Browsing by Author "Smith, Amanda April Heather."

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Attitude of psychiatric nurses to de-escalation as a strategy for management of psychiatric patient aggression in a Nigerian psychiatric hospital.
(2016) Oyelade, Oyeyemi Olujamoke.; Smith, Amanda April Heather.; Jarvis, Mary Ann.
Aim The aim of this study was to present an intervention and describe the response of psychiatric hospital-based South West Nigerian mental health nurses. Methods A content analysis qualitative approach, using audio recordings of pre- and post- intervention focus group discussions was adopted. The intervention -one oral and visual de-escalation presentation - bisected the focus group discussions. The objective for the pre-intervention focus group: to describe participants’ current experiences and practices towards verbal aggression and violence management in order to inform relevant application of information within the intervention. The objective of the post-intervention focus group discussion: to describe participants’ responses to the intervention. Purposive sampling, comprised of nurses at unit or ward manager level, yielded eight participants. Results Participants felt betrayed by all role players within the mental health care service system, were disappointed that de-escalation was considered the evidence-based practice, and hopeless about its introduction. Participants’ fears for their safety are suggested to have informed a more militant approach to the management of aggression to strengthen nurses’ control over patients’ physical and emotional welfare, as well as their own. Review of Nigerian mental health legislation to set the context for human rights of both nurses and mental health patients is recommended. A need exists for further research utilizing a participatory action research approach that addresses ‘on the spot’ management of verbal aggression and includes trauma counselling and support for nurses.
Describing midwives’ perceptions of maternal postnatal care role within a level one district hospital in eThekwini, KwaZulu-Natal.
(2017) Ojuri-King, Mercy Itohan.; Jarvis, Mary Ann.; Smith, Amanda April Heather.
Background The quality of maternal postnatal care is reported to have decreased resulting in maternal deaths (WHO, 2013: 722), with the majority that occurred in sub-Saharan Africa between 2000 and 2008 were as a result of complications that were further exacerbated by the compromised quality of postnatal maternal care particularly between 24-72 hours post-delivery (WHO, 2013: 721). Postnatal care, in the first 72 hours post-delivery, is crucial to the survival of mother (WHO, 2012a:18). Aim/Purpose The purpose of the study was to describe hospital based midwives’ perceptions of their role within maternal postnatal care in a level one hospital in eThekwini, KwaZulu-Natal in order to improve maternal health outcomes. Methodology Motivated by constructivist paradigm, qualitative approach and descriptive research design were used to describe midwives’ perception of maternal postnatal care role within a level one district hospital, in eThekwini, KwaZulu-Natal. A two-part sampling process involved convenience sampling for the level one hospital, followed by purposive sampling to select ten registered midwives working in the maternity unit. Through one-on-one interviews, an interview schedule guided an advanced psychiatric nurse to use open ended, probing questions to meet the three objectives. Data saturation was reached after eight interviews. Inductive approach of content analysis was used to analyse the data transcribed from the audio recordings. (Elo and Kyngäs, 2008: 107). Results The following categories and sub-categories emerged which address the objectives of the study. Category 1 ‘care is good…but’ described midwives’ perceptions of their postnatal maternal care knowledge of the national guidelines.(Sub-category A: Yes we know the guidelines) however administrative tasks impacted on time spent with direct patient care (Sub-category B: Paper work vs. Patient). Category 2 ‘(general responsibilities) reflected the midwives’ perceptions of their role in providing postnatal maternal care to mothers to and student midwives (Sub-category A: Teaching and supervision; Sub-category B: Post discharge advice and care; Sub-category C: Midwives responsibilities). Category 3 – described “the other people involved in Postnatal Maternal Care”, such as HIV Counsellors and Social workers and their “Reliance of Support” (Sub-Category A). Category 4 and 5 answer the third objective in describing the factors affecting postnatal care in the level one hospital. Category 4 described the “Positive factors” that facilitate midwives’ role in providing effective post-natal maternal care (Sub-category A: Language factor; Sub-category B: Team work), while Category.5 described the “negative factors” that hindered midwives’ role in providing effective post-natal maternal care (Sub-Category A: shortage of staff; Sub-category B: Shortage of equipment). Conclusion In order for the realization of quality care outcomes, namely decreased maternal mortality and morbidity, the process standards need to be in place. Despite the presence of The Guidelines for Maternity Care in South Africa (2015) and midwives reporting themselves to know these guidelines gaps were evident that midwives descriptions of their practice that suggested a failure to reflect an awareness and preparation for postnatal dangers in the descriptions of their teaching function and other roles. Further structure standards of inadequate staffing and availability of beds and equipment were perceived to be lacking. It is concerning that National Guidelines for Maternity Care (2015) are not fully adhered to in the postnatal care the setting which is restricted by the process standards of administrative demands, in its contribution to South Africa meeting its international obligation to cutting maternal mortality. Despite the circumstances that midwives found themselves, this study has provided insight into midwives’ differing perceptions of postnatal maternal care in level one hospital in eTheknini KwaZulu Natal. Key words: Maternal postnatal care, Midwives, Midwives’ perceptions, health care services and level one hospital.
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
Describing the incidence of depressive symptoms and associated person's variables among emerging adults within a selected general hospital outpatient department in Kenya.
(2015) Nteere, Jacqueline Gatwiri.; Smith, Amanda April Heather.
Introduction: Suicide is a global health concern, specifically among the youth. Bio-psychosocial factors, specifically depression, are associated with suicide behaviour and viewed as potential risk indicators. Depression is under detected in health care settings and argued to add to the increasing incidence of suicide behaviour. Aim: To describe the incidence of physiological symptoms, and other person’s variables, and their association with depressive symptoms within the emerging adult, 18-24 age group, attending a general health care outpatient facility in Kenya. Method: A quantitative design utilized an interview assisted physiological symptom checklist, and a self-reported questionnaire obtained demographic data and participant responses to Becks Depression Inventory Scale vs. II (BDI 11). Data was collected for a two week period. Results: Of the potential participant sample (N=101) that accessed services 83.1% (n=84) indicated having one or more of the targeted physiological symptoms. BDI II scores for this group indicated that; 60.8 % (n=51) experienced the normal ups and downs of daily life, 20.2 % (n=17) scored for mild depression, 7.1 % (n=6) had borderline clinical depression and 11.9% (n=10) achieved a score indicating moderate depression. Common physiological symptoms reported included; headache (54.8%, n=46), general fatigue, cough (31%, n=26) and changes in appetite (26%, n=22).There was a medium positive correlation between total physiological symptoms and depression. Despite this, total physiological symptoms were not as strongly predictive of depression as the single physiological symptom of pain, specifically headache. Trends were suggested between depressive symptoms and; aged 20/21, cohabiting with partner, university educated, and employed. Conclusion and recommendation: Screening for depression within general health care facilities is relevant and recommended. Specific physiological symptoms, such as pain, should be recognised as potential indicators of depression, or risk for development of depression. General health care workers need to be trained to use screening instruments and mhGAP interventional guidelines for prompt identification and management of depression in general health care facilities. It is recommended that all health care programmes include a mental health care module that includes screening for depression and suicide risk in order to build capacity within the general health care worker population.
A description of mental health care practitioners and a mental health care director's perceptions of mental health care nurses obtaining prescription authority in eThekwini district KwaZulu-Natal.
(2014) Ramasamy, Maragatham.; Smith, Amanda April Heather.
Aim To explore Mental Health Care Practitioners and a Mental Health Care Directors perceptions of mental health care nurses obtaining prescription authority in eThekwini District KwaZulu-Natal. Methodology A qualitative design was used to gather data through individual interviews and a focus group interview. Purposive sampling was used to select the study setting (five (5) Out Patient Departments, two (2) Community Health Centres, one (1) tertiary educational institution, and one district office), potential participants were not sampled. Participants included; twenty six mental health care nurses (n=26), one (1) psychiatrist (n=1), four (4) medical officers (n=4) and one (n=1) mental health care director. Thematic analysis using the steps outlined by Braun and Clark (2006) was used to analyse the data. Results The majority of participants were not aware of policies or legislation allowing nurses to prescribe medication. Participating mental health care nurses from an education setting were more knowledgeable than other participants about current legislation and policy. Study findings indicate that nurses’ obtaining prescriptive authority is not on the provincial department of health agenda. In addition, participating ppsychiatrists and medical officers expressed reservations about nurses obtaining prescriptive authority, specifically independent prescriptive authority. Participating mental health nurses displayed ambivalence related to the pursuit of prescriptive authority. Conclusion and Recommendations The challenge for mental health nurses is suggested to be the achievement of a collaborative working relationship within the discipline of nursing, and between the discipline of nursing and medicine / psychiatry. It is suggested mental health care directors, and the SANC, be proactive, look to the future in advising the health minister about access and barriers to mental health care treatment. In addition, the SANC champion the nurse, specifically the mental health care nurse in obtaining prescriptive authority for schedule 5-6 psychotropic medications. Further research is required to generate more in-depth data, specifically research that explores mental health care nurses’ reluctance to pursue prescriptive authority.
Description of psychiatric nursing students' stereotypical beliefs associated with mental illness labels and the potential mediating effects of information and contact.
(2014) Mbongwe, Cecilia M.; 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).
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 of 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. Stigmatizing 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.
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.
Experiences of primary health care nurses providing mental health care services at primary health care clinics in eThekwini South Sub-District, KwaZulu-Natal.
(2014) Glover, Cynthia Nomthandazo.; Smith, Amanda April Heather.
Primary Health Care (PHC) is a basic mechanism that brings healthcare close to the people. PHC promotes access to holistic care and improves the health of the population. The integration of mental health care into its package of services aimed at closing the treatment gap. However, successful integration requires well trained innovative nurses and a supportive government agenda that facilitates capacity. This study explored the experiences of PHC nurses, within PHC clinics, in the planning and provision of mental health care services in EThekwini district, KwaZulu-Natal. A qualitative descriptive study design used individual semi structured interviews to collect data from nurses within two PHC clinics. Interviews focused on the experiences of the PHC nurses rendering care to the MHCUs. Although the PHC nurses viewed the integration of mental health care into PHC as positive, they reported the integration process as poorly planned and implemented too quickly. Nurses felt unprepared for integration and apprehensive about their preparation. In addition, ongoing support, specifically experienced resources and service collaboration was reported as lacking. Integrated services were, in principle, acknowledged by participants as cost effective and having the potential to improve mental health care outcomes. However, its introduction happened quickly and the nurses felt ill equipped to institute their roles. Integration is said to improve the overall effectiveness of the health system thus benefiting the health of the population by addressing the health problems in a holistic manner (WHO, 1996).
An exploration of stakeholders perceptions of the advanced psychiatric nurse practitioner's role in the provision of health care in a psychiatric hospital at Umgungundlovu district.
(2012) Zondi, Ronah Tholakele.; Smith, Amanda April Heather.
No abstract available.
Exploring the effects of substance abuse on the family in a selected eThekwini District.
(2015) Radebe, Nondumiso Gladys.; Smith, Amanda April Heather.
Aim To explore the effects of substance abuse on the family in a selected EThekwini district. Background Substance abuse is a socio economic and heath problem contributing to the 40% global burden of mental illness that hinders social development and disintegrates communities. The commonly abused substances in South Africa are alcohol, cannabis and heroin. Previous studies conducted focused on various aspects of substance abuse problems ranging from personal to social reasons and implications for substance related HIV infections, but there is limited research on the effects of substance abuse on the family. Research Methodology Objectives for the study were twofold; to describe family members’ perceived effects of substance abuse on the family, and family members’ beliefs about substance abuse contributory factors. It was essential to conduct this study using a qualitative approach to obtain a deeper understanding of the experiences of families living with a substance abuser. A Coloured (mixed race) community living in the north of Durban in KwaZulu-Natal was purposively sampled due to known incidence of substance abuse within the community. Purposive sampling was used to identify key informants from 5 families experiencing substance abuse who were attending a community empowerment workshop. Two families participated, a total of seven individual participants aged between 23 and 67 years of age. Ethical considerations were followed by requesting permission to do the study from the community gatekeepers and by obtaining ethical approval from the Human and Social Science Reseach Ethics Committee at UKZN. Privacy and voluntary participation were emphasised. Data collection and Analysis Data collection was done using face to face and audio recorded interviews using open ended questions that allowed participants to disclose and narrate their everyday experiences with substance abuse. Content analysis was used. Results Families reported that the acceptability of illicit drugs in their community lured family members to experiment with these out of curiosity, they learn the cultural behaviour that predispose them to abdication of responsibility resulting in low education and inaccessibility to employment. Family lives are disrupted due to poor cohesion and financial hardships. Conclusion and recommendation The greatest concern is the increasing use of these illicit drugs resulting in a global health burden without adequate rehabilitation services due to lack of funds. There is a noticeable uphill battle in reducing both the source of production of these harmful substances especially with the new market developments of the inclusion of licit chemicals in modifying illegal substances. A multi-sectoral policy is needed to eliminate the socio-political factors that predispose families to the substance abuse burden.
Exploring the lived experiences of community members involved in a community conversation programme to promote mental health in a community in EThekwini district, KwaZulu-Natal.
(2016) Awolesi, Bukunola Esther.; Smith, Amanda April Heather.
Aim The aim of the study was to explore the lived experiences of participants of a CC programme in a community within eThekwini district, KwaZulu-Natal (KZN), and to describe the positive and negative contributions of the CC programme towards community life and mental health among participants who attended the programme. Methodology The researcher adopted a descriptive phenomenological approach, using eight focus group discussions and one individual interview with fifteen participants divided into three groups. The selection of the setting was based on the researcher’s prior involvement in two community conversations in the community, and, ultimately, on the participants who were on the attendance list, met the inclusion criteria and were willing to participate. The focus group discussions and interview consisted of questions about participants’ demographics, experiences and probes into the areas of feelings, relationships, change, personal decisions and group belonging. Data transcription was done manually. Data was gathered and analyzed using Colaizzi’s method of data analysis. Results Significant statements were extracted and grouped to form larger units or clusters. The clusters were then organised into six themes, with associated significant statements made by the community members: Theme 1: Mixed feelings: hope, anger, fear and empathy. The participants express differing emotional impact during their participation in the CC programme. Theme 2: The reality of the power differential. Evident throughout the interview and focus group discussions were issues of how community members perceived themselves as powerless in providing solutions to the education and drug abuse problems in the community. This is due to the resultant tension between community members and other major stakeholders including their non-involvement. Theme 3: Learning from others. Details emerged from the interview and focus group discussions about how community members have learned from the experiences of others particularly those that are directly affected. Community members become less judgemental and developed empathy. Theme 4: Community resolve. This involves change that affects the community’s living experience rather than individual behavioral change. The participants expressed thoughts related to change that was expected to have occurred as a result of the CC programme and the feeling of needing to be part of the change. Some believed they, as individuals, can make a change to affect the whole. However, others felt that the ability to effect change was dependent upon the willingness of other members in the community to participate as a collective, a group. Theme 5: Theme 5: Community identity. Various implications emerged in the study such that there was a collective ownership and responsibility regarding issues affecting the community. Emphasis was placed on areas where they could make a difference without necessarily waiting on other stakeholders. Theme 6: The reality of not being the only one. Emerging topic in this theme is the safe space that the CC provided. This safe space provides an opportunity to appreciate and identify with other people’s stories. It allows the individual to meet with others going through the same situation. Also through the CC programme people who felt judged based on their circumstances were given the opportunity to clarify their situation. Conclusion and Recommendations It was notable that participation and commitment, including power-sharing among all stakeholders, is essential for visible change to occur within the community. The recommendations focus around key factors for ensuring increased participation, commitment and collaboration among all stakeholders for sustained change in promoting community life and mental health. These include clarifying the roles of each stakeholder, providing additional training for the programme facilitators to develop their capacity to deal with conflict, the use of multiple strategies when tackling prevalent issues in the community, good communication skills, extensive training in the community conversation process, and up-to-date documentation and evaluation.
Graduate ancillary health care workers' perceptions of the ancillary health care learnership programme in eThekwini District.
(2014) Bhengu, Lindiwe Rejoice.; Smith, Amanda April Heather.
Aim The aim of this study was to describe ancillary health care workers’ perceptions of the Ancillary Health Care Learnership programme, and their current employment status within the health care sector. Methods A non-experimental cross sectional survey was used that incorporated complementary mixed method data collection (Balnaves & Caputi, 2001; Polit & Beck, 2010). Quantitative data collected during the first phase, a telephonic interview assisted self-report questionnaire was used to inform semi structured focus group interviews that took place during the second phase to obtain richer descriptions and explore response and results of the phase 1 cross sectional survey (Bell, 2005). A Convenience sample of ninety two (n=92) was achieved for the telephonic interview assisted self- report questionnaire, and was substantially lower that the number of potential participants (N=200). Purposive sampling was used to obtain fifteen (N=15) potential key informant participants, a final sample of nine (n=9) achieved for the focus group interviews. Results The research revealed that majority (69%) of participants had their expectations of the course met. Subjects such as agriculture and business plan were perceived as not valuable and participants recommended that these be removed from the course. Computer course information was seen as and needed addition in order to bridge the skills gap and improve the opportunities for employment.Despite particpants perceptions of the course being met, expectations regarding emplyment were not. Employment rates were low, specifically within the health care sector. Conclusion and Recommendations The Ancillary Health Care Programme has not assisted the graduates in gaining employment. The review of the Ancillary Health Care Programme and some of the unit standards is one of the recommended options that can be done to improve the employment opportunities.
A pilot study to explore mental health psychosocial rehabilitation beliefs, goals and practices of registered nurses working in primary health care clinics within the eThekwini district.
(2014) Govender, Ashley Christopher.; Smith, Amanda April Heather.
Aim: To describe psychosocial rehabilitation beliefs, goals and practices of registered nurses’ working in Primary Health Care clinics in the eThekwini District. Methodology This study was based on an interpretavist approach using a quantitative cross sectional survey. The population included all registered nurses working for at least three months at any of the PHC clinics where treatment to MHCUs was provided.. The Psychiatric Rehabilitation Beliefs, Goals, and Practices (PRBGP) scale was used to collect data from participants. Descriptive statistics were requested using SPSS version 18. Non-parametric tests were employed for analysis of associations between the scale scores and the demographic variables; and inter-correlations between factor scores. Results The sample consisted of 41 participants. The age group 22-29 years and nurses with a Diploma had the majority of contacts with MHCUs.. All nurses who had PSR training had contact with MHCUs. Nurses who had SANC Psychiatric Nurse registrations or PSR training were significantly more likely to have contact with MHCUs. Most participants did not favour consumer directed agendas and lacked flexibility when dealing with the unique needs of MHCUs.. There were disagreements between the claims of nurses’ consumer driven approach and allowing MHCUs’ needs to actually direct the process including personalizing the services; and between claims that nurses used PSR evidence and the actual process of allowing consumers’ needs to direct this process. The Cronbach’s alpha coefficient for the PRBGP scale was .81. Conclusion and Recommendations Nurses working in PHC have the potential to adopt a PSR approach and they are able to articulate PSR beliefs, goals and practices but were unable to translate this into their actual practice settings. Future research should; differentiate between the ideological stance of nurses and their actual beliefs, determine the support for PSR from both organizational structures and colleagues, determine the actual content of PSR programmes in South Africa ,determine whether the age of nurses independent of PSR training or SANC psychiatric registration influences the attitude of nurses towards MHCUs and finally whether advanced nurses have a more positive attitude towards MHCUs ..