Search

Abstract Background The human immunodeficiency virus (HIV) and acquired immunodeficiency deficiency syndrome (AIDS) epidemic have left an overwhelming impact on communities worldwide, particularly in Sub-Saharan Africa, where its effects on family structures are particularly pronounced. Caregivers of HIV/AIDS orphans encounter challenges in fulfilling their caring duties. Consequently, they rely on the outreach team leaders (OTLs) for support to care for HIV/AIDS orphans. Aim This study aimed to explore and describe support provided by OTLs to caregivers of HIV/AIDS orphans in the North West Province of South Africa. Methods The exploratory, descriptive, and contextual design meaning the study was conducted was in the contexts where caregivers of HIV/AIDS orphans reside. The study was conducted in five local municipalities in the Ngaka Modiri Molema district of the North West Province of South Africa. Ward-based outreach nurses were participants in the study. Semi-structured focus group interviews were used for data collection. Thematic analysis was used to analyze data. Throughout the study, ethical principles were adhered to. The study also adhered to four trustworthiness principles: credibility, confirmability, transferability, and dependability. Results Three main themes emerged from this study: the conduction of home visits to caregivers of HIV/AIDS orphans, the coordination of a multidisciplinary team for support, and the facilitation of support groups. Conclusions This study revealed that that caregivers of children orphaned by HIV/AIDS benefitted from the support provided by OTLs in the North West province of South Africa. The support provided by OTLs harnessed positive relationship between caregivers and children orphaned by HIV/AIDS.

No abstract available.

Background: Cerebral palsy affects children’s movement and posture because of damage to the brain’s development. Care assistants in healthcare facilities provide care to children. Caring for the children is overwhelming, hence support is required. Such support is absent, causing frustration among care assistants, which leads to poor quality care for children. Objectives: To explore and describe the experiences of care assistants of children admitted with cerebral palsy in healthcare facilities of the Gauteng province, and to develop a support programme for care assistants. Method: A qualitative, exploratory, descriptive, and contextual research design was used. Participants were selected from healthcare facilities in Gauteng province. Semi-structured interviews were used to collect data. Content data analysis was used to analyse data. The results were used to develop a support programme for care assistants. Results: Three themes emerged, namely, a lack of training opportunities, a lack of resources, and a lack of support. The results were used to develop a support programme, using the three steps of the Donabedian model for care: structure, process and outcome. Conclusion: Care assistants are not given training opportunities, work with limited resources and are not supported, hence the development of a support programme. If effectively utilised, the programme can lead to staff satisfaction and improvement of quality care for children. Contribution: The study enabled managers in healthcare facilities to see the need for policy and the need for support strategies for care assistants. A support programme was further developed.

Background: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a pandemic that has affected families and left many children orphaned worldwide. After the death of their parents, HIV/AIDS orphans are often taken care of by caregivers who are faced with overwhelming challenges that affect their capabilities to perform caring tasks. It has been reported that caregivers of HIV/AIDS orphans use different coping mechanisms to deal with the challenges faced during caring. Coping mechanisms play an integral role in maintaining individuals’ physical and mental well-being, particularly those caring for orphans. This study explored coping mechanisms used by caregivers of HIV/AIDS orphans. Methods: A qualitative design was adopted, and individual semi-structured interviews were used to collect data from 13 caregivers of HIV/AIDS orphans in North West province. Non-probability purposive sampling was used to select the participants. Thematic analysis was used to analyze data. Rigor was maintained throughout the study. Results: Three main themes were identified with eight subthemes. The first theme includes support from significant others, and subthemes are family support, neighbour support, and life partner support. The second main theme emerged from this study was religious practices and two subthemes namely singing gospel songs and using prayer to cope. The third main theme identified includes the use of social support services, and subthemes were government support, support from local schools, and stokvels and social clubs. Conclusion: The identified coping mechanisms in this study improved caregiving skills of caregivers to better care for children orphaned by HIV/AIDS.

Background: This research addressed the need to have a deeper understanding of nursing students’ experiences of clinical placement and support in primary healthcare (PHC) settings. Aim: To explore and describe the experiences of nursing students’ clinical placement in PHC settings. Setting: The study was conducted at PHC clinics in a specific province in South Africa. Method: A qualitative, exploratory, descriptive and contextual research design was used. The population comprised fourth-year nursing students selected using purposive sampling. Five semi-structured focus group interviews were conducted. Data saturation determined the sample size which comprised 25 nursing students. Thematic data analysis produced four main themes. Results: The main themes were (1) the meaning of placement, (2) experiences of clinical placement, (3) needs for support, and (4) resilience of nursing students. Conclusions: Nursing students encountered negative and positive experiences. Both experiences confirmed that PHC settings can be valuable learning opportunities for nursing students. Nursing students appreciated the supervision of professional nurses who created an atmosphere conducive for teaching and learning by welcoming and encouraging nursing students’ independence. Recommendations include: appointing a professional nurse specifically for supervision of nursing students, tutor support before summative examinations, improvement of services, including the availability of resources. Contribution: This article contributes to awareness of how nursing students manage to stay resilient irrespective of negative experiences during clinical placement and how tutors and professional nurses can support them. The study’s recommendations can guide professional nurses, nurse educators, nurse managers and other healthcare PHC workers to support nursing students.

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Café” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical) definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982–2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.

Background: Professional nurses employed in trauma units encounter numerous stressors in their practice environment. They use different strategies to cope with this stress, including venting traumatic information to their partners and other family members. Aims: To describe how partners of professional nurses cope with traumatic information being vented to them. Methods: A qualitative research method with an interpretive descriptive inquiry design was used to explore, interpret and describe the coping experiences of the nurses’ partners. Purposive sampling was used to select a total of 14 partners, but only ten participated in semi-structured interviews. Tesch’s eight steps of open coding were used for data analysis. Results: Four main themes were identified indicating adaptive and maladaptive coping skills, namely partners’ experiences of traumatic information vented to them; partners’ coping activities; reciprocal communication and relationship support between partners and nurses; and resilience of partners to deal with the nursing profession. Conclusion: Partners employed different ways to cope with traumatic information. It was essential for partners and nurses to be supported by nurses’ practice environments and to develop resilience to fulfil reciprocal supportive roles in their relationships.

Background: Research on coping and resilience is on the rise. However, there is a paucity of information addressing strengths, assets, competence or resilience that enable nurses to remain committed and cope in their profession despite the adversities they face in their working environment. Objective: The purpose of this research was to explore and describe how to strengthen the resilience of nurses in a work environment with involuntary mental health care users. Method: An exploratory and descriptive research design, which is contextual in nature, was used. Results: Narrative responses to two open-ended questions (How do you cope with providing mental health care to involuntary admitted mental health care users? and; How can your resilience be strengthened to provide mental health care to involuntary mental health care users?) yielded coping mechanisms and resilience strengthening strategies. Conclusion: Nurses caring for involuntary mental health care users are faced with challenging situations while they themselves experience internal conflict and have limited choices available to be assertive. To strengthen their resilience, the following factors should be taken into account: support, trained staff, security measures and safety, teamwork and in-service training and education.

Background: A shortage of nurses caring for older persons is experienced due to adverse working conditions. Resilience might empower nurses to persevere while caring for older persons. Research regarding the resilience of nurses caring for older persons is scarce. Objectives: The objectives were to explore and describe the strengths and coping abilities of nurses caring for older persons and to formulate recommendations to strengthen their resilience. Methodology: An explorative, descriptive qualitative research design was used. An allinclusive sample of nurses caring for older persons in an urban setting in the North West Province, South Africa, participated in the study. During phase one, demographic information was obtained, and narratives were written (n = 43). Four focus group interviews were conducted in phase two (n = 17) and recommendations were formulated in phase three. Content analysis was used. Principal results: Participants experienced adverse working circumstances while caring for older persons and they needed resilience to balance the emotional nature of the work, work ethics, staff shortages, physical demands of the work and the dependency of the older persons. These nurses used personal, professional, contextual and spiritual strengths to handle adverse working conditions. Conclusions: By applying their personal, professional, contextual and spiritual strengths, nurses could further enhance these strengths and possibly their resilience. The participants' identified strengths were used to formulate recommendations to strengthen resilience of nurses caring for older persons.

Background: Although families caring for a mentally-ill family member may experience challenges, some of these families may display strengths that help them to overcome difficulties and grow even stronger in caring for their family member. In cases where these families are unable to cope, the mentally-ill family member tends to relapse. This indicated the need to explore the strengths of families that cope with caring for mentally-ill family members. Objective: The purpose of this study was to explore and describe the strengths of families in supporting mentally-ill family members in Potchefstroom in the North-West Province. Method: A qualitative, explorative, descriptive and contextual design was employed, with purposive sampling and unstructured individual interviews with nine participants. Tesch’seight steps of thematic content analysis were used. Results: Twelve themes emerged from the data. This involved strengths such as obtaining treatment, utilising external resources, faith, social support, supervision, calming techniques, keeping the mentally-ill family member busy, protecting the mentally-ill family member from negative outside influences, creative communication, praise and acceptance. Conclusion: Families utilise external strengths as well as internal strengths in supporting their mentally-ill family member. Recommendations for nursing practice, nursing education and for further research could be formulated. Psychiatric nurses should acknowledge families’ strengths and, together with families, build on these strengths, as well as empower families further through psycho-education and support.

Background: Interventions have been developed and implemented to reduce the stigma attached to mental illness. However, mental healthcare users are still stigmatised. Objective: The objective of this study was to critically synthesise the best available evidence regarding interventions to reduce stigma attached to mental illness. Method: An exploratory and descriptive research design was followed to identify primary studies; systematic review identifid primary studies answering this research question: What best evidence is available regarding interventions to reduce the stigma attached to mental illness? A search was done on selected electronic databases. Seventeen studies (n = 17) were identifid as providing evidence that answered the research question. The following instruments were used: Critical Appraisal Skills Programme, John Hopkins Nursing Evidence-Based Practice research evidence appraisal tool and the Academy of Nutrition and Dietetics Evidence Analysis Manual. The study was submitted to the Post-graduate Education and Research Committee of the School of Nursing Science at Potchefstroom Campus of North-West University for approval. Results: Results indicated some interventions that reduce the stigma attached to mental illness, such as web-based approaches, printed educational materials, documentary and antistigma fims, as well as live and video performances. Conclusions: Humanising interventions seems to have a positive effect on reducing stigma attached to mental illness. From the results and conclusions recommendations were formulated for nursing practice, nursing education and research. Agtergrond: Ingrypings is ontwikkel en geïmplementeer om die stigma verbonde aan geestesongesteldhede te verminder. Die persone wat aan geestesongesteldhede ly, ondervind egter steeds dat daar 'n stigma aan hulle kleef. Doelstellings: Die doel van die studie was om die beste beskikbare voorbeelde van intervensies om stigmatisering van geestesongesteldhede te verminder, krities saam te vat. Metode: ’n Verkennende en beskrywende navorsingsontwerp is gevolg om primêre studies te identifieer. ’n Sistematiese oorsig is gekies as metode om primêre studies te identifieer om die volgende navorsingsvraag te beantwoord: Wat is die beste beskikbare voorbeelde van ingrypings om die stigma verbonde aan geestesongesteldhede te verminder? ’n Ondersoek is gedoen op ’n uitgesoekte elektroniese databasis. Resultate: Tydens die keuring van studies is 17 studies geïdentifieer (n = 17) as bewyslewering en wat die navorsingsvraag beantwoord. Die volgende instrumente is gebruik: ‘Critical Appraisal Skills Programme’, ‘John Hopkins Nursing Evidence-Based Practice’, ‘Research Evidence Appraisal Tool and Evidence Analysis Manual’, en ‘Academy of Nutrition and Dietetics’. Gevolgtrekking: Die studie is aan die Nagraadse Onderrig- en Navorsingskomitee van die Skool van Verpleegkunde van die Potchefstroomkampus, Noordwes-Universiteit, voorgelê vir goedkeuring. Aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing.

Background: Non-compliance to treatment remains one of the greatest challenges in mental healthcare services, and how to improve this remains a problem. Aim: The aim of this study was to critically synthesise the best available evidence from literature regarding interventions to promote psychiatric patients’ compliance to mental health treatment. The interventions can be made available for mental health professionals to use in clinical practice. Method: A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were critically appraised and identifid as answering the research questions. Evidence extraction, analysis and synthesis were then conducted by means of evidence class rating and grading of strength prescribed in the American Dietetic Association’s manual. Results: The systematic review identifid several interventions that can improve patients’ compliance in mental health treatment, for example adherence therapy and motivational interviewing techniques during in-hospital stay. Conclusions: Conclusions were drawn and recommendations formulated for nursing practice, education and research. Agtergrond: Geen-samewerking met behandeling bly steeds een van die grootste uitdagings in geestesgesondheidsorgdienste, en genoegsame kennis oor hoe om dit te verbeter, is steeds ’n probleem. Doelwit: Die doel van hierdie studie was om die beskikbare bewyse vanuit literatuur aangaande intervensies ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling krities te sintetiseer. Hierdie intervensies kan aan professionele gesondheidsorgpersoneel beskikbaar gestel word ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling. Metode: ’n Sistematiese literatuuroorsig is gekies as die ontwerp om primêre studieste identifieer wat die volgende navorsingsvraag beantwoord: Wat is die huidige kennis ten opsigte van intervensies wat psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling bevorder? Resultate: Studies is ingesluit vir kritiese gehalte-beoordeling ten opsigte van metodologie, en is uiteindelik geïdentifieer as bronne van bewyse wat die literatuuroorsigvraag toepaslik beantwoord. Bewysonttrekking, -analise en -sintese is gedoen deur middel van die beoordeling van bewysklas en -gradering van bewyssterkte, soos voorgeskryf in die American Dietetic Association se handleiding. Die sistemiese literatuuroorsig het aangedui dat daar heelparty intervensies is wat psigiatriese pasiënte se samewerking met behandeling kan verbeter, byvoorbeeld samewerkingsterapie en motiveringsonderhoudstegnieke. Gevolgtrekking: Gevolgtrekkings is gemaak en aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing in verpleging.

Background: New research findings, changes in legislation and the use of information technology in nursing, require continuous in-service training of psychiatric nurses to cope with, reflect on and modify their clinical practice based on emerging knowledge. Many international studies have been conducted on the importance of in-service training and authors agree that in-service training improves the quality of nursing care. However, few studies have been conducted on in-service training in South Africa and psychiatric nursing. Objectives: The objectives of the study were to explore and describe the needs and benefits of in-service training for psychiatric nurses; and to formulate recommendations for in-service training. Method: The research project followed a qualitative, explorative, descriptive and contextual approach. Six focus group interviews were conducted and the following questions were asked: ‘What are your in-service training needs as psychiatric nurses?’, ‘What are the benefits of doing in service training?’ and ‘What can be done to ensure that in-service training is done continuously?’ Data were analysed through the use of content analysis and Tesch’s eight steps of data analysis were used. Results: The findings of this research included three main themes, namely, that on-going in-service training is necessary, in-service training is beneficial to psychiatric nurses and that challenges exist with regard to in-service training. Conclusion: The findings confirmed the need for ongoing in-service training which has many advantages for psychiatric nurses. Aspects that hinder in-service training need to be addressed by planning ahead and by implementing the recommendations as identified by the psychiatric nurses and their managers. Agtergrond: Nuwe navorsingsbevindinge, veranderinge in wetgewing en die gebruik van inligtingstegnologie in verpleegkunde, vereis deurlopende indiensopleiding van psigiatriese verpleegkundiges om hulle kliniese praktyk soos gebaseer op opkomende kennis, te hanteer, daarop te reflekteer en dit aan te pas. Internasionaal is daar baie studies gedoen oor die belang van indiensopleiding en outeurs stem saam dat indiensopleiding die kwaliteit van verpleegsorg verbeter. Daar is egter nog net ’n paar studies oor indiensopleiding in Suid-Afrika en psigiatriese verpleegkunde gedoen. Doelwitte: Die doelwitte van die studie was om die behoeftes en voordele van indiensopleiding vir psigiatriese verpleegkundiges te verken en te beskryf en om aanbevelings te formuleer vir indiensopleiding. Metode: Die navorsingsprojek het ’n kwalitatiewe, verkennende, beskrywende en kontekstuele benadering gevolg. Ses fokusgroeponderhoude was gedoen en die volgende vrae was gevra: ‘Wat is jou indiensopleiding behoeftes as ’n psigiatriese verpleegkundige?’, ‘Wat is die voordele daarvan om indiensopleiding te doen?’ en ‘Wat kan gedoen word om te verseker dat indiensopleiding deurlopend gedoen word?’. Data was ontleed deur die gebruik van Tesch se agt stappe van data analise. Resultate: Die bevindinge van die navorsing sluit drie hooftemas in, naamlik, dat deurlopende indiensopleiding is nodig, indiensopleiding is voordelig vir psigiatriese verpleegkundiges en daar is verskeie uitdagings in indiensopleiding. Gevolgtrekking: Die bevindinge bevestig die behoefte aan indiensopleiding wat baie voordele het vir psigiatriese verpleegkundiges. Aspekte wat indiensopleiding verhinder moet aangespreek word deur vooruit te beplan en deur aanbevelings, soos geïdentifiseer deur psigiatriese verpleegkundiges en hulle bestuurders, te implementeer.

The literature and practice show that many professional nurses feel emotionally overloaded and are experiencing job dissatisfaction, which often results in them leaving the profession. Paradoxically, some nurses choose to remain in nursing and survive, cope and even thrive despite their unique workplace adversities. It is, however, not known what the prevalence of resilience amongst nurses is, and what influence working in private versus public contexts has on this resilience. The aims of this study were to determine the prevalence of resilience in a group of professional nurses, to determine whether private versus public contexts played a role in nurses’ resilience, and to obtain an indication of participants’ views of their profession and resilience therein. A cross-sectional survey design was used where professional nurses (N = 312) working in public and private hospitals in South Africa voluntarily completed measures of psycho-social well-being as indicators of their degree of resilience. They also answered three open-ended questions on their profession. Results showed moderate-tohigh correlations amongst scales, indicating conceptual coherence as indicators of resilience. Prevalence of resilience was determined by normalising the mean scores of the measuring instruments. The total value of the normalised mean scores was given as a fraction (0−1), representing a level of resilience manifested by the participants across all scales. This indicated three levels of resilience: 10% of participants manifested low resilience, 47% moderate resilience and 43% high resilience. Nurses in private health care had significantly (small practical effect) higher levels of resilience than nurses in public health care. Opsomming Die literatuur en praktyk dui daarop dat baie professionele verpleegkundiges emosioneel uitgeput is, werksontevredenheid ervaar en dikwels die beroep verlaat. Paradoksaal kies sommige verpleegkundiges om in die beroep te bly, en floreer selfs ten spyte van hul unieke en moeilike werksomstandighede. Dit is egter nie bekend wat die voorkoms van veerkragtigheid in verpleegkundiges is nie, of wat die invloed van werk in privaat versus die openbare omgewing op veerkragtigheid is nie. Die doelwitte van die studie was om die voorkoms van veerkragtigheid in ‘n groep professionele verpleegkundiges te bepaal, om die rol van privaat versus openbare omgewings in veerkragtigheid te bepaal, en om ‘n aanduiding van deelnemers se siening oor hul professie en veerkragtigheid daarin, te bekom. ‘n Dwarsdeursnit ontwerp was gebruik waarin professionele verpleegkundiges (N = 312) werksaam in openbare of privaat hospitale in Suid-Afrika vrywillig vraelyste oor psigososiale welstand as aanduiders van die vlak van veerkragtigheid, voltooi het. Hulle het ook drie oop-einde vrae oor hul beroep beantwoord. Bevindinge het op matige tot hoë korrelasies tussen skale gewys wat dui op konseptuele koherensie tussen die indikatore van veerkragtigheid. Veerkragtigheid is bereken deur normalisering van die gemiddelde tellings vir die meetinstrumente van al die skale. Die totale waarde van genormaliseerde gemiddeldes was as ‘n fraksie (0−1) uitgedruk. Drie vlakke van veerkragtigheid het gemanifesteer, 10% van die deelnemers het met lae veerkragtigheid gemanifesteer, 47% met matige veerkragtigheid en 43% met hoё veerkragtigheid. Verpleegkundiges in privaat gesondheidsorg het beduidende (klein praktiese waarde) hoёr vlakke van veerkragtigheid getoon as verpleegkundiges in openbare gesondheidsorg.