The participants believed that including them in the illnesses, dying and funeral preparations of their parents would have facilitated their healing., Abstract The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study. [ABSTRACT FROM AUTHOR]

Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Background and aim: Given the myriad occupational stressors of nursing itself, plus the challenges of moonlighting, we aimed to investigate the emotional well‐being of moonlighting nurses and their work engagement. Well‐being was defined by levels of general health, mental health, emotional exhaustion, personal accomplishment, compassion satisfaction and compassion fatigue. Design A cross‐sectional descriptive survey (December 2017 to March 2018) at private health care facilities in a Metropolitan Municipality, South Africa. Methods: Two hundred and fifty‐one nurses completed self‐administered questionnaires, which comprised of validated scales. Results: Nurses were at low risk for emotional exhaustion (M=12.8; SD=11.23) and scored high on compassion satisfaction (M=42.34; SD=7.22) and work engagement (M=4.87, SD=1.18). Personal accomplishment (t= 2.535; P<.05) compassion satisfaction (t= 6.790; P=.000) and mental health (t=3.206; P<.05) made a statistically significant unique contribution to the prediction of work engagement. Nurses who had considered leaving the profession scored significantly higher on emotional exhaustion and compassion fatigue. Conclusion: Nurses who moonlighted in private health care facilities reported low risk for burnout and high levels of compassion satisfaction and work engagement. Further research is needed to explore the reasons for these findings. Attention must be given to ensuring the occupational well‐being of nurses in order to retain them in the profession. SUMMARY STATEMENT: What is already known about this topic? Nursing is a stressful occupation.Moonlighting (dual employment) is fraught with challenges for nurses as individuals and for institutions where they work.Very little is known about the emotional well‐being of nurses who moonlight. What this paper adds? This is the first cross‐sectional study on emotional well‐being and work engagement of nurses who moonlight in private hospitals in South Africa.Nurses moonlighting in private health care facilities reported low risk for burnout and high levels of compassion satisfaction and work engagementMoonlighting nurses who had considered leaving nursing scored higher on emotional exhaustion and compassion fatigue than those who had not considered leaving nursing. The implications of this paper: Better‐resourced private health care facilities may contribute towards the finding that nurses moonlighting in private health care facilities reported low risk for burnout and high levels of compassion satisfaction.Attention must be given to ensure the occupational well‐being of nurses in order to retain them in the profession.The finding that lower categories of nurses score higher on work engagement than professional nurses requires further research. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare the communication and practice experiences of migrant nurses in geographically distant, culturally dissimilar countries in Eastern and Western contexts. Background: Considerable research has focused on the experience of acculturation of migrant nurses into geographically diverse locations. However, there remains scant comparative research which considers the ways in which migrant nurses interpret their experience through making "sense" of events encountered in their practice. Design: An exploratory qualitative study was conducted using face‐to‐face interviews with 36 migrant nurses currently practising in New Zealand and 20 migrant nurses practising in the United Arab Emirates. Methods: The same question schedule was used to explore influences on communication and practice in both settings. Thematic analysis and sensemaking theory guided coding and analysis of data. COREQ guidelines informed the reporting of qualitative data. Results: Qualitative analysis resulted in five representative themes, three illustrating similarities across diverse cultures and two that demonstrate the differences migrant nurses require to navigate across contrasting cultural environments successfully. Conclusion: Cultural value‐based differences in both locales caused both systemic and interpersonal sensemaking challenges for migrant nurses that emphasise the importance of orientation and education programmes for internationally qualified nurses. However, cultural conflicts also exist within groups. Orientation programmes should address culturally patterned responses among different groups of internationally qualified nurses. Relevance to clinical practice: Findings demonstrate a need for migrant nurses to be willing to embrace ambiguity in order to acculturate into a collaborative team culture in each of the geographical locations in this study. As registered nurses (RNs) also carry their cultural imprint, orientation interventions targeting the cultural variations of nurses in less standardised orientation programmes may be more beneficial in enhancing acculturation and in turn, staff retention. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine underlying factor structure of the Critical Care Family Needs Inventory—Emergency Department across three countries to identify similarities and differences. Background: Understanding family needs assists nurses to provide family‐centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments. Design: Retrospective secondary analyses of data collected in three cross‐sectional surveys. Methods: Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item‐matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist. Results: The factor structure of the 40‐item Critical Care Family Needs Inventory—Emergency Department differed between countries. Analyses of the Australian data revealed a four‐factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four‐factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two‐factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1). Conclusions: The findings suggest family members from different countries responded to Critical Care Family Needs Inventory—Emergency Department items in different ways. Consistent with concepts of family‐centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED. Relevance to clinical practice: Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory—Emergency Department has limited utility. Participation and communication needs emerged as common family needs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. Background Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice. Context-specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators' qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking. Design A cross-sectional, observational design. Methods Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February-August 2015 in medical and surgical units from eight public hospitals. Twenty-five medication administrators completed dose calculations. Results In total, 296 medication errors were identified, of which most were wrong-time errors and omissions. Interruptions and patient acuity were significantly associated with wrong-dose and wrong-route errors, respectively. Most medication administration-related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages. Conclusions Medication administration errors, especially wrong-time errors and omissions, are prevalent in public hospitals in the Gauteng Province. Interruptions lower the risk of wrong-dose errors, while patient acuity exacerbates this risk. Relevance to clinical practice Factors associated with wrong-time errors and omissions should be addressed. Patient identification and asepsis protocols should be adhered to. Dosage calculation training is indicated. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and validate a modified Situation-Background-Assessment-Recommendation communication tool incorporating components of the Cape Town modified early warning score vital signs chart for reporting early signs of clinical deterioration. Background Reporting early signs of physiological and clinical deterioration could prevent 'failure to rescue' or unexpected intensive care admission, cardiac arrest or death. A structured communication tool incorporating physiological and clinical parameters allows nurses to provide pertinent information about a deteriorating patient in a logical order. Design Mixed methods instrument development and validation. Methods We used a sequential three-phase method: cognitive interviews, content validation and inter-rater reliability testing to validate a self-designed communication tool. Participants were purposively selected expert nurses and doctors in government sector hospitals in Cape Town. Results Cognitive interviews with five experts prompted most changes to the communication tool: 15/42 (35.71%) items were modified. Content validation of a revised tool was high by a predetermined ≥70% of 18 experts: 4/49 (8.2%) items were modified. Inter-rater reliability testing by two nurses indicated substantial to full agreement (Cohen's kappa .61-1) on 37/45 (82%) items. The one item achieving slight agreement (Cohen's kappa .20) indicated a difference in clinical judgement. The high overall percentage agreement (82%) suggests that the modified items are sound. Overall, 45 items remained on the validated tool. Conclusion The first modified early warning score-linked Situation-Background-Assessment-Recommendation communication tool developed in South Africa was found to be valid and reliable in a local context. Relevance to clinical practice Nurses in South Africa can use the validated tool to provide doctors with pertinent information about a deteriorating patient in a logical order to prevent a serious adverse event. Our findings provide a reference for other African countries to develop and validate communication tools for reporting early signs of clinical deterioration. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore and describe the perceptions of nurse managers, nurses, and a physician in the community health centre with the most positive practice environment in a province of South Africa. Methods Ten (N = 10) semistructured individual interviews were conducted with personnel of the community health centre with the most positive practice environment. Results Personnel cited the following as the most important characteristics of a positive practice environment in a primary health care setting: support, leadership and governance, collegial nurse-physician relationships, and quality of care. Conclusion In a primary health care setting, it is important to train, appoint, and support managers who in turn will be able to train and support their personnel. Furthermore, reciprocal community involvement must be encouraged between personnel of the community health centre and stakeholders in the community to improve the health status of the community. Finally, group cohesions between all health care workers and managers at different organisational levels should be encouraged, as this enhances teamwork and a culture of teaching-learning and improves the competence of all staff. [ABSTRACT FROM AUTHOR]

Aim To report a study of emergency nurses' experiences of caring for survivors of intimate partner violence. Background Emergency nurses have the opportunity to intervene during the period following exposure to intimate partner violence when survivors are most receptive for interventions. The confrontation with the trauma of intimate partner violence can, however, affect emergency nurses' ability to engage empathetically with survivors, which is fundamental to all interventions. Design The research was guided by the philosophical foundations of phenomenology as founded by Husserl. Method A descriptive phenomenological inquiry grounded in Husserlian philosophy was used. The phenomenological reductions were applied throughout data collection and analysis. During 2010, concrete descriptions were obtained from interviewing 11 nurses working in emergency units of two public hospitals in an urban setting in South Africa. To arrive at a description of the essence, the data were analysed by searching for the meaning given to the experience of caring for survivors of intimate partner violence. Findings Emergency nurses in South Africa are often witnesses of the emotional and physical effects of intimate partner violence. Exposure to the vulnerability and suffering of survivors elicits sympathy and emotional distress. Emergency nurses are left with the emotional impact and disruptive and recurrent memories. Conclusion Exploring the tacit internal experiences related to caring for survivors of intimate partner violence revealed emergency nurses' vulnerability to the effects of secondary traumatic stress. The findings generated an opportunity to develop guidelines through which to support and empower emergency nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives. To investigate inter-relationships between emotional intelligence (EI), work stress and burnout in a group of nurses in the Western Cape Province, South Africa. The moderating effect of EI in the stress-burnout relationship and group differences (nurses working in different wards) in burnout were also investigated. Background. Stress and subsequent burnout commonly threaten the occupational health and well-being of nurses in South Africa and elsewhere. Developing EI in nurses may increase individual stress resistance and combat burnout. Design. A cross-sectional research design with anonymous questionnaires was conducted. Self-report data were used. Methods. Survey data were collected from 122 nurses working in different wards at four hospitals from a private hospital group. The Swinburne University Emotional Intelligence Test, Sources of Work Stress Inventory and Maslach Burnout Inventory were used to measure EI, stress and burnout, respectively. Results. Consistent inverse relationships between emotional control and management as dimensions of EI, and stress and burnout emerged. A differential effect of high vs. low EI on the stress-burnout relationship was evident. Workload and the work/family interface emerged as significant predictors of burnout. Respondents working in maternity, paediatric and ER wards reported more feelings of personal accomplishment than those working in general wards. Conclusions. Higher EI is significantly related with lower stress and burnout in a sample of South African nurses. The moderator effect of EI in the stress-burnout relationship suggests that enhanced EI may help diminish burnout development when chronic stress is experienced. Relevance to clinical practice. EI developmental interventions, if introduced in nursing curricula, may increase emotional coping resources and enhanced social skills, which may benefit the long-term occupational health of nurses. This may be relevant in developing countries, where environmental stressors related to the organisational context (budget constraints) and wider social factors (shortage of qualified nurses) are difficult to address. [ABSTRACT FROM AUTHOR]