Masters Degrees (Nursing)

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Identifying contributory factors to adolescents’ late utilisation of antenatal care at primary healthcare clinics in a sub district north of eThekwini District, South Africa.
(2020) Reddy , Preantha.; Baloyi , Olivia Baorapetse.; Jarvis , Mary Ann.
Background The late utilisation amongst adolescents of Antenatal Care (ANC) has shown to be detrimental to the pregnancy and the mother as inappropriate screening, testing and management is done due to delayed initiation. This is especially so, in the vulnerable population of adolescents where they are more susceptible which can contribute to maternal and child mortality. The adolescent is exposed to many challenges during pregnancy that can affect their utilisation of ANC, resulting in late booking. Aim The aim of the study was to identify the contributing factors to the adolescent’s (15-19 years) late entry to ANC at the select Primary Health care clinics. Methodology A quantitative study was conducted with self-administered questionnaires to adolescents who had booked late (>20 weeks) for ANC. The questionnaire was adapted to identify the contributory factors to the late utilisation of ANC with adolescents in which the variables socio-economic factors, knowledge of ANC, experiences of ANC services and obstetrical history were examined. The questionnaire was structured to maintain anonymity and had asked short ended questions and has Likert scales. Content and face validity was used to verify the questionnaire and show evidence that the tool is measuring the target construct. Face validity was obtained with the help of three health care experts (Medical officer, Nursing service manager and Midwife). Data analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) version 26. Descriptive statistics such as frequencies and percentages were used to summarise categorical variables. Central tendency and dispersion of data were measured using means and standard deviations for normally distributed variables and medians and interquartile ranges for skewed variables. The Anderson and Newman`s Health Utilisation model guided the study. Results The response rate was 88%, with 96 respondents completing the questionnaire (anticipated sample size of 109). The data was collected from participants (15-19 years) in 13 clinics (eight Primary Health Care Clinics and five Community Health Care Clinics). The demographics showed majority age group of 18 years (n= 27, 28.1%), 95.8% (n= 92), of participants were single and 85.45% (n= 82) unemployed. The obstetrical and current history results showed the majority of participants had not used any contraception method (n= 68, 70.8%), 88.5% (n= 85) had not planned their pregnancy and 77.1% (n= 74) had no health problems. The majority of participants reported that they were satisfied with the experiences at the clinics, with 78.1% (n= 75) and 65.6 % (n= 63) were satisfied with the privacy and the staff respectively. A quarter (n =24, 25%) of the participants did not know the importance of ANC for pregnancy, while a lesser number (n=18, 18.8%) were unaware of the significance of ANC for their unborn baby. Conclusion Study findings highlighted the contributory factors to adolescents’ late utilisation of Antenatal Care. Basic Antenatal Care Plus Programme (BANC PLUS) has been shown to be beneficial to the adolescent as early utilisation of ANC can reduce maternal mortality. However, based on the Anderson and Newman Health Utilisation framework contributory factors, specific to the select geographical area were identified for late ANC utilisation. The targeting of the contributory factors through the recommendations can add value to the maternal health of the adolescent and in so doing recognise the global goal of universal health coverage and achieving Sustainable Development Goal 3.1. Recommendations Recommendations included Antenatal learning and supports, strengthening of health care systems and promotion and recognition of staff. Limitations Only selecting one district from eThekwini and only including the Department of Health clinics.
Factors influencing the involvement of male students in sexual and reproductive health at the University of KwaZulu-Natal.
(2023) Sobekwa , Sinazo.; Mudau, Tshimangadzo Selina.
Background: In the dynamic landscape of sexual and reproductive health (SRH) initiatives, understanding the extent and determinants of the involvement of male students’ sexual health issues is pivotal in promoting comprehensive and equitable SRH outcomes at the University of KwaZulu-Natal (UKZN). Male involvement in SRH is essential in preventing sexually transmitted infections (STIs) and unplanned pregnancies, and in promoting safer sexual practices. In contrast, deferring healthcare leads to morbidities and mortalities, which could mostly be avoided through seeking early primary healthcare and preventative health as diseases are not responsive to gender. Recognising that SRH encompasses physical wellbeing and broader societal and interpersonal dimensions, this study offers a comprehensive analysis of the factors influencing the involvement of male students in sexual and reproductive health at the University of KwaZulu-Natal. Exploring the intricate web of socio-cultural, educational, and healthcare system factors, this study aims to provide insights into the challenges encountered by male students in the context of SRH. Research methodology: The qualitative, participatory action research approach was employed to explore and describe factors influencing the involvement of male students in sexual and reproductive health at the University of KwaZulu-Natal (UKZN) in South Africa. The objectives of the study were: to explore and describe factors affecting male students’ involvement in SRH at the UKZN and; to explore and describe strategies that will enhance male students’ involvement in SRH at UKZN. In total, 24 male student participants were conveniently and purposely sampled to share their views and opinions on factors influencing the involvement of male students in SRH at the university in question. regarding SRH services received at the UKZN campus health clinic. The data collection methods employed included semi-structured interviews, focus-group discussions (FGDs), and virtual meetings. The researcher collected data using an interview guide, an audio recorder, and taking field notes. The thematic analysis method was conducted to identify codes and themes emerging from the generated data. Findings revealed the students’ attitudes towards HIV tests, condom use, staff-related issues, stigma and stereotyping, attitudes towards SRH programmes and campaigns, infrastructural issues, and solutions to the identified challenges. Conclusion: Involving male students in SRH in campus health clinics at UKZN is marred by socio-hegemonic orientations related to masculinity-related roles, cultures, and male-friendly services, and it is necessary to delve into issues around stigmas and stereotypes. It is therefore important to enhance health promotional campaigns and reviving male-friendly programmes in comfortable environments that are not formal for male students' involvement. Recommendation: Topics on ways of breaking the gender stereotypes affecting young males and ways of enhancing male involvement in SRH matters have to be generated and explored. Nurses working in campus health clinics should be trained on Adolescent and Youth-Friendly-Services (AYFS). The necessity of developing policies that enhance interventions, strategies, and goals to close the gap of male SRH on the campus cannot be overemphasized.
Developing a brochure to be used by registered nurses working in the oncology settings to educate patients undergoing chemotherapy in public and private oncology settings in KwaZulu-Natal, South Africa: a mixed method study.
(2024) Mdletshe , Rachel Bonisiwe.; Wentzel , Dorien Lesley.; Gumede , Emelda Zandile.
Background The delivery of cancer care is facing unprecedented challenges, new technologies, shortage of human and other resources, increased number of patients with cancer and educational challenges. Registered nurses have to administer chemotherapy, function as guides to patients and their families as they make sense of their cancer experiences. Lack of knowledge hinders patients’ capacity to engage in effective interactions with care providers and can also lead to adverse medical outcomes, malpractice lawsuits, missed appointments and medication errors. Purpose The purpose of the study was to develop a brochure for registered nurses working in oncology settings to educate patients undergoing chemotherapy in public and private oncology settings in KwaZulu-Natal. Methodology The study employed a mixed methods approach embracing the sequential designs and pragmatic paradigm. The study was conducted in three oncology settings, one being a private outpatient and two public in/out-patient settings. A sample size of 85 participants was obtained through the use of Stata V15 sample size calculator with the assistance of a statistician and 64 gave consent to participate. Non-probability purposive sampling was used and all recruited participants were informed about the multi-staging processes in data collection (stages). All participants who volunteered to take part in the study gave their consent signed and their ethical issues/rights were explained in detail before the actual commencement of data collection. Mixed methods were employed to ensure that the quantitative aspect of the data was used to probe further or enrich the dialogue in the qualitative phase until data convergence. Using manifest content analysis, themes were identified which together with quantitative data guided the development of the brochure. The brochure was subsequently verified by experts. Findings Based on literature review and the findings of the study a brochure was developed, aimed at enhancing nurses’ support to their patients. The highlight was that nurses tend to focus more on managing patients’ physical side effects and neglect the emotional stages that patients go through chemotherapy. Patients need to know that registered nurses are available to support and guide them through the chemotherapy process. Conclusion When patients first receive the news that they have cancer, most of them feel scared and anxious and this can make them particularly vulnerable. Patients worry about their coping skills during this period and they need support from the healthcare providers. The current study described the knowledge, attitudes and competence of nurses working in oncology settings. Emanating from the quantitative and qualitative data obtained, a brochure was then developed and evaluated by experts. Registered nurses play an important role in educating patients. It is hoped that nurses working in oncology settings will use this brochure to empower patients as they provide valuable emotional support to patients undergoing chemotherapy. In turn, it is hoped that patients will feel emotionally resilient by being able to be aware of the various emotions that could be encountered as well as the knowledge to access support, whilst receiving chemotherapy.
A descriptive survey of nurses` attitudes regarding family importance in nursing care in four selected emergency departments in eThekwini district.
(2022) Ngiba, Ntombifuthi Jennet.; Brysiewicz , Petra.; Oyegbile, Yemisi Okikiade.
Introduction: Family members have been found to provide valuable support in the emergency department where patients are critically ill and dependent on their loved ones (family) for decision-making and to communicate their wishes to healthcare workers. Literature documents reactions and responses of nurses to the presence of families, which appears to question their relevance in the emergency department. Purpose: This study described the attitude of nurses regarding family importance in nursing care in the emergency departments at four hospitals, in eThekwini district, KwaZulu-Natal. Methodology: This study adopts a quantitative, non-experimental, descriptive design and utilised the Families Importance in Nursing Care Nurses` Attitude (FINC-NA) questionnaire to obtain responses. The FINC-NA consists of 26 question items, and four subscales measured on a five-point Likert scale. Purposive sampling was used to collect data from 137 enrolled nurses and professional nurses working at the emergency department in one tertiary and three regional hospitals. Descriptive and inferential statistics were used to analyse the data. Results: These revealed that enrolled nurses and professional nurses demonstrated supportive attitude towards families and recognised their importance in providing nursing care. The results shows that there are significant associations between the three sub-scales measured in the study. Although the family as a resource in nursing care (Fam-RNC) score was lower for nurses less than 40 years of age, p= 0.038; family as a burden (Fam-B) score was high for nurse managers and this corresponds with supportive attitude, p= 0.029; family as own resource (Fam-OR) scores were low for nurses with less than five years of working experience in the emergency department, p=0.03. Conclusion: The study revealed that nurses generally have positive attitude towards family importance in the emergency department. However, elderly nurses and nurse managers appear to demonstrate supportive attitude to family members. These findings have significant implications for nurses to see family members as resources rather than perceived as burdens. Nurse managers should train and support nurses to demonstrate positive attitude towards family members in the emergency department.
A description of midwives’ perceived roles in health educating pregnant women at primary healthcare clinics in a Sub-District of eThekwini, KwaZulu-Natal, South Africa.
(2020) Ramnund , Sanveer.; Baloyi , Olivia Baorapetse.; Jarvis , Mary Ann.
Introduction and background Antenatal care (ANC), the care preceding birth, is described as a careful, systematic assessment and follow up of pregnant women through their pregnancy, culminating in the delivery of the foetus (Al-Ateeq and Al-Rusaiess, 2015). Health education has shown it can result in better pregnancy outcomes (Al-Ateeq et al., 2015). ANC health education is frequently conducted in PHC clinics by midwives (Phillips, 2014; Susuman, 2015), but with the advent of mHealth, it is not confined to the PHC setting (Skinner et al., 2018; Susuman, 2015). Aim/Purpose The aim of the study was to describe midwives’ perceived roles in maternal health education and their acceptance of mHealth in health educating pregnant women during and between antenatal visits at Primary Healthcare clinics in a sub-district of EThekwini, KwaZulu-Natal, South Africa. Methodology A quantitative approach was used, with an explorative and descriptive design, framed within a merged model of Donnabedian’s quality framework and the Unified Theory of User Acceptance of Technology (UTAUT) model. Purposive sampling selected a sub-district of eThekwini, and the participating midwives and unit managers. Data collection occurred over three and a half weeks, in February 2020, using a self-administered questionnaire with the midwives and a researcher-developed survey of the health education landscape with the unit managers. The four-part questionnaire included two validated scales to measure health education (Aldossary et al., 2013) and mhealth (Yakubu et al., 2019). Findings were grouped according to the sections of the questionnaire, namely Section A: Demographics, Section B: Roles and perception of health education, Section C: Acceptance of technology and mHealth in the PHC clinic and Section D: Actual health education conducted. Data was entered into IBM SPSS version 24, and descriptive and inferential statistics calculated. All ethical considerations were adhered to. Results Response rate was 88.5% (n= 92) for the completion of the self-administered questionnaire and 16 surveys of the health education landscape of the PHC clinics The mean age of the respondents was 39 years, with the majority of midwives being female (87%). Responsibility of midwives (m= 18.17/24 [CI95% 17.68-18.67]) was the highest of the subscales, emphasising the important role that midwives play in health education towards pregnant women. Performance Expectancy (m= 16.61/20 [CI95% 15.92 – 17.29]) was the highest of the mHealth subscales. Significant differences were found in the midwives >50 years of age for responsibilities of midwives, and in the male midwives for responsibilities of midwives and perceptions of patient’s responses to health education and midwives perceptions of their role in delivery of health education. During the survey of the health education landscape in the PHC clinics (n=16), the midwives mainly focused on ANC care with 730 sessions conducted in PHC clinics, but less mHealth registrations (n=22, 23.9%). Maternity health policies were available in all clinics (n=16), but just over half (n=10; 62.5%) were able to provide policies on mHealth. Conclusion The study identified both structure and process related information in its description of midwives’ perceived roles in maternal health education and their acceptance of mHealth in health educating pregnant women during and between antenatal visits. Structurally, mHealth polices need greater visibility in the clinics and increased facilitating conditions, such as support for the midwives for mHealth. In particular, midwives older than 50 years and male midwives could add further resistance to the seamless implementation of health education, when utilising both digital and face-to-face approaches. However, from the process perspective of quality care, the midwives showed positive perceptions towards both their roles and responsibility in health education, with high Performance Expectancies of a mHealth application to deliver maternal health education. The level of Performance Expectancy can be drawn on in the COVID-19 pandemic, to ensure continued maternal and neonatal health, despite constraints brought about by social distancing and thereby mitigate against increased maternal mortality rates. Recommendations Studies to identify mitigating circumstances and barriers towards mHealth applications as well as further investigation towards male midwives perceptions of their roles, and responsibilities towards maternal health education. Limitations The use of one district resulted in a small number of clinics and respondents. During this study the Chronbach α scores of the highest subscale ‘responsibilities of midwives’ was low (α= 0.37), thereby affecting the generalisability of that subscale to the population of studies.
Teaching and learning support received by teenage mothers during the coronavirus disease lockdown in Makhado Municipality, Vhembe district.
(2023) Makaleng, Kepse Christina.; Mudau , Tshimangadzo Selina.
Background: In the wake of the Coronavirus disease lockdown, schools, creches and higher education institutions worldwide closed their doors, disrupting teaching and learning. All learners, including teenage mothers were forced to study from home due to a shift from traditional classrooms to online learning platforms, increasing the probability of school dropouts. Home learning became overwhelming to teenage mothers as they had to balance motherhood and learning while studying from home. The sudden shift worsened education inequality, thus negatively impacting the achievement of the Sustainable Development Goal 3; namely, Good Health and Wellbeing since quality education promotes health. Learners from poor provinces such as Limpopo, specifically those living in rural areas such as the Makhado municipality, face obstacles such as poor connectivity and limited access to the internet. Purpose: The purpose of the study, therefore, is to explore and describe teaching and learning support received by teenage mothers during the COVID-19 lockdown in the Vhembe district, Makhado municipality, Limpopo province. Research methodology: The study employed qualitative, participatory action reseach (PAR) through community engagement since the latter is community driven, ensuring that teenage mothers and stakeholders are included in an enquiry that seeks to promote social justice. The participatory arts-based action research created a safe space for the teenage mothers to share their stories. Data were generated from 11 participants through unstructured individual and group interviews. Findings: The study revealed that teenage mothers were supported by families, community members and teachers during the coronavirus school closures and rotational classes. However, the support was not adequate and consistent to promote the continuity of teaching and learning. The teenage mothers were further supported emotionally thus promoting their self-concept. Remote learning has proven to be a challenge to most teenage mothers due to the inaccessibility of online resources. It was difficult for teenage mothers to balance motherhood and learning due to frequent interruptions such as taking care of the baby resulting in poor concentration. Conclusion: The teenage mothers were socially, emotionally and financially supported by their families and some teachers, however, the support provided was insufficient and inconsistent to promote continuity of teaching and learning, resulting in teenage mothers not having access to quality education. Due to the frequent interruptions by crying babies, teenage mothers had difficulty balancing motherhood and learning.
Investigating factors associated with absconding behaviours amongst hospitalised mental health care users within Harry Gwala District Kwazulu-Natal Province.
(2024) Malunga, Seluleko.; Ngcobo, Winnie Baphumelele.
Introduction: Absconding of hospitalized mental health care users is a significant concern, compromising treatment adherence and safety. Further investigation is needed to identify potential absconders and also gain insights from nurses' perspectives on the reasons behind this problem absconding. The aim of the study was to investigate factors associated with absconding behaviours amongst Hospitalized Mental Health Care Users in Harry Gwala District KwaZulu-Natal Province. Methods: As such the study used a positivist paradigm and a non-experimental descriptive exploratory survey to investigate factors leading to inpatient mental health care absconding. Data was collected from 51 participants and analyzed using Predictive Analysis Software, focusing on the impact and characteristics of absconding. Theoretical framework Research objective Questionnaire item was applied in this section to prove the validity of the instrument. To explore and describe the factors associated with absconding and impact of absconding on treatment as well as the characteristics of absconding and the motive or reasoning being the absconding behavior. The reliability of the instrument was tested by administering the questionnaire to five (10) mental health professionals of the population, and then administering the same questionnaire to the same respondents after two weeks later. The two rounds of the questionnaire from these respondents were then checked to see if the results remained consistent, which would indicate the reliability and trustworthiness of the questionnaire to elicit the necessary information. The University of KwaZulu-Natal's Research and Ethics Committee approved the study proposal, ensuring human subjects' rights and adhering to ethics principles such as respect, beneficence, justice, and autonomy. Results: The results indicated that hospital environment, particularly seclusion rooms, can be distressing and dehumanizing, contributing to a desire to escape to regain a sense of freedom and dignity. Additionally, the study showed that severity and type of mental health symptoms played a significant role. Individuals with psychotic disorders, especially those experiencing exacerbations of symptoms, were more likely to abscond. The desire to escape, distressing symptoms or delusional thoughts were identified as supporting the prevalence of absconding behaviours. In terms of experiences with Caregivers study results showed that mixed emotions regarding caregivers influenced absconding. While some patients felt overly controlled and infantilized, leading to a desire for independence, others felt burdened by the emotional and financial strain their care imposed on their families. This complex dynamic thus motivated patients to abscond in order to relieve perceived burdens on their caregivers. Also, study findings showed that in terms of hospital resources and services, poor hospital conditions, including inadequate facilities and lack of engaging activities led to feelings of boredom and frustration among patients and this prompted them to abscond. Conclusion: This study realized that by enhancing hospital resources and providing more therapeutic activities these feelings could be mitigated. The study concluded that in order to reduce absconding behaviours, a comprehensive approach involving hospital environment improvements, caregiver-patient dynamics enhancement, resource allocation, and structured leave processes can be implemented.
Teaching and learning coping strategies adopted by teenage mothers during coronavirus disease lockdown in Makhado Municipality, Limpopo Province.
(2023) Moganedi, Shonisane Emily.; Mudau, Tshimangadzo Selina.
Background: The COVID-19 pandemic exposed inequalities in access to technology between rich and poor, rural, and urban, girls and boys and across and within countries. The other negative social and health related impacts that COVID-19 and related restrictions had on the poorest, most marginalized, and vulnerable sectors of society are likely to have been disproportionately affected by school closures due to COVID-19. Teenage mothers living in rural areas have fewer resources such as access to the internet, smartphones, and computers to adapt to and implement measures needed to continue with online learning during school closures. The aim of the study was to explore and describe teaching and learning coping strategies adopted by teenage mothers in the rural communities of Makhado Municipality during the coronavirus disease lockdown in Limpopo Province, South Africa. Design: The study adopted a qualitative critical participatory action research through the community engagement approach. Methods: Purposive and snowballing recruitment were employed in this study. Methods of generation of data included semi-structured face-to-face interviews which were audio-taped, transcribed verbatim, and participatory arts were also applied to generate data. Data was analysed using qualitative thematic analysis. Findings: Thematic analysis of data revealed that teenage mothers experienced challenges such as stigma and discrimination, stress, inability to cope with self-study, financial constraints in caring for and supporting their babies, lack of gadgets and the internet essential for home learning, and inconsistent support from parents and teachers. Recommendations: Policies need be reviewed to address the issue of stigmatization and discrimination in schools. Authorities in education need to be geared in enriching social change towards transformative learning and addressing the issue of the digital divide in rural communities. Conclusion: It was concluded that the COVID-19 pandemic has broadened a huge gap between the rich and the poor, urban and rural learners. It was concluded by the researcher that there was evidence of social segregation and social injustice for teenage mothers in teaching and learning.
Critical care nurses’ perceptions of caring for patients at a selected hospital in KwaZulu-Natal.
(2022) Jugroop, Merashni.; Emmamally, Waheedha.
Background: Caring in a critical care setting requires a holistic process of individualised, patient-focused, and specialised care within a work intensive and technologically focused environment. These are what have an impact on how caring unfolds within a critical care environment. The COVID-19 pandemic has further altered the care relationship between critical care nurses, critically ill patients and their families. Aim: To determine critical care nurse’s perceptions of caring for patients at a selected hospital in KwaZulu-Natal Methods: A quantitative, descriptive, cross-sectional study was conducted on 139 participants in a tertiary quaternary hospital. Data collection used the Caring Assessment for Caregivers questionnaire, and analysis was with descriptive statistics. Results: Results revealed that most of the participants were females above 30 years, holding a Diploma in Nursing and had > 10 years of work experience. Participants had an overall high perception of caring, with a total mean score of 116.01 (range of 25- 125). Of the five subscales, the subscale of “Maintaining belief,” had the highest mean composite score 24.25(range of 5-25) and the subscale of “Being with,” had the lowest mean composite score 22.70. There was no significant relationship found between the critical care nurses’ socio-demographic characteristics, the overall score and the total scores of each of the five subscales. Conclusion: Whilst critical care nurses reported a high overall perception of caring, lower mean scores on the subscale “Being with” suggest that there areas for critical care nurses to grow in their role as carers. Further research is necessary for replication of the study using qualitative approaches to bring forth valuable findings on how the critical care environment has an impact on the caring experiences of critical care nurses.
Perceptions of nursing students, nurse educators and clinicians of the clinical learning environment at selected institutions in Northern Ghana.
(2016) Abugri, Atuut.; Mbeje, Pretty Ntombithini.
Aim The aim of the study was to describe the perceptions of nursing students, nurse educators and clinicians of the clinical learning environment at selected institutions in northern Ghana, as a way of assisting to address clinical teaching and learning challenges. Methods A non-experimental quantitative research of the descriptive type was used. A convenient sampling technique was used for the college and the hospital, and stratified random sampling used for the nursing students. There was no sampling for the nurse educators and clinicians and all participated. A scale developed by Chuan & Barnett (2012:194) on student, tutor and staff nurse perceptions of the clinical learning environment was utilised on the respondents (n=215). Section A consisted of three questions on the category of the respondents. Section B consisted of 34 items on the perceptions of the clinical learning environment and section C consisted of two open-ended questions that required respondents to list the factors they believed contributed to student learning in the ward, and the factors they believed hindered students’ learning in the ward. The data obtained was entered onto the computer and analysed using the Statistical Package for Social Science (SPSS), version 23, for descriptive statistics, comparisons using one-way analysis of variance (ANOVA) and reliability. Results A response rate of 96.8 % was obtained from the respondents (n=215) who were representative of the student and nurse educator populations at the selected college. It was however, not representative of the clinicians and not generalisable to other colleges in the country. The mean of the perception score was 103.81(SD=13.97). The range of scores was 72 and 150, out of a possible score of 170. The skewness value was 1.83 The majority of the respondents perceived the clinical learning environment to have shortcomings in the areas of clinical supervision, satisfaction, learning tensions and the translation of learning into clinical practice. Learner friendliness and peer support were positively perceived. Analysis of variance (ANOVA) revealed statistically significant differences between the respondents’ perceptions of five areas of interest in the clinical learning environment, however, there was no statistical difference found for peer support. A Post-hoc test using LSD comparison revealed the specific groups that differed. Cronbach’s alpha coefficient was 0.76 Conclusions and recommendations There were challenges within the clinical learning environment in the areas of supervision, satisfaction, learning tensions and the translation of learning into clinical practice. Learner friendliness and peer support was positively perceived. In order to assist in addressing the challenges, recommendations were made which focused on strengthening guidance and supervision of the students, motivation of clinical instructors and staff nurses, periodic in-service training of staff regarding attributes of professionalism, reviewing and redefining the scheduling of students, collaboration between academic and clinical institutions and the promotion of peer support.
Exploring the perceived competency levels of HIV/AIDS management among student nurses from selected nursing education institutions in the eThekwini municipality.
(2018) Buthelezi, Pinky Gugu.; Mtshali, Ntombifikile Gloria.
Background Globally, there is a changing landscape of healthcare, which is more pronounced in developing countries, including South Africa. This is a result of the battle against HIV and AIDS as well as the sudden increase in non-communicable diseases. South Africa has the highest HIV statistics in the region. The rapid rise in HIV infections has resulted in a shift of requirements in the preparation of nurses who are within the community orientated driven nature of health care in South Africa. Nurses are at the forefront of health care service delivery; therefore, the purpose of the study was to explore the perceived competency levels of HIV and AIDS management among student nurses from selected nursing education institutions in the eThekwini Municipality. Research methodology A non-experimental descriptive design based on the positivism paradigm was used. Using a quantitative approach, the questionnaires were used to collect data from 129 participants from two nursing education institutions in the eThekwini Municipality. Ethical principles were observed throughout the study. Data was analysed using the version 24 SPSS software. Results Most HIV and AIDS, 90.7% were females and 54.3% were at 3rd year of training. Ninety five point three percent had experience in caring for PLWH. Results showed that 50.4% of the participants had adequate level of knowledge on foundational knowledge level and 76.5% had adequate skills in health provision. In health promotion, 85.7% had adequate level of knowledge whilst for leadership skills, 64% had adequate skills. Results also showed that 83.9% had good skills in handling ethical issues related to HIV and AIDS. In research, 54% reported they had adequate skills. The findings revealed that while clinical exposure was limited and time allocated for teaching and learning of HIV and AIDS care was short, content was extensive. Two themes emerged from open ended questions. They were the need for updates and integration of HIV and AIDS management from first to fourth year of training. Recommendations Recommendations are related to the integration of HIV and AIDS content into the curriculum, the ways of strengthening the process of developing the required HIV and AIDS management in the clinical settings and the need for further research.
Description of psychiatric nursing students’ stereotypical beliefs associated with mental illness labels and the potential mediating effects of information and contact.
(2014) Mbongwe, Cecilia Makhosazane.; Smith, Amanda April Heather.
Aim To describe psychiatric nursing students’ stereotypical beliefs associated with mental illness labels and the potential mediating effects of information provided from curriculum content and contact through clinical placement. Methodology Four nursing campuses were sampled, resulting in one hundred and thirty two (n=132) participants. Participants remained the same for all three phases of the repeated measure. A quantitative approach, non-experimental survey design with repeated measures made use of a self-report questionnaire. Section A included demographic data (age, gender and cultural group), while Section B consisted of a semantic differential measure (SDM) focusing on three mental illness labels; schizophrenia, major depressive disorder and bipolar mood disorder. Data was collected on the first day of the psychiatric nursing training block, the last day of the training block, and the first day of the second training block, after approximately six weeks of clinical placement in specialist psychiatric settings. Results Participant scores suggested greater negative stereotypical beliefs associated with the schizophrenia label in all the three phases of data collection. The bipolar mood disorder label was the least associated with negative stereotypical beliefs. Information given during the initial teaching block and contact during the clinical placement period resulted in a slight reduction of negative stereotypical beliefs associated with the schizophrenic label. In contrast negative stereotypical beliefs associated with the bipolar mood disorder label were increased slightly after information and contact. Conclusion and recommendation The results of the study confirmed that health care professionals are not different from the general population in their negative stereotypical beliefs towards mental illness labels. A review of the proposed new nursing curriculum should specifically include emphasis on psychosocial rehabilitation. In addition, clinical placement of the student nurses must be designed to ensure interaction with mental health care users engaged in recovery and community integration to remove perceptions of inability to recover associated with mental illness labels (Adewuya & Oguntade, 2007; Adewuya & Makanjuola, 2008; Corrigan, 2007; Smith, 2010).
The effects on familiarity on stigma components in potential employers towards people with a serious mental illness in Durban, KwaZulu-Natal.
(2010) Smith, Amanda April Heather.; Middleton, Lyn Elizabeth.
Aim The purpose of the research study was to explore and to describe stereotypes associated with serious mental illness and the effects of familiarity on the serious mental illness stigma process in potential employer informants in the greater Durban area, eThekwini district, KwaZulu-Natal. Methods A quantitative non-experimental cross sectional survey relational research design was used to describe firstly, the stereotyping and individual discriminatory behavior (desire for social distance) of potential employers to a person with a SMI, and secondly, the effect of familiarity and other person variables (culture, age and gender) on the stigma components of stereotyping, emotional reaction and individual discriminatory behavior (desire for social distance). The population included potential employers of the SMI person in the greater Durban area, eThekwini District, KwaZulu-Natal. The target population was all students enrolled for a part-time management course at two academic institutions in the Durban central area. Non-randomized, non-probability purposive sampling was used. Demographic data and four self report tools were compiled into one self report questionnaire to collect data. Results The sample was evenly distributed amongst male and female within the various age groups. All cultural groups were represented but this representation was not a perfect fit with national or provincial population statistics. Just less than half of the participants (48% n=55), both genders and across all cultural groups, had intimate and or personal contact with persons with a serious mental illness. Demographic associations suggest that male participants had greater perceptions of dangerousness, unpredictability and incompetence and a greater desire for social distance. The statistical results indicated limited correlations between emotional reactions and desire for social distance, stigmatizing attitudes and desire for social distance, and evidence of no significant relationship between familiarity and other components within the stigmatizing path. Fear was associated with a desire for social distance and with perceptions of limited potential for recovery. Stigmatising attitudes were most negative towards persons who had a previous admission to a psychiatric hospital and the least negative towards 'bipolar mood disorder'. Stigmatising attitudes were recorded for all serious mental illness labels (including that of bipolar) with 75% of participants scoring closer to the negative polar adjective of stigmatizing attitude. Conclusion and Recommendations In conclusion, the supposed lack of desire for social distance, the dependent variable in this study, may reflect political policy and current ideology but the strength of the negative stereotypes suggests that changing policy is easier than changing attitudes. It is suggested that the stigmatizing stereotype of limited potential for recovery may have more salience in developing countries such as South African than the developed western world. Limited potential for recovery has financial and emotional implication within a developing country and to this extent, desire for social distance and fear are correlated to perceptions of limited potential for recovery. Recommendations include additional research include measures of social desirability bias to clarify the relationship between familiarity, emotional reaction and social distance. Secondly, intervention studies, specifically with potential employers, are required to obtain empirical data related to the combine effectiveness of disconfirming information and contact with people with a serious mental illness. Further, that health departments actively engage in evidence based anti-stigma initiatives. Lastly it is recommended nursing curricula recognise the importance of student psychiatric nurses developing a balanced view of mental health care users assigned the serious mental illness labels through a balanced clinical exposure to recovered, as well as acutely ill mental health care users. That the new undergraduate nursing degree curricula strengthen content related to recovery and psychosocial rehabilitation, specifically nursing interventions / strategies to facilitate rehabilitation in all the areas of study, socialization, community living, and specifically in the area of work.
Describing nurses’ stigmatising attitudes towards persons with mental disorders in a selected district hospital setting in Rwanda.
(2013) Baziga, Vedaste.; Smith, Amanda April Heather.
Aim The purpose of this study was to describe mental disorder stigmatising attitudes held by nurses, in a selected district hospital in Rwanda, and to analyse the potential mediating effects of person variables, specifically familiarity, on these stigmatising attitudes. Methodology The stigma process framework informed a quantitative, non-experimental, descriptive research design. A self-report questionnaire included person variables (age, gender, nursing qualification, nursing category and years of nursing experience) and two scales; Level of Contact Scale (LOC) and Community Attitudes towards Mental Illness - Swedish version (CAMI-S). A sample of one hundred and two (n=102) was achieved. Ethical approval was obtained from educational institutions, University of KwaZulu-Natal in SA and Kigali Health institute in Rwanda, and at local health care service level in Rwanda. Data were analyzed using the Statistical Package for Social Sciences (SPSS) Version 21. Analysis includes descriptive statistics and multivariate analysis; associations between scale scores and person variables, inter-correlations between CAMI-S subscales and total scores and correlations of CAMI-S and LOC scale scores. Non parametric tests were used, Mann–Whitney U Test, Kruskal-Willis H Test and Spearman’s rho correlation coefficient test and significance was determined by Cohen’s guide lines (Cohen, 1988) cited in Pallant (2010; 2013). Results Although participants reported negative stereotypes in all items on the CAMI-S, related to persons with a mental disorder in keeping with previous international (Griffiths, Nakane, Christensen, Yoshioka, Jorm, & Nakane, 2006; Veer, Kraan, Drosseart & Moddle, 2006; Putman, 2008) and local studies (Smith & Middleton, 2010), the extent of contradiction within participant responses suggests social desirability bias. Results suggest that, while participants acknowledge community integration of mental health services in principle, their desire for social distance from persons with a mental disorder was strongly evident in responses to proximity of living arrangements and support of segregation. Statistical results indicated no associations between negative stereotypes and participants’ gender, category of nurses or level of education. However, associations between negative stereotypes and the younger age group and the less experienced participants are reported as statistically significant. There was high levels of familiarity amongst participants, more than half of participants (57.8%, n=59) scored levels of familiarity at 9, A friend of my family has a mental disorder, and above. A negative correlation is reported between familiarity and stigmatizing attitudes. Conclusion and recommendation Results suggest familiarity has a positive mediating effect on negative stereotypes. In addition older more experienced nurses are reported to have less stigmatising attitudes towards persons with a mental disorder. Despite these results, contradictions within participants’ responses on the CAMI-S suggest that additional research and intervention studies, specifically with general health care practitioners, are recommended to clarify the contradictions and obtain empirical data about effectiveness of contact with persons with a mental disorder. Key words: Stigma, negative stereotypes, mental disorder, district hospital
Exploring factors influencing nursing staff turnover at a selected public hospital in KwaZulu-Natal.
(2018) Uhunamure, Neshani Sukhraj.; Dube, Barbara Makhosazane.
Background: Turnover of nursing staff is a major challenge within healthcare settings and for healthcare in general, urging the need to improve retention in hospitals. Nurses are the largest group of health professionals and account for a large proportion of total healthcare costs. During periods of economic austerity, nurses are the worse affected. Patients remain indirectly affected, owing to decline in care, as these time periods of economic downturn are marked with the merging of health care facilities, cost reduction leaving institutions with post available for new staff which leads high staff turnover rate. Purpose: The purpose of this study is to explore the factors influencing nursing staff turnover at a selected public hospital in KwaZulu-Natal. Methodology: A quantitative descriptive design was used for the study. Convenience sampling was used to select a sample consisting of 92 nurses, from all categories, working at a selected public hospital in Durban, KwaZulu- Natal. The data obtained was analyzed using SPSS, Version 25. Descriptive statistics were used to summarize and describe the characteristics of the respondents, while correlation analysis and the Chi-square test were used to establish the relationships of the study variables and the respondents’ characteristics. Findings: The study found that inadequate compensation and availability of training programmes for nursing staff increases the number of nurses leaving the institution. In respect to personal factors, respondents perceived that there is not enough flexibility in regard to working hours that respondents would like to work. When the relationship between organisational factors and the reasons nurses leaving the organisation was assessed, the majority 62.0% (n=57) of the participants stated the organisation organisational factor as the reason. Other indicated inadequate remuneration, training programmes, and staff development in the organisation lead to job dissatisfaction. Recommendations: In response to nurses leaving the organisation, the commendation to management should attempt to provide better remuneration for staff such as bonuses or better salaries to retain staff and prevent them going to other organisations for employment. Conclusion: Improving the working environment and job satisfaction becomes increasingly important to retain nurses and reducing staff turnover.
Exploring the use of e-Learning platforms by Postgraduate Nursing students in a selected Higher Education institution.
(2018) Buthelezi, Lindeni Ivy.; Dube, Barbara Makhosazane.
Background: E learning is one of the latest trends in nursing education to enhance learning and flexibility in the teaching and learning process. Literature however shows that while undergraduate students adjust easily to the use of technology, postgraduate students tend to struggle due to their lower levels of computer literacy computer literacy and unfamiliarity with eLearning. Study aim: To explore and describe the use of e-Learning platforms by postgraduate nursing students’ at a selected higher educational institution within KwaZulu-Natal. Methods: A quantitative approach and descriptive exploratory design were adopted in this study. About 60 postgraduate nursing students registered in 2016 participated in this study. Data was collected using a self-report questionnaire. Ethical clearance was obtained from the University Ethics Board; protocol number HSS/1718/016M and ethics principles were observed throughout the study. Data was analysed statistically using frequency distributions and the Chi-square test to assess the associations between each item on the perceptions and challenges with the socio-demographic factors. Results: The participants positively viewed the use of technology and e-learning in the postgraduate programme. About 70% reported exposure for the first time to Moodle at the university, 62.1% reported training in the use of Moodle, and 68.3% had access to the computer at home for learning purposes. The majority however expressed discomfort with the use of Moodle, and this was associated with the technical challenges they had due to limited IT skills. There was a statistically significant association between ability to use Moodle and proficiency in English, computer literature, availability of technical support and access to computer Conclusion: E-learning has value in a postgraduate programme and has a potential to yield positive outcomes if the students are introduced early during their undergraduate studies, if they are trained on the use of Moodle and have technical support available when necessary.
Exploring the perceptions of student nurses on patient-centered care provided in psychiatric institutions in Pietermaritzburg, KwaZulu-Natal.
(2013) Matanzima, Luntukazi.; Engelbrecht, Charlotte.
The purpose of the study was to explore and describe how student nurses perceive patient-centered care in their allocated units in the uMgungundlovu district. The main objectives of this study were to: • Explore the student nurses ‘perceptions of patient – centered care provided. • Describe the student nurses’ perceptions of patient-centered care provided. • Describe where the working environment in the psychiatric institution is supportive of patient-centered care. • Explore and describe what factors could hinder the provision of patient-centered care according to the student nurses’ perceptions. • Explore and describe what factors could promote the provision of patient-centered care according to the student nurses’ perceptions. The researcher used the qualitative , explorative and descriptive approach. Focus group interviews were used to collect data from fourth year psychiatric nursing students who were doing the four year course diploma programme at two psychiatric institutions in the uMgungundlovu district, where student nurses from other campuses were allocated. The interviews were tape recorded and later transcribed to facilitate easy analysis. Thematic data analysis was used. The findings suggest that inconsistent practices are the biggest hindrances to patient-centered care. Patients and relatives are not often involved in their own care and there is a lack of information given to patients by health providers which contributes to patients’ inability to make decisions and choices for themselves. Their rights in this regard are violated. The lack of resources interferes with the goal of promoting patient centered care. A number of recommendations for psychiatric nursing practice, education, policy making and nursing research based on the data from the study were made. If accepted and implemented, patient-centered care in the psychiatric institutions might improve.
Student nurses’ perceptions of peer mentorship in clinical settings.
(2016) Mlaba, Zanele Penelope.; Emmamally, Waheeda.
Novice student nurses face many challenges when making the transition to clinical learning because of the complex and unpredictable nature of the clinical settings. Adequate support of students in clinical placements and positive clinical experiences can increase students’ enthusiasm and retention in the profession. Nursing schools use peer mentoring to provide a supportive and non-threatening learning environment for students thus facilitating professional growth and development of student nurses in clinical settings. The KZNCN has a student peer-monitoring programme whereby the third year student nurses are assigned to be peer mentors for the first year students thereby facilitating transition through provision of orientation, guidance, support, accompaniment and teaching basic clinical skills. The aim of the study was to explore and describe the perceptions of student nurses on peer mentorship in order to enhance the quality of the peer mentorship programme in the clinical setting. A quantitative, non-experimental descriptive design was used to achieve the research objectives. All 210 student nurses doing the four year diploma course were invited to participate in the study. A sample size of 170 (66 mentors and 104 mentees) eligible and willing students was conveniently obtained. Fifty six participated as mentors and ninety-four as mentees in the main study. Ten students from each cohort were utilized for pilot study and did not form part of the main study. Data was collected using self - administered questionnaires that were developed from reviewed literature. Descriptive and inferential statistics were used to analyse data. Study findings revealed that mentees should be actively involved in clinical practice and should engage in personal relationships with experienced individuals in order to learn about the profession and promote professional socialisation. The development of leadership and teaching skills, self-confidence, independence and increased ability to perform clinical skills emerged as benefits of engaging in the programme. Despite notable gains from peer mentoring, this study highlighted that the students experienced a number of challenges that impacted negatively on peer mentoring in clinical settings. These barriers include, inter alia, insufficient practice opportunities for the students because of the short duration of the placement, time and resource constraints and mentoring too many students at the same time. The questionnaires had three open-ended questions, the common responses that emerged were grouped and quantitatively analysed into percentages. A total of 15.9 percent (n = 15) mentees expressed gratitude and appreciation for having worked with senior and experienced nurses on their first days. They appreciated the support and assistance they got from mentors. Based on the findings, it is suggested that the peer mentoring programme should be embedded in the nursing college retention strategy with an intention to improve formalization and structuring of the programme.
An exploration of the learners’ perceptions, awareness and satisfaction regarding the implementation of Integrated School Health Programme (ISHP) in selected secondary schools in uMgungundlovu district, Kwazulu-Natal, South Africa.
(2017) Khoza, Thabisile Rebecca.; Mchunu, Gugu Gladness.
When learners are subject to adverse health risks, school attendance and academic performance are correspondingly affected. This phenomenon is a nationally and internationally recognized problem considering healthy youth productive to members of the society. The Department of Health (DoH) has introduced a re-engineering program for primary health care of which school health programs are one of three main areas of the primary health care services focusing on, but not limited to immunization, teenage pregnancy education about Human Immune Deficiency Virus /Acquired Immune Deficiency Virus (HIV/AIDs), and screening for health problem such as poor eyesight and hearing impairment. In 2012, the new Integrated School Health Program (ISHP) was piloted in very poor schools in the provinces of KwaZulu-Natal, Gauteng and Limpopo. This study examines the learners’ perceptions, awareness and satisfactions regarding the implementation of the ISHP services in uMgungundlovu, District, in KwaZulu-Natal, South Africa. A quantitative, non-experimental, descriptive design was used in this study to collect data from the four selected secondary schools to reach the following objectives: To determine the extent to which the ISHP is reaching people it is intended to effect; to describe learners’ perception regarding the implementation of ISHP; and to determine the learners’ level of satisfaction with the implementation of ISHP. The total population of the study was expected to be 300 respondents from age 13-16 years which was calculated using a sample size calculator. The sample was 75 learners according to the percentages of the population in secondary schools and the grades of the study of the respondents. However, only 269 learners agreed to participate which left the response rate at 80.4 percent. Data was collected using a self-administered questionnaire after obtaining ethical clearance from the University and were analysed descriptively. The findings revealed that participants perceived that school health nurses who are coming to visit the school once in 6 months only 20.1 percent had never seen school health nurses in the schools, 16.4 percent were learners and 4.1 percent were learners saying school health nurses visit weekly. According to the ISHP, oral health 35.3 percent were offered in their schools ,vision 27.1 percent ,immunization 19.7 percent, TB screen 17.1 percent and anaemia 4.1percent. This indicated that learners in rural areas were likely to receive oral care, hearing care, speech care and TB screening. Awareness about ISHP services offered in their schools as “know your body” revealed 48.7 percent of learners showed that they know about these services. HIV/AIDs 26.0 percent, medical male circumcision 22.3 percent, sexual reproductive 30.5 percent, and learner referral 14.9 percent. Learners were not sure about learners’ health problems, physically and emotional challenges educators are not equipped to deal with or do not have sufficient time to manage. It was found that 61 percent had a high perception, 31.5 percent, had a medium perception and 7.4 percent had a low perception about ISHP implementation in the school. It was concluded that the implementation of the programme is not consistent with the objectives of the School Health Policy (ISHP, 2012). Due to lack of infrastructure and shortages of nurses, the ISHP did not cover all schools. These findings were not expected and they came as a surprise to the researcher. Conclusion made from the research findings, contributed to recommendation for nursing practice, nursing education and nursing research to enhance the quality of life of learners of ages between 13 to 16 years through comprehensive school health services. Key Words: ISHP, Learner, secondary schools, perception.
Exploring the knowledge, attitude and practices of PHC students regarding preconception care in a selected higher education institution in eThekwini district: a descriptive study.
Ukoha, Winifred Chinyere.; Dube, Barbara Makhosazane.; Mtshali, Ntombifikile Gloria.
Sub-Saharan African countries have been the worst affected by the HIV/AIDS pandemic and high incidence of maternal and child mortality rates, more than all other continents in the world. Preventive care in nursing is the area that requires serious attention, as a lot of maternal and child morbidity and mortality can be averted through rendering a comprehensive holistic care to women of child-bearing age. The ‘Draft Action Plan for the Prevention and Control of Non-Communicable Diseases 2013-2020’, that was discussed at the 66th World Health Assembly in May 2013, urges governments to decrease the modifiable risk factors for non-communicable diseases and the underlying social determinants. Preconception care as part of the national policy framework is recognised as an important contributor to prevention and control of noncommunicable disease, with the aim of intervening in the early life with the ultimate goal of improving maternal and child health outcomes. The purpose of this study was to explore and describe the knowledge, attitude, and practices of Primary Health Care students regarding preconception care in a selected institution in the eThekwini District. A non-experimental, exploratory, descriptive, quantitative design was used for the study. The study population comprised of all the primary health care nursing students of the selected higher education institute. The total population from the three sites selected, based on their geographical location, was 163 and all the nurses were invited to participate in the study. Only 138 participated in the study, giving a response rate of 85%. A self-administered questionnaire was used to collect the data and the data was entered and subsequently analysed using the Statistical Package for Social Sciences SPSS version 24. The findings of the study revealed that although primary health care nurses possessed high knowledge and a favourable attitude towards preconception care, they were still lacking in implementation and 71.7% had never received any training on the provision of preconception care. Based on these findings, it is recommended that preconception care is incorporated into the curriculum of primary health care nurses. Key terms: Preconception care, PHC nurses.

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