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Mental health care users (MHCUs) living with schizophrenia experience an altered reality with regard to cognition and perceptions. Research shows that between 37% and 58% of patients diagnosed with schizophrenia relapse due to poor treatment compliance; lack of insight into their illness; and non-adherence to medication. The aim of the current study was to explore and describe the views of family members on preventing and managing relapse of MHCUs, and their support needs with regard to preventing and managing relapse of MHCUs at a selected government psychiatric hospital in Gauteng, South Africa. An exploratory, descriptive and contextual research design was followed. Fourteen family members of MHCUs were purposively sampled from the hospital outpatient department. Data was collected through in-depth individual interviews. Ethical considerations were adhered to, and approval was obtained from the Institutional Review Board and gatekeepers. Written informed consent was obtained from each participant. The findings of the study indicated that violence, financial burden, emotional burden and stigmatisation by the community were challenges experienced by family members. The family members were of the view that substance use and non-adherence led to relapse of MHCUs. Thus, the family members viewed themselves as a source of emotional support who provided supervision and monitoring. Enhanced health care provider support and improved health care services to MHCUs and their family members are needed. Relapse could be addressed by means of a holistic integrated and multidisciplinary approach to the care, treatment and rehabilitation of MHCUs.

Higher education institutions (HEIs) are challenged by increased costs, low student success rates, and a changed educational environment. A continuous exploration of possible solutions to these challenges is therefore required. The HEI concerned encountered similar challenges in ensuring nursing students’ success. The purpose of this study was to explore the views of lecturers and senior nursing students regarding selection characteristics and to make recommendations regarding student characteristics. A qualitative, explorative, and descriptive design was used to collect data purposefully from lecturers and students. Five semi-structured interviews were conducted with lecturers and two World Café discussions were held with 19 senior students. Trustworthiness measures and ethical principles were applied. This article aims to share the views of lecturers and senior students on selection characteristics that may enhance the success of students in a nursing programme to inform further research. The findings suggest that personal characteristics such as a caring attitude, resiliency, commitment, and conflict management skills are important. An acceptable performance at secondary school level and in specific secondary school subjects is suggested. A fair selection process should include an interview and a psychometric test. It is recommended that all candidates be tested for specific personal characteristics for the purpose of risk identification and support, but not as selection criteria. Further research is required to determine the predictive value that these characteristics and the selection process have for academic success.

Background: The articulation of the scope of practice in nursing is important to provide boundaries for registered nurses in which to practice. Registered nurses in Botswana have frequently experienced challenges and raised concerns with their scope of practice. Research related to registered nurses’ knowledge, attitudes and practice regarding their scope of practice appears to be limited in the African context, particularly in Botswana.Aim: The aim of this study was to develop guidelines for professional nurses to explore and describe registered nurses’ knowledge, attitude and practice regarding their scope of practice in Botswana.Methods: A convergent parallel mixed-methods design was employed using a three-tier sampling approach to ensure a representative sample of various settings, health facilities and nurses. For the purpose of this article, the data from the qualitative component are reported. Thirty registered nurses, working in the public health sector in Botswana, participated in semi-structured interviews. Data were analysed using thematic content analysis.Findings: Data analysis revealed that registered nurses’ scope of their knowledge was lacking. Registered nurses’ attitudes were reflected in the adaptation process to expanded practice, as demonstrated through emotive aspects, adjustments to practice beyond scope and the learning of new skills considered beyond scope. Participants reported implementing many skills deemed beyond their scope, whilst their motive to do so included their experience of a lack of control over practice, lack of resources or they were doing so out of consideration for the patient. Guidance in terms of their scope was found to be inadequate.Conclusion: As in other resource-limited countries in Africa, registered nurses in Botswana experience challenges with their scope of practice. Inadequate boundaries may result in compromised nursing care and may have detrimental consequences for both the patient and the nurse.

Nursing students face numerous challenges and stressors related to the dynamics within the academic, psycho-social, and health care environments. Peer mentoring has the potential to support nursing students with these challenges by providing academic and psychosocial support, which may increase retention in the programme and student wellbeing. The focus of this article is on peer mentors’ and mentees’ views of professional relationships as an essential requirement to create and maintain an effective peer mentoring programme. The aim of the study is to support the design and implementation of a peer mentoring programme to enhance students’ academic success in an undergraduate nursing programme. It is thus important to determine students’ views about the relationship that would create a supportive environment for them. A descriptive qualitative research design was used. A purposive sample of 20 participants participated in semi-structured individual interviews and focus groups with peer mentors and mentees in an undergraduate nursing programme. Measures to ensure trustworthiness and ethical research were implemented. The importance of professional relationships as the glue that holds a peer mentoring programme together emerged. In order to establish the professional relationship, participants explained the importance of boundaries in the relationship, commitment toward the programme by all role players, and the qualities required of a mentor. Recommendations were made for training mentors and mentees in establishing and maintaining boundaries, negotiating relationship contracts, and developing the qualities required of mentors.

Over the years, extensive task shifting and sharing has taken place in nursing. In several countries, especially Botswana and other African countries, nurses are often responsible for duties and interventions they consider to be beyond their Scope of Practice (SoP) or regard as ‘non-nursing’ tasks. Issues and concerns affecting SoP may have considerable impact on the quality of care and welfare of nurses. The aim of this article is to present the results of a literature review regarding the Scope of Practice of Registered Nurses. Method: A literature search was performed, using the following internet databases EbscoHost, Nursing@Ovid and Google Scholar. ResearchGate, Science Direct, Sage and Sabinet were also consulted, as well as websites of professional organizations and the Botswana Collection at the University of Botswana Library. Articles published in English between 2000 and 2018 were reviewed. Key search concepts included: scope of practice of nurses and knowledge, attitude, practice and regulation. Findings and discussion: Knowledge of nurses regarding their SoP appears variable and attitudes are usually positive, as long as scope expansion is congruent with legislation. Literature illustrates that nurses regularly practise outside their scope, either beyond or below, whereas SoP may overlap, both intra-disciplinary as well as interdisciplinary. Although the SoP of nurses appears to be regulated in many countries, regulation often appears insufficient to meet the evolving nature of the nursing profession. Conclusion: In the current changing worldwide health arena, scoping issues remain relevant and warrant imminent attention. Keywords: Scope of practice of nurses, Knowledge, Attitude, Practice, Regulation

Background: The increase in nurses enrolling in postgraduate programmes as well as the need to improve their completion requires academics to establish environments conducive for postgraduate studies. The challenges experienced during postgraduate studies have to be identified to establish conducive environments. Objective: The objective of this study was to explore and describe the challenges experienced by postgraduate nursing students enrolled in postgraduate coursework and research programmes at a South African university. Methods: An exploratory, descriptive and qualitative design was used. The study was contextual in nature. Purposive sampling was used. Fifteen honours, master’s and doctoral students participated in the study. Data were analysed through qualitative content analysis and measures to ensure trustworthiness, and ethical implementation of the study were implemented. Results: Three themes with categories were identified, namely personal challenges (i.e. finances, employment, family and accommodation), academic and institutional challenges (i.e. workload and time constraints, contact sessions, subject information and assessment) and research-related challenges (i.e. information literacy, supervisory relationship and supervisory structure and process). Conclusion: Institutional support addressing personal, academic and research-related challenges should be provided to enhance student experiences and completion.

Ethics and health care in South Africa is largely influenced by biomedical ethical principles and Western values, concepts and theories. The history and highlights in nursing ethics in South Africa has not been well documented. Colonising thinking and actions are spread throughout the nursing profession with the indigenous worldview under-examined in ethics in nursing. There is minimal incorporation of postcolonial concepts, specifically about ethics and indigenous knowledge in health care. For nursing to remain relevant in South Africa decolonisation is critical. The decolonisation process involves, among others asserting and stimulating discussions about indigenous knowledge to reveal the abundance and richness of indigenous languages, worldviews, teachings and experiences. Decolonising of nursing, health care and nursing ethics within the context of the nursing profession is critical to address the current health challenges faced by the population of South Africa.

Introduction The quality of the relationship between postgraduate students and their supervisors often determines the progress of the students. Background Successful supervision according to students is associated with the expertise of the supervisors and their willingness to share their knowledge with their students. On the other hand, supervisors expect their students to be able to work independently to a large extent. Contradictory expectations of supervisors and postgraduate students can cause delays in the progress of students. Aim The aim of this study was to explore and describe the aspects of the supervisory relationship that postgraduate students in nursing science at a selected university in South Africa appreciate. Method A qualitative research design with an appreciative inquiry approach was used and 18 students under the guidance of an independent facilitator provided the data during group interviews. Findings and discussion Specific personal and professional qualities of the supervisors contribute to a valued supervisory relationship. Regarding personal qualities, the supervisors should show their understanding of the unique circumstances of the students in challenging times. Supervisors should also be expert researchers. The valued relationship refers to an open and trusting relationship between the students and the supervisors. Conclusion The students' appreciation of the research supervisory relationship contributes to the understanding of the expectations of postgraduate students regarding the support that they need to become scholars in an academic discipline. Implications for nursing and health policy There is a need for continuing professional development of supervisors to sensitize them about the expectations of the students.

Background Intrapersonal, interpersonal, social and economic factors associated with chronic mental illness influence mothers' parenting abilities which in turn influence childhood mental health. Aim The aim of the study was to explore and describe the parenting experiences of mothers with a chronic mental illness. Methods An explorative, descriptive and qualitative research design was used. Ten participants were purposively sampled until saturation occurred. Data was collected using in-depth individual interviews and a content analysis was carried out. Results Mothers with a chronic mental illness experienced various challenges and expressed their family support needs. Conclusion A family-centred approach to mental healthcare, treatment and rehabilitation is proposed.

Background: The ability to consent promotes children’s access to health services. Healthcare providers should assess and arrive at a clinical judgement about the child’s maturity and mental capacity to obtain valid consent. Research objective: The objective of the study was to determine practices employed by South African healthcare providers to obtain consent for treatment from children. Research design: A qualitative, explorative, descriptive research design was used and the study was contextual. Participants and research context: In all, 24 healthcare providers (professional nurses and medical practitioners) were purposively sampled from a hospital and primary health clinics. Semi-structured interviews were used. Ethical consideration: Ethical approval was obtained from the Institutional Review Board and gatekeepers. Written informed consent was obtained from each participant. Findings: Healthcare providers’ current practices in obtaining consent from children revealed inconsistency in implementation as well as the yardstick used to determine children’s mental capacity. Building trust with children, sharing information and assessment were interlinked in obtaining consent. Discussion: The inconsistent practice has implications for children’s access to healthcare services. Conclusion: Inconsistent practices in the implementation of consent laws have the potential to violate children’s rights to bodily and psychological integrity, access to health services and having their opinions heard and be taken into consideration. Through uncovering the current perceptions and practices and a literature review, guidelines intended for use by the Department of Health could be developed.

Model development may seem a daunting task for the novice. The purpose of this article is to illustrate the steps of model development applied to a real-life phenomenon using an inductive theory-generating research approach. The value of the illustration is that nurse researchers can follow the application of the process as a point of departure for their own work. A logical stepwise discussion is followed for empirical theory development. The logical thought process from identifying the phenomenon to describing the model as a visual metaphor of the phenomenon is illustrated.

Of all hospital staff, nurses are the most exposed to violence in the workplace that can cause long-term negative effects. The purpose of this study 'is to increase the understanding of violence against nurses in acute care psychiatric wards in a Gauteng hospital to promote the nurses mental health. A qualitative, explorative, descriptive and contextual research design was used by purposively sampling nurses who had experienced violence. Semi-structured individual interviews were conducted. Nurses had experienced physical, sexual and psychological violence and perceived the risk factors of violence to be mental health care user-related. They described the physical and emotional effects of the violence they experienced. Recommendations are made to prevent violence and manage incidents after their occurrence to promote nurses mental health.