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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: What is already known about this topic?: Integrating mental health counselling into primary care services is a recommended strategy for reducing the mental health treatment gap in low‐ and middle‐income countries.To support this strategy, potential barriers to counselling integration must be identified and addressed.Organizational preparedness for implementation may influence the extent to which the introduction of counselling is successful.Features of primary care facilities associated with preparedness for the implementation of mental health counselling have not been explored. What the paper adds to existing knowledge?: This study uses a novel approach to explore variations in preparedness of primary care services to implement counselling and factors potentially associated with these variations.Findings suggest there is considerable variation in the preparedness of facilities to implement counselling.Organizational factors such as resource availability, management style and facility environment are potentially associated with capability for implementing mental health counselling. What are the implications for practice?: Health planners could use this method to identify poorly functioning services that may benefit from additional interventions to build preparedness for counselling implementation.Future research should examine whether differences in facility preparedness impact on the implementation and outcomes of this service. Introduction: Differences in primary care facilities' preparedness for implementing mental health counselling may affect the implementation process but have rarely been studied. Aim: To assess the feasibility of using a novel methodological approach to explore variations in capability for implementing mental health counselling and factors potentially associated with this variation among primary care services in the Western Cape, South Africa. Methods: Staff from 26 facilities participated in discussions about their facility's mental health implementation capability. Three researchers conducted observations of the facility's environment, staff–patient interactions and resources. We used qualitative comparative analysis to identify factors potentially associated with implementation capability. Results: Facilities appeared to vary in their capability for implementing counselling services. The availability of person‐centred health services, a therapeutic environment and sufficient human resources may be requirements for implementation preparedness. Other factors that seem to support preparedness include the availability of confidential space for counselling and an adequately managed facility. Discussion: This study identified several features of well‐functioning primary care facilities. Facilities with these features may be better prepared to implement a new counselling service. Implications for practice: This method may identify facilities that are poorly prepared for implementation that could benefit from preparedness‐building interventions. Whether differences in preparedness affect counselling outcomes is yet to be established. [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]

Pillay R. International Journal of Nursing Practice 2010; : 545-554 Defining a competency-based model for nursing management development will help to establish core competencies for nursing managers which will not only strengthen their practice and provide further learning and development opportunities, but will also provide the basis to focus training and professional development efforts. This paper identifies the competencies important for effective nursing management in the public and private health sectors. A total of 420 senior nursing managers in South Africa were surveyed using a self-administered questionnaire. Respondents had to rate the importance of 51 competency items as it pertains to effective nursing management. elf-management, ontrolling, ealth/clinical, rganizing, eople management, lanning and thical/legal competencies were found the most valuable for optimal nursing management. These findings reflect the reality of the nursing management milieu and will be useful in the design and delivery of management development programmes aimed at enhancing nursing management capacity. [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]

Amidst an unprecedented swell in global protest, scholars and activists wrestle with the question of why protests succeed or fail. I explore a new answer: more cohesive crowds, where protesters agree on their demands, are more likely to win concessions than less cohesive crowds. Drawing on psychology and linguistics, I theorize that cohesive demands are more comprehensible and thus persuasive. I test this theory with a multimethod approach. First, I use cross‐national data from 97 protests to estimate the relationship between crowd cohesion and subsequent concessions, applying natural language processing to measure cohesion in participants' self‐reported motivations. Second, a survey experiment in South Africa tests the causal effects of crowd cohesion and assesses comprehensibility of demands as the mechanism driving concessions. Third, case studies of two British protests demonstrate the theory in real‐world settings. My findings suggest that activists can improve their odds of success by coordinating around a common goal. [ABSTRACT FROM AUTHOR]

Aim: Tuberculosis (TB) continues to challenge global health systems, especially in South Africa. Nurses are especially vulnerable to TB exposure, because of their prolonged front‐line contact with infected patients—especially in primary health care (PHC) clinics. Their infection control practices, influenced by key factors such as knowledge and attitudes towards TB prevention, become an important consideration. The aim of the study was to (1) describe the TB prevention knowledge, attitudes, and practices of PHC nurses in a South African district and (2) explore moderating factors on TB prevention practices. Methods: A cross‐sectional survey was undertaken at all 41 PHC facilities in Mangaung Metropolitan district, Free State province, South Africa, using self‐administered questionnaires. Captured data were analysed to yield descriptive and multivariate statistics. Results: Results suggest several instances of inadequate TB prevention knowledge, attitudes, and practices. Good TB practice was predicted by TB attitudes and knowledge, and the relationship between TB prevention knowledge and practices was not moderated by training, attitudes, or nurse category. Conclusion: Results echo previous indications that nurses often do not exhibit the desired knowledge, attitudes, and practices required to adequately protect themselves and others against TB and suggest further exploration towards understanding the influences on TB prevention practice among nurses. SUMMARY STATEMENT: What is already known about this topic? Nurses are especially at risk for tuberculosis infection.Not much is known about nurses' tuberculosis prevention capabilities in primary health care settings, the front line of contact with infection.Little is known about the influences on nurses' tuberculosis prevention practices. What this paper adds? Nurses in primary health care settings do not have adequate tuberculosis prevention knowledge, attitudes, and practices to create optimally safe health care environments.The physical make‐up of N95 respirators are currently inadequate to promote its use among nurses in primary health care settings.While tuberculosis prevention knowledge is positively linked to tuberculosis prevention practices, it remains unclear what factors may moderate this relationship. The implications of this paper: Tuberculosis prevention practices among nurses remain suboptimal to curb tuberculosis infection in health care facilities.Better interventions aimed at improving tuberculosis prevention among nurses are needed.Such intervention will require a closer understanding of the influences on tuberculosis practices. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a correlational study of the relationships between demographic variables, job satisfaction, and turnover intent among primary healthcare nurses in a rural area of South Africa. Background. Health systems in Southern Africa face a nursing shortage fuelled by migration, but research on job satisfaction and turnover intent of primary healthcare nurses remains poorly described. Method. A cross-sectional study with survey design was conducted in 2005 in all local primary healthcare clinics, including nurses on duty at the time of visit (n = 143). Scale development, ANOVA ANOVA, Spearman's rank correlation, and logistic regression were applied. Results. Nurses reported satisfaction with work content and coworker relationships and dissatisfaction with pay and work conditions. Half of all nurses considered turnover within two years, of whom three in ten considered moving overseas. Job satisfaction was statistically significantly associated with unit tenure (P < 0.05), professional rank (P < 0.01) and turnover intent (P < 0.01). Turnover intent was statistically significantly explained by job satisfaction, age and education (P < 0.001), with younger and higher educated nurses being more likely to show turnover intent. Satisfaction with supervision was the only facet significantly explaining turnover intent when controlling for age, education, years of nursing and unit tenure (P < 0.001). Conclusion. Strategies aimed at improving job satisfaction and retention of primary healthcare nurses in rural South Africa should rely not only on financial rewards and improved work conditions but also on adequate human resource management. [ABSTRACT FROM AUTHOR]

Bambara groundnut (BG) (Vigna subterranean) is an underutilized, indigenous crop in South Africa that has nutritional and associated health benefits. Decreasing the antinutrients in food sources can potentially increase the digestibility of proteins and mineral absorption. To determine the effect of traditional processing (cooking) on the antinutrient content and metabolome of this crop, BG was sampled from 12 rural farms in three districts of the Mpumalanga province, South Africa. The four main colors that were identified (cream, orange, brown, and purple) were pooled together according to the district they were obtained from. One‐half of each color sample obtained from each of the three districts was dehulled, color sorted, milled, and subjected to subsequent antinutrient and metabolome analyses, while the other half was cooked, air‐dried, and milled prior to analyses. Samples were analyzed for phytate and tannins (antinutrients) by hydrochloric acid extraction methods as well as metabolome constituents by ultraperformance liquid chromatography coupled with quadrupole time‐of‐flight mass spectrometry (UPLC–QTOF‐MS). Phytate, tannins, as well as other metabolomic constituents, namely, catechin, epicatechin, procyanidin, as well as citric acid, were identified in all raw and cooked BG samples. The cooking process resulted in a significant decrease (p < 0.05) in the phytate and tannin content as well as an increase in the health‐associated phenolic compounds. [ABSTRACT FROM AUTHOR]

Aims and Objectives To explore and describe the link between culture and dementia care with the focus on the influence of the belief in dementia as witchcraft and people with dementia as witches. Background In South Africa, especially in townships and rural areas, dementia is often perceived as connected to witchcraft rather than to disease. Persons labelled as witches-mostly older women-may be bullied, ostracised, beaten, stoned, burned, even killed. Method One strand of findings from a larger international study is presented with in-depth qualitative interviews of one close family member and seven nurses caring for patients with severe dementia in nursing homes in Tshwane in South Africa. A hermeneutic analytic approach was used. Results Two main themes are found, namely 'Belief in witchcraft causing fear of persons with dementia' and 'Need of knowledge and education.' Fear of and violence towards people with dementia are based on the belief that they are witches. Some of the nurses had also held this belief until they started working with patients with dementia. There is a great need for education both among healthcare workers and the populace. Discussion The 'witch' belief prevents seeking professional help. As nursing homes tend to be private and expensive, professional dementia care is virtually unattainable for the poor. Dementia needs a more prominent place in nursing curricula. Nurses as educators need to know the local culture and language to be accepted in the various communities. They need to visit families affected by dementia, give awareness talks in churches, schools and clinics and facilitate support groups for carers of people with dementia in the local language. Conclusion Improved nurses' education in gerontology and geriatric care is needed. Trained specialist nurses may work as mediators and help eradicate the witchcraft beliefs connected to severe dementia. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify final‐year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries. Background: Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society. Design: A multi‐site cross‐sectional study. Methods: A self‐administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines. Results: Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students. Conclusion: Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates. Relevance to clinical practice: Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore client and provider experiences and related health outcomes of sexual and reproductive health interventions that have been led by or that have involved mining companies. Background Miners, and those living in communities surrounding mines in developing countries, are a vulnerable population with a high sexual and reproductive health burden. People in these communities require specific healthcare services although the exact delivery needs are unclear. There are no systematic reviews of evidence to guide delivery of sexual and reproductive health interventions to best address the needs of men and women in mining communities. Design A narrative synthesis. Methods A search of peer-reviewed literature from 2000-2012 was undertaken with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. Results A desire for HIV testing and treatment was associated with the recognition of personal vulnerability, but this was affected by fear of stigma. Regular on-site services facilitated access to voluntary counselling and testing and HIV care, but concerns for confidentiality were a serious barrier. The provision of HIV and sexually transmitted infection clinical and promotive services revealed mixed health outcomes. Recommended service improvements included rapid HIV testing, the integration of sexual and reproductive health into regular health services also available to family members and culturally competent, ethical, providers who are better supported to involve consumers in health promotion. Conclusion There is a need for research to better inform health interventions so that they build on local cultural norms and values and address social needs. A holistic approach to sexual and reproductive health beyond a focus on HIV may better engage community members, mining companies and governments in healthcare delivery. Relevance to clinical practice Nurses may require appropriate workplace support and incentives to deliver sexual and reproductive health interventions in developing mining contexts where task shifting exists. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the perspectives of patients and health professionals on facilitators and barriers to care in a diabetes clinic in urban South Africa. Background: Although much attention has been given to the science behind diabetes management, a qualitative approach to exploring experiences, facilitators and barriers to care may have considerable value in understanding and improving diabetes care. Design: We conducted a qualitative study in the context of a 3‐year collaboration at a diabetes clinic. The present study formed part of the preparatory phase to the larger project. Methods: Linguistically and culturally matched research assistants collected data over a period of 18 months. Methods included interviews, focus groups, ethnographic observations and informal discussions with 38 patients and health professionals. Data from each participant group were transcribed, translated and analysed using reflexive thematic analysis principles and thereafter triangulated. The Standards for Reporting Qualitative Research checklist was followed. Results: Initial findings suggest that factors can be classified into three overarching themes: relationships, health systems and the interplay between disease and the lifeworld. System resource pressures, the nuances of team interactions and a complex healthcare site may adversely affect care, even at sites where there are elements of good practice. Conclusions: The collective psychosocial experience of patients appears to conflict with the biomedical approach to diabetes management. The all‐consuming nature of the disease, together with contextual and systemic factors, plays a significant role in influencing experiences of care. Relevance to clinical practice: While systemic and contextual influences on experiences of diabetes care may be difficult to modify, our study suggests a need to focus on ways of enhancing relationships within the clinic and seeking to understand the lifeworld of the patient. [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]

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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]

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]

Aims and objectives To learn about the meaning of traditional food to institutionalised patients with dementia. Background Traditional food strengthens the feelings of belonging, identity and heritage, which help persons with dementia to hold on to and reinforce their cultural identity and quality of life. Taste is more cultural than physiological. Dietary habits are established early in life and may be difficult to change. Being served unfamiliar dishes may lead to disappointment and a feeling of being betrayed and unloved. Design and method The three studies presented have a qualitative design. In-depth interviews of family members and nurses experienced in dementia care were conducted in South Africa and among ethnic Norwegians and the Sami in Norway. Content-focused analysis, hermeneutic in character, was used to enable the exploration of the thoughts, feelings and cultural meaning described. Results Traditional foods created a feeling of belonging and joy. Familiar tastes and smells awoke pleasant memories in patients and boosted their sense of well-being, identity and belonging, even producing words in those who usually did not speak. Conclusions In persons with dementia, dishes remembered from their childhood may help maintain and strengthen cultural identity, create joy and increase patients' feeling of belonging, being respected and cared for. Traditional food furthermore improves patients' appetite, nutritional intake and quality of life. To serve traditional meals in nursing homes demands extra planning and resources, traditional knowledge, creativity and knowledge of patients' personal tastes. Relevance for clinical practice This study provides insight into culture-sensitive dietary needs of institutionalised patients with dementia. The cultural significance of food for feeling contentment and social and physical well-being is discussed. Besides helping to avoid undernutrition, being served traditional dishes may be very important to reminiscence, joy, thriving and quality of life. [ABSTRACT FROM AUTHOR]

Aims To conduct a quantitative investigation of stress and the relationship with burnout among AIDS care volunteers. Background Volunteer caregivers experience stress that could lead to burnout. Yet, very few studies quantify stress and its relationship with burnout among AIDS care volunteers. Design This study uses a cross-sectional, exploratory survey design. Methods Face-to-face interviews were conducted with 126 volunteer caregivers working in 13 semi-rural communities (townships) in Durban, South Africa in April 2009. All participants were women, Christian and with low levels of education. A 22-item instrument was drawn from Pearlin et al.'s role overload and role captivity scales, Van Dyk's stress factor scale and the Maslach Burnout Inventory. Results Most of the volunteers had moderate-to-high levels of stress. 'Role/work overload' 'lack of support' and 'overwhelming nature of the disease' explained most of the variance in stress. Volunteers' age and number of patients in their care were predictors of stress. Caring for only AIDS patients, lack of support, stress emanating from perceived stigma and lack of training; and the overwhelming nature of AIDS were predictors of burnout. Conclusion High levels of stress could negatively impact volunteers' health and well-being and on-the-job performance. Policy makers must develop and fund home-based care models that take into account the stressors associated with AIDS care, by reducing the work load, providing ongoing psychosocial support and recruiting nurses to assist volunteers. The small non-probability sample used in this study highlights the need to treat the findings with caution. [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]