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Background: Literature shows that in South Africa there are insufficient resources to meet mental healthcare needs. At general or district hospital level, the non-specialist doctor is often responsible for the holistic assessment and management of mental health service users. Such situations inevitably increase doctors' care load as they are required to treat across disciplines. We highlight the particular challenges faced by a community service (CS) doctor in this context. Methods: The presented case study formed part of a larger project that investigated public mental healthcare provision in the Eastern Cape province. Data were collected through a once-off semi-structured interview with the participant. The interview was transcribed and data analysed by utilising thematic analysis to yield results. Results: The study suggests that the CS doctor experiences being overloaded with duties, and feels overwhelmed in a healthcare context that lacks resources needed for service provision, which may lead to inadequate mental healthcare provision to public health service users. Conclusion: Healthcare facilities in rural parts of the Eastern Cape province are in need of assistance. This in-depth account highlighted the consequences of working on the front line of a disadvantaged and under-resourced health system. The presented account can be interpreted as a cry for help by CS doctors for relevant authorities to improve access and provision of mental healthcare in the area. Contribution: The paper provides an exploration of the circumstances wherein mental healthcare is provided in rural parts of South Africa. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases (PWCDs) were severely affected by the coronavirus disease 2019 (COVID-19) pandemic, as they were prevented from making the necessary visits to health facilities for medical review and to collect their medication. The emergence of the health crisis and inadequate access to quality care affected chronic care management. The perspectives of PWCDs are not known, and therefore the research on which this paper is based sought to investigate the lived experiences of these patients during the COVID-19 pandemic. Methods: A qualitative phenomenological design was used to obtain the lived experiences of PWCDs identified for participation in the study by means of purposive sampling. Patients' experiences were obtained during individual structured interviews, and a checklist was used to gather patient characteristics from their files. Results: Three themes emerged from the study findings, namely poor healthcare services, the socio-economic impact of the COVID-19 pandemic, and the psychological impact of the COVID-19 pandemic. The COVID-19 pandemic had devastating effects on PWCDs, in that they experienced barriers to accessing quality chronic care services and suffered psychological and financial difficulties that affected their health, life, needs and expectations. Conclusion: Policymakers should consider PWCDs when responding to a public health concern in the future. Contribution: The study findings may have an impact on future policies regulating the management of chronic diseases during epidemics, in order to improve patient health outcomes and satisfaction with healthcare services and the chronic care model based on the experiences of PWCDs. [ABSTRACT FROM AUTHOR]

Complementary medicines (CMs) that are formulated to facilitate weight loss are a popular and widely available treatment option, particularly among women. There is limited research regarding their use in the South African context. The aim of this study was to gather information on the use and perceived effectiveness of CMs for weight loss among adult women. A quantitative, descriptive survey design was used. Johannesburg, South Africa. A purposive sample of women over the age of 18 years who had used CMs for weight loss within the past five years were recruited from health stores and a university campus healthcare centre. Data were obtained through a self-administered 29-item, paper-and-pen questionnaire. Responses were descriptively analysed using cross-tabulation, multiple response analysis and frequency tables. Data from 160 questionnaires were analysed and the results demonstrated that a wide variety of CM products are used for weight loss, with branded combination products, green tea, Garcinia cambogia and conjugated linoleic acid being the most popular. Most participants also adopted lifestyle interventions such as exercise and calorie restriction during their weight loss attempt. While minor side effects were experienced by over half of the participants, the majority were satisfied with their product choice as well as the amount of weight that they lost. Most participants perceived their CM weight loss product of choice to be effective. However, other concomitant weight-loss strategies that were employed may have been responsible for these results. Despite their popularity, there is only very limited research surrounding the safety and efficacy of these weight-loss products, with most studies being conducted on single constituents rather than whole formulations as sold on the market. Healthcare providers should encourage the disclosure of the use of CM weight-loss products to ensure safe and effective patient care and mitigate the potential risks associated with their inappropriate use. [ABSTRACT FROM AUTHOR]

Background: Gender equality remains an outstanding global priority, more than 25 years after the landmark Beijing Platform for Action. The disconnect between global health policy intentions and implementation is shaped by several conceptual, pragmatic and political factors, both globally and in South Africa. Actor narratives and different framings of gender and gender equality are one part of the contested nature of gender policy processes and their implementation challenges. The main aim of this paper is to foreground the range of policy actors, describe their narratives and different framings of gender, as part exploring the social construction of gender in policy processes, using the Adolescent Youth Health Policy (AYHP) as a case study. Methods: A case study design was undertaken, with conceptual underpinnings combined from gender studies, sociology and health policy analysis. Through purposive sampling, a range of actors were selected, including AYHP authors from government and academia, members of the AYHP Advisory Panel, youth representatives from the National Department of Health Adolescent and Youth Advisory Panel, as well as adolescent and youth health and gender policy actors, in government, academia and civil society. Qualitative data was collected via in-depth, semi-structured interviews with 30 policy actors between 2019 and 2021. Thematic data analysis was used, as well as triangulation across both respondents, and the document analysis of the AYHP. Results: Despite gender power relations and more gender-transformative approaches being discussed during the policy making process, these were not reflected in the final policy. Interviews revealed an interrelated constellation of diverse and juxtaposed actor gender narratives, ranging from framing gender as equating girls and women, gender as inclusion, gender as instrumental, gender as women's rights and empowerment and gender as power relations. Some of these narrative framings were dominant in the policy making process and were consequently included in the final policy document, unlike other narratives. The way gender is framed in policy processes is shaped by actor narratives, and these diverse and contested discursive constructions were shaped by the dynamic interactions with the South Africa context, and processes of the Adolescent Youth Health Policy. These varied actor narratives were further contextualised in terms of reflections of what is needed going forward to advance gender equality in adolescent and youth health policy and programming. This includes prioritising gender and intersectionality on the national agenda, implementing more gender-transformative programmes, as well as having the commitments and capabilities to take the work forward. Conclusions: The constellation of actors' gender narratives reveals overlapping and contested framings of gender and what is required to advance gender equality. Understanding actor narratives in policy processes contributes to bridging the disconnect between policy commitments and reality in advancing the gender equality agenda. [ABSTRACT FROM AUTHOR]

Background: A major disparity exists in access to specialised healthcare between rural and urban areas. Specialist outreach programmes are one of the ways in which rural specialist healthcare inequality is being addressed. A number of rural district hospitals (RDH) employ local, private specialists (LPS) to supplement public specialist outreach. Limited research exists on private specialist outreach and support (PSOS) in sub-Saharan Africa or South Africa. Methods: This was a descriptive, exploratory, qualitative study using thematic analysis of semi-structured interviews. Non-probability, purposive sampling was used to obtain a sample size of 16 participants. The audio recordings were transcribed verbatim and analysed with the framework method and ATLAS.ti version 8© software. Results: Four major themes emerged, namely roles of LPS, effects, sustainability and feasibility of PSOS. Overall PSOS was considered sustainable, feasible and had positive effects in and beyond the sub-districts. The value of PSOS was supported by improved access and timeliness of services, improved competency of RDH medical practitioners, improved coordination, comprehensiveness and continuity of care. Private specialist outreach and support was, however, associated with increased burden on the RDH resources and required a basic level of RDH infrastructure to function effectively. Conclusion: The perceived contribution of private specialist outreach services was positive overall. Implementation in RDHs is feasible, but should involve consideration of factors in the hospital, town, sub-district and district prior to implementation. Contribution: This paper provides evidence that private specialist outreach and support services are feasible in the state health sector, provided that certain considerations are taken into account. [ABSTRACT FROM AUTHOR]

Background: HIV and sub-optimal infant feeding practices remain important threats to child growth, development, and survival in low- and middle-income countries. To our knowledge, few studies have explored health service users' perspective of infant feeding in the context of WHO Option B+ policy to prevent vertical HIV transmission (PMTCT). This paper is a sub-analysis of qualitative data from a mixed-methods multi-level process evaluation of Option B+ implementation in South Africa (SA). In this study we explored health facility users' infant feeding knowledge, perceptions, and practices one year after SA adopted the 2016 updated World Health Organization prevention of mother-to-child transmission of HIV Option B+ infant feeding guidelines. Methods: Nineteen focus group discussions (FGDs) were held with six groups of men and women whose infants were aged < 6 months. Participants were attending randomly selected primary health care facilities within six purposively selected priority districts. The six groups included in the FGDs were: (i) adolescent girls and young women living with HIV (WHIV), (ii) adolescent girls and young women not living with HIV (WNHIV), (iii) older postnatal WHIV (iv) older postnatal WNHIV (v) pregnant women, and (vi) men. Data collection took place between April and December 2018. Data analysis involved coding and thematic framework analysis. Results: Women and men have suboptimal knowledge of the recommended breastfeeding duration and exclusive breastfeeding, especially for HIV-exposed infants. Most women received sub-optimal infant feeding counselling and mixed messages from health care workers. Fewer WHIV initiated breastfeeding at birth compared to WNHIV. Most parents believed that HIV-exposed infants should be breastfed for 6 months and many postnatal women on antiretroviral drugs and younger mothers lacked confidence to breastfeed beyond 6 months. Mixed feeding was predominant among all women due to individual, family, and socio-structural barriers. Many men were supportive on infant feeding; however, they lacked the appropriate information and skills to influence their partners' infant feeding decisions. Conclusions: Differences in breastfeeding practices between WHIV and WNHIV are highly influenced by the lack of knowledge of infant feeding policy recommendations. Multiple-level factors deter many mothers from adhering to recommended guidelines. Appropriate ongoing infant feeding counselling and breastfeeding support are required for women and their partners. [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]

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]

With a shift in moving towards the 4th industrial revolution, digital storytelling has been identified as a novel way of facilitating teaching and learning. This paper will be aimed at offering an understanding of the experience and perspective of occupational therapy students in using digital storytelling as a reflective tool as an assignment as part of their undergraduate and masters occupational therapy curriculum at a university in South Africa. A descriptive qualitative study was undertaken, and five participants were purposively recruited. Individual semistructured interviews were conducted as well as a focus group with participants. An inductive analysis revealed two themes: Reflections on relevance within the occupational therapy curriculum and Is technology the new direction? The findings conclude that digital storytelling as a medium to showcase reflections on identifying formation was an innovative and novel way of documenting the reflective experiences of occupational therapy students. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to explore how individuals living with multiple sclerosis experience their disorder in the South African working environment. In this paper we present the experiences of office-based workers living with multiple sclerosis, their challenges, and coping mechanisms. We purposively recruited seven participants who have been diagnosed with multiple sclerosis in the last five years. Participants were interviewed telephonically. Interviews were guided by a semi-structured interview schedule which was supplemented with additional probes. Interviews were analysed thematically using a qualitative software programme. We identified two superordinate themes: bringing multiple sclerosis into the workplace and adapting to multiple sclerosis in the workplace. The findings demonstrated the diverse manner in which participants chose to disclose their multiple sclerosis and manage co-workers' perceptions of multiple sclerosis. Participants employed practical strategies, such as making using of mobility aids, taking notes, conserving energy, and adapting responsibilities. Participants also negotiated accommodations, such as changing working hours, to overcome their unique challenges. Participants emphasised the importance of keeping a general positive attitude but showed reluctance to prepare for their future decline. Our findings indicate that participants manage the disclosure of their diagnosis of multiple sclerosis in order to maintain a favourable relationship with the workplace. Further, despite various physical and psychological limitations, participants were mostly able to adapt to their work environment. Although further research is required, employers and clinicians should consider focusing on the current needs of individuals living with multiple sclerosis to mitigate work-related challenges, rather than planning for future decline. For individuals living with multiple sclerosis and in employment in South Africa, disclosure, management of perceptions and providing accommodations are key aspects in the experience of multiple sclerosis in the workplace. Finding ways to help those in employment disclose their MS diagnosis to employers and co-workers, is an important avenue and next step for intervention research in this field. Early adjustment and adaptation to MS in the workplace is challenging and further negotiation with line-managers regarding accommodations is often required. Employers and clinicians should focus on accommodating the needs of those diagnosed with multiple sclerosis as they arise, rather than focusing solely on the accommodations needed in the future. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore Congolese refugees and asylum seekers' survival strategies in South Africa, the focus of this paper will be on the role of the social worker. The paper is part of the study that was conducted on Congolese refugees and asylum seekers in South Africa post-war or conflicts. The study employed a qualitative research method and a descriptive case study of 10 female Congolese refugees living in Yeoville, Johannesburg South Africa. The participants have lived in South African for less than five years and there were 30–40 years of age. Data were collected by means of one-on-one in-depth interviews in the form of semi-structured interviews. Purposive sampling and snowball sampling techniques were used in the selection of participants. Thematic content analysis was used in analyzing the data collected. The paper provides recommendations on what role can social workers play can in mental wellbeing interventions. This study also contributes to a better understanding of mental wellbeing issues of Congolese refugees and asylum seekers. Ethical approval for this research study was obtained from the Department of Social Work Human Research Ethics Committee (Non-medical) of the University of Witwatersrand. [ABSTRACT FROM AUTHOR]

Concise and effective business English communication underpins successful organisations. During the 4th Industrial Revolution (4IR) much of the working day is spent in some form of communication, usually e-mails. This paper examines the effectiveness of English communication between integral parts of a business operation during the 4IR. A mixed methods approach utilising a non-experimental design was used to investigate effective business communication using e-mails in English in a medium sized organisation in South Africa. A questionnaire consisting of 10 Likert type scale questions and 5 open ended questions was used. Purposive sampling was utilised as the population was small (150 employees, final sample 55) thus results cannot be generalised. Certain barriers to communication were identified which were considered important. For instance, many staff members were second language English speakers and often misunderstand e-mails. As a result, they reported that they felt frustrated in their working life and were demotivated. It was concluded that many e-mails were challenging to staff and needed to be written in everyday English not business language. The authors recommended that workshops and initial training in business language skills when people enter the organisation should be undertaken. Human Resources could also audit the use of appropriate English. [ABSTRACT FROM AUTHOR]

Informal settlements remain a public health problem as they lack basic infrastructure. Furthermore, it is challenging to enforce public health regulations and protocols to prevent the spread of infection during a pandemic. This paper was set out to explore the impact of lockdown during COVID-19 among people living in informal settlements. An exploratory qualitative design was utilised. Purposive sampling was used to select research participants. In-depth one-to-one interviews were held involving 30 research participants through a WhatsApp online telephone platform. A thematic approach underpinned by the four stages of data analysis in interpretive phenomenological analysis was utilised to analyse the data. The study found that during the the research participants were affected by lack of space to practice social distancing, over-burdened infrastructure, lack of savings, loss of income and shortage of food, hunger and diseases, anxiety and depression and poor access to education. There is a need to prioritise the needs of informal settlers and endeavour to establish permanent homes. Health promotion and communication initiatives and pandemic awareness programmes are needed to mitigate the impact of lockdown during a pandemic in informal settlements. [ABSTRACT FROM AUTHOR]

Pre‐abortion counselling may play a key role in abortion seekers' understanding of their decision to terminate a pregnancy and the subsequent emotions that they feel. In this paper, we report on a study conducted in the Eastern Cape province of South Africa concerning womxn's experiences of the pre‐abortion counselling offered as part of the implementation of the Choice of Termination Act that governs the provision of legal abortion in the country. Using a narrative‐discursive lens, the analysis revealed four micro‐narratives in which participants appreciated non‐directive and empathic counselling, as well as being provided with information. They also indicated that the counselling was upsetting and hurtful, particularly when providers drew on the awfulisation of abortion discourse to suggest that abortion leads to terrible consequences, and foetal personhood discourse to intimate that terminating the pregnancy is wrong and other alternatives (adoption, parenting) are better. The connection between these broadly positive and negative responses may lie in the dominance of anti‐abortion discourses coupled with the powerful positioning of healthcare providers as experts. The attendant disempowerment of clients within the health clinic setting may constrain pregnant people's ability to question such 'expert' information. The implications for feminist client‐centred pre‐abortion counselling are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Healthiness is constructed, in Western culture, as a moral ideal or supervalue. This paper will interrogate the assumption that health and the pursuit of healthiness is always and unquestionably positive, by exploring how discourses of health and freedom interact to reinforce the current inequalities and detract from social transformation. Method: Twenty young South African adults were interviewed about their understandings and experiences of health. These discussions were analysed using Foucauldian discourse analysis. Results: Participants constructed healthiness as facilitating the experience of freedom, while at the same time being dependent on a personal orientation towards freedom (as opposed to merely submitting to dominant health authorities). Freedom discourses also played a role in connecting health to neoliberal discourses idealizing economic productivity and hard work. Participants were able to construct a self that is active, productive, valuable, hopeful, and self-assured when talking about health using discourses of freedom. However, these discourses also functioned to moralise and idealise healthiness, which contributed to blaming poor health on its sufferers. Conclusion: Health/freedom discourses can further reinforce the neoliberal value of individual responsibility by constructing self-improvement and self-work as the solution to ill-health, thereby contributing to victim-blaming and weakening support for public health interventions. [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]

The effects of HIV and AIDS have devastated families and communities in South Africa. The scourge has also left many children orphaned in the country. Given the vulnerability of orphaned children, social workers are in the forefront of ensuring that these children are cared for and protected from any harm. Hence, the purpose of this paper was to explore the role of a social worker in issues related to children orphaned by AIDS in their middle childhood. This study was situated within a qualitative research paradigm utilizing purposive, non-probability sampling of 10 participants recruited from Potchefstroom in the Northwest Province of South Africa. A semi-structured interview schedule was employed as a research tool, and in-depth one-on-one interviews were adopted as the method of data collection. A thematic content analysis was used to analyze the data collected during the interviews. The main findings point towards the need to educate children about HIV and AIDS and to empower their caregivers. The primary conclusion drawn from this study is that social workers play various key roles which contribute towards the well-being of orphaned children. Recommendations are posed in relation to social work service providers, government interventions, and future research. [ABSTRACT FROM AUTHOR]

A paper that compares emigration to the process of uprooting. Topics discussed include systemic interconnectedness, the impact of emigration on the family life and social networks of South African emigrants, and social and interpersonal of impact of departure. Information on how to maintain relationship with extended family and friend following migration is offered.

Background: Reducing under-five mortality rates is a global priority. Although under-five mortality has decreased in South Africa, it is still unacceptably high. The implementation of the Integrated Management of Childhood Illness (IMCI) guideline is a key World Health Organization intervention aimed at reducing under-five mortality. Most primary care consultations are with professional nurses and they are usually trained in IMCI in a year-long primary healthcare diploma, which qualifies them to be a clinical nurse practitioner. This study aimed to evaluate the effect on training outcomes of introducing an automated IMCI guideline. Methods: Thirty professional nurses enrolled for the diploma course were purposively allocated in a quasi-experimental design to train with either paper-based or automated versions of the guideline. Their knowledge of IMCI was evaluated before and after the initial 12 hours of classroom teaching. Data on assessment, classification and management of children was extracted from the medical records of their consultations during supervised clinical training. Results: Both groups improved their knowledge of IMCI, but were not significantly different at the end of classroom teaching. Nurses in the automated group performed significantly better in use of the IMCI guideline (p < 0.05): checking immunisations (68% vs. 93%), making a complete assessment (62% vs 100%), prescribing correct medication (50% vs 85%) and correct dose (42% vs 85%). Conclusion: Use of automated IMCI guidelines showed potential for improved training outcomes. The potential for improved quality of care and clinical outcomes needs to be further studied along with a cost-benefit analysis. [ABSTRACT FROM AUTHOR]

Aims This paper describes the perceptions of nurse managers about their dual role in nursing units as cost centres. Background The tertiary hospital in the Limpopo province is the first institution to appoint nurse managers with a dual role in cost centres. The development of a conceptual framework for a context-specific programme for Cost Centre Managers is the first of its nature in South Africa. Method A qualitative, exploratory, descriptive design was followed. The target population included nurse managers ( n = 35) formally appointed as cost centre managers with a dual role of delivering quality care and cost management. A focus group and individual interviews were conducted until data saturation occurred. Results Personal and professional distress, an empowering potential of being a cost centre manager, and the need for decentralized cost centre management were indicated as barriers for nurse managers that led to a framework for a context-specific training programme. Conclusion There is a need for a context-specific training programme for cost centre managers in a hospital with cost centres. Implications for nursing management The training of cost centre managers for their dual role in cost centres could enhance cost effectiveness, quality care and staff satisfaction. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to explore and describe health promotion strategies for adolescents orphaned by human immunodeficiency virus ( HIV) and acquired immunodeficiency syndrome ( AIDS), as well as the evaluation thereof. Introduction and Background Among the Sub- Saharan countries, such as Swaziland, Botswana and Lesotho, South Africa is rated as fourth in the list of countries with the highest number of people living with HIV and AIDS. Method The study employed phenomenological qualitative design. The population consisted of the purposively selected health promoters working in the Hammanskraal region, directly and indirectly involved with families with adolescents orphaned by HIV and AIDS. Following the focus group interviews, data were analysed using the seven steps of Colaizzi. Results Four categories and eight subcategories were concluded as the strategies for adolescents orphaned by HIV and AIDS as well as the evaluation thereof. The main categories identified were: the door-to-door outcome, workshop outputs, statistical data and community projects. Discussion It is evident that the health promotion strategies informed by the four themes will be implemented. The outcomes may raise an awareness in the community, support families and provide statistics on the impact of HIV and AIDS on families. Study Limitations The study was limited to one subdistrict and to health promoters in a rural area, therefore the results cannot be generalized to all other subdistricts including health promoters, especially those in urban areas. Conclusion The successful evaluation programme will pin out the strong points and challenges while assisting in improving the quality of work provided in the communities. Implication for nursing and health policy Continuing professional and practice development are required to maintain the standard of health care in South Africa. Therefore the policymakers need to include relevant information regarding health promotion strategies in reducing the statistics of people living with HIV and AIDS. [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: The study reported here formed part of a larger study that explored the experiences of health-care workers providing palliative care in patients' homes in rural South Africa. This paper hones in on the experiences of male caregivers. Zulu culture has been strongly patriarchal and the gender of a caregiver may affect both patients' and caregivers' experiences. Methods: The study was exploratory, qualitative, and combined a visual methodology with unstructured interviews. The setting was a hospice and three home-based care organisations in rural KwaZulu-Natal, South Africa. Participants were a male Zulu nurse and two male informal home-based caregivers who have been trained in components of palliative care. Results: These male caregivers appeared to care deeply and altruistically for their patients and appeared to provide gender-appropriate care for male patients. Female patients were wary of being cared for by a man, for example having concerns that male caregivers may perpetrate physical abuse, including rape. Thus, challenges of being a male caregiver included the potential to not be appreciated by and/or to be subject to physical and verbal abuse from the community they serve. Conclusions: This study contests South African literature that presents male caregivers in a negative way. It emphasises a need to value and support male caregivers. The challenges faced by male caregivers are largely unexplored and further research is required as men could potentially play a valuable part in providing palliative care in rural homes. [ABSTRACT FROM AUTHOR]

Abstract: Mitigation of the tuberculosis (TB) and HIV syndemic is undermined by critical clinical, operational and social challenges of which the social aspects have been least explored. This paper examines the lived experience of TB disease and HIV from the perspective of affected individuals to analyze how they may think about their dual illness; how they understand their illness with TB in relation to HIV, and vice versa; and how they characterize their (stigmatized) experiences in the context of their perceptions and identities. From February–August 2009, qualitative, semi-structured interviews were conducted with 40 adults with HIV and TB disease at three ambulatory clinics in KwaZulu-Natal, South Africa. Subjective meanings of illness experience were analyzed using modified grounded-theory. Emergent themes on illness perception and disclosure revealed how patients constructed dichotomous identities associated with TB and HIV through social constructs of moral susceptibility and (im)permanence. Each identity was associated with relatively disparate degrees of stigma as a product of labeling, negative stereotyping and discrimination. HIV bore the least desirable identity and invoked the greatest stigma. However, the confluence of the two epidemics rendered TB symbolic and symptomatic of HIV, and enhanced the visibility of AIDS. Dual illness thus introduced a paradox to patients'' identity constructions, and produced a unique, overlapping double stigma. This facilitated new forms of stigma against TB, and aggravated existing stigma against HIV. It also conferred visibility to some forms of extra-pulmonary TB. Patients managed their double stigmas through novel forms of information sharing that relied on segregating their dual illness identities. Patients deflected the dominant stigma of HIV through concurrent processes of HIV ‘othering’ – their symbolic distancing from persons affected by HIV, and ‘covering’ – their selective disclosure of illness (and identity associated) with TB over that of HIV. Findings call for greater consideration to the complex role of stigma in the delivery of TB/HIV healthcare. [Copyright &y& Elsevier]