Nursing

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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.
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.
AN Analysis of nonverbal communication between nurses and hospitalised older adults in selected hospitalsi in Cameroon.
(2023) Keutchafo, Esther Lydie Wanko.; Kerr, Jane.
Background: Nurse-patient communication has been recognised as one of the most important aspects of successful patient outcomes. In relation to older adults, whose numbers are growing worldwide, nurses’ communication with older adults is essential because older adults will seek medical assistance more than before. Since most rely on nonverbal communication because of hearing deficits, and changes in attention and coding of information – all restrictions in interaction and effective verbal communication – nurses’ nonverbal communication will be a vital skill to develop good nurse-older patient relationships. In a context where there are no long-term care settings, nurses will be required to achieve effective nonverbal communication when older adults are admitted to the wards. Aim: This study aimed at analysing nonverbal communication between nurses and hospitalised older adults in selected hospitals in Cameroon, to develop a model for effective nonverbal communication between nurses and older adults. Methods: A mixed-methods approach was used in this study. A total of 372 participants were included through overt, theoretical, and convenience sampling. To collect the qualitative data through participant observations and individual interviews, twenty-seven (27) nurses were observed, of which 13 nurses were interviewed, and 29 older adults were observed, of which eight (8) were interviewed. In addition, 316 nursing students participated in the survey. Qualitative data analysis was composed of open coding, axial coding, and selective coding, which were intertwined as the researcher moved back and forth between data collection and data analysis. Additionally, comparative analysis, theoretical sensitivity, and memos were used during the process of analysing the qualitative data. Quantitative data were analysed using SPPS version 25, where descriptive and inferential analyses were run. Additionally, an explanatory factor analysis based on the principal component analysis method with varimax rotation was conducted, to determine the common factors that explain the order and structure among measured variables. Results: Firstly, the results showed that there was limited evidence of studies on nonverbal communication between nurses and cognitively intact hospitalised older adults in clinical settings. Secondly, the results showed that hospitalised older adults made both positive and negative interpretations of nurses’ nonverbal communication. They also had specific nonverbal communication needs. Thirdly, the results showed that nurses mainly used haptics, kinesics, and proxemics to communicate nonverbally with hospitalised older adults to build relationships with them, convey affection, reassure them, and support verbal communication. Further, the results showed that nursing students held slightly positive attitudes towards older adults; yet, the tool used to assess their attitudes showed moderate psychometric properties and two factor loadings. Finally, the results showed that the proposed model for effective nonverbal communication with hospitalised older adults, which emerged from the data, encompassed all six categories of Strauss and Corbin’s framework, which are: causal conditions, contextual conditions, core phenomenon, action/interaction strategies, intervening conditions and expected outcomes. Conclusions: This study revealed that nurses mainly use few nonverbal communication techniques to communicate with hospitalised older adults, which cannot achieve effective communication, vital in nurse-patient relationships. The proposed model provides a guide for effective nonverbal communication with older adults and acknowledges that older adults’ interpretations and needs of nonverbal communication, as well as attitudes towards them, all influence effective nonverbal communication with hospitalised older adults. It is hoped that nurses will consider these to improve their nonverbal communication with hospitalised older adults for better patient outcomes such as: patient satisfaction, shorter lengths of stay in hospitals and improved quality of care.
Analysing the implementation of patient safety incident reporting and learning guidelines in specialised care units, in the selected hospitals in KwaZulu-Natal, South Africa.
(2023) Mathe, Thusile Mabel Hycinth.; Mkhize, Sipho Wellington.
Background: Despite the implementation of patient safety strategies, patient safety incidents (PSIs) in specialised care units (SCUs) remain high and are of serious concern worldwide, including in South Africa. Implementing Patient Safety Incident Reporting and Learning (PSIRL) Guidelines is critical in guiding clinical practice and improving clinical outcomes in SCUs. There is limited research on evidence of the implemented PSIRL Guidelines in SCUs at the global level. Aim: To analyse the implementation of the PSIRL Guidelines in SCUs and to develop a strategy for the effective implementation of the PSIRL Guidelines in selected hospitals in KwaZulu-Natal, South Africa. Methods: A convergent parallel mixed methods or embedded strategy was used to collect quantitative and qualitative data. A descriptive, non-experimental, cross-sectional survey was used to collect the quantitative data via online questionnaires from March 2021 to May 2021. A purposive sample targeted 237 healthcare professionals. Furthermore, a descriptive, explorative, qualitative approach was used to collect qualitative data from senior healthcare professionals through focus groups and individual interviews, for in-depth information, from August 2021 to October 2021. Content data analysis was performed using Tesch’s method of analysis process. The quantitative and qualitative data were analysed separately and then converged to provide a comprehensive analysis of the research problem. Results: For a quantitative study, a total of 181 questionnaires were returned, yielding a response rate of 76%. Notably, 83% of respondents had high-perceived knowledge of the PSIRL Guidelines, while 98% had low perceptions of the implementation. For the qualitative study, the main themes that emerged during data analysis were ineffective reporting systems affecting the communication of PSI guidelines, inadequate institutional management for the healthcare professionals, insufficient education and training of healthcare professionals and poor human resources affecting the implementation of PSI guidelines. The findings highlighted that there were more major barriers to the implementation of the PSIRL Guidelines. Conclusion: For the quantitative study, the respondents demonstrated good perceptions of knowledge of the PSIRL Guidelines; however, the perception of the implementation was poor. The qualitative study confirmed that the PSIRL Guidelines are still not successfully implemented in the SCUs and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised PSIRL Guidelines, designed in consultation with the frontline healthcare professionals, consisting of standardised, simple -user-friendly reporting processes as well as an implementation strategy to guide the healthcare professionals.
Analyzing and strengthening the clinical support of undergraduate midwifery students and developing a mentorship training program at a higher education institution in KwaZulu-Natal, South Africa: a mixed method and action research design.
(2022) Amod, Hafaza Bibi.; Mkhize, Sipho Wellington.
The competence of midwifery students is highly dependent on the quality of clinical support they receive during clinical placement. Offering support and training to midwifery practitioners, who supervise students during placement, is necessary in South Africa. This study aimed to analyze and strengthen the clinical support of undergraduate midwifery students, and develop a mentorship-training program. This study adopted a mixed-method and action research approach incorporating a descriptive and exploratory design. A convenient and purposive sampling technique, multiple research tools (systematic scoping review protocol, questionnaires, interviews and focus groups), and three different study populations (60 midwifery students, 28 practitioners and 10 educators) complimented the aim of conducting a mixed-methods study. Data collection commenced for Cycle 1 in May 2019 and concluded with Cycle 4 in April 2022. Quantitative data was inserted into SPSS version 27 for descriptive and comparative analysis whilst qualitative data used a thematic content analysis approach. Cycle 1 results highlighted that 93% of students had support from midwifery practitioners and found that the clinical placement benefitted their learning outcomes. Although students received three types of clinical support, namely clinical supervision, mentorship and preceptorship, 80% of clinical support was clinical supervision. Postclinical placement, students were incompetent in 11.4% of their clinical requirements. In Cycle 2, a two-round Delphi method evaluated the quality of a mentorship-training program using midwifery experts in round 1 and midwifery practitioners in round 2. There was an overall quality score achieved of 81% round 1 and 96% in round 2. In Cycle 3, three themes emanated from the focus group discussions. Mentorship training was a new phenomenon, empowered mentorship abilities, and an investment toward midwifery leadership. Interview results showed that the mentorship training program was a new, well-structured and valuable program; a refresher course for midwifery clinical practitioners and educators, adequate to support midwifery practitioners in their mentorship roles and responsibilities, and produced recommendations for midwifery practice and education. Mentorship during clinical placement is likely to strengthen the clinical support of midwifery students. A mentorship training program for midwifery practitioners developed in this study is valuable to midwifery educators and practitioners in South Africa.
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.
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.
Developing a competence-based framework for theprovision of mental healthcare in patients with mental health problems and HIV in primary healthcare in Maseru, Lesotho = Ukuthuthukisa uhlaka olususelwa ekukwazini ukuhlinzekela iziguli ezigula ngokomqondo eziphinde zibe negciwane le-HIV ezelashwa ngonakekelo oluphezulu eMaseru, eLesotho.
(2023) Posholi, Malerotholi Thabida.; Ngcobo, Winnie Baphumelele.
In 2017 there were approximately 792 million people with mental health problems globally. mental health problems are increasing rapidly globally but mental health services are lacking. Approximately 80% of people living with Human immunodeficiency virus have mental health problems yet these disorders have been absent from the global health agenda. Around 90% of people who require MHS do not obtain them in Low and middle-income countries. The aim of the study was to develop a competence-based framework for mental health provision in people living with Human immunodeficiency virus in primary Health Care in Lesotho. A mixed method study was used. In total, 88 questionnaires were returned by the respondents and 50 interviews were conducted. The findings from the quantitative and qualitative study were supportive and used to develop a competence-based framework that would facilitate the provision of mental health services for people presenting with mental health problems and Human immunodeficiency virus in primary health care. The quantitative data was analysed using an appropriate software package, in this case SPSS version 26. Qualitative data was analysed using the software called Nvivo and thematic framework analysis. 92 % of the participants needed competence-based frame work to enable them to successfully manage mental health problems in people presenting with mental health problems and Human immunodeficiency virus however the majority (69.7%) of the participants had inadequate knowledge regarding mental health. Competence-based frame work was developed to enable health professional to successfully manage people with mental health problems and Human immunodeficiency virus. Currently, mental health services are lacking in primary health cares in Lesotho. There was lack of knowledge regarding mental health in health professionals, mental health was also not an in-country priority as the professionals are taught about mental health in colleges, but do not practice it in their professional work. Availability of competence-based framework was seen as a great need by health professionals to manage mental health problems. Many studies emphasized the need to integrate mental health services with Human immunodeficiency virus services as they are related. However, in Lesotho it was still a serious problem during the time of the study. Iqoqa. Enyakeni wezi-2017 kwakunabantu abacishe babe yizigidi ezingama-792 abanenkinga yokugula ngokomqondo emhlabeni jikelele. Izinkinga zokugula ngokomqondo zikhula ngesivinini esikhulu emhlabeni jikelele kodwa izindawo zokwelapha ukugula ngokomqondo azanele. Cishe abantu abangama-80% abaphila negciwane lesandulela ngculazi banezinkinga zokugula ngokomqondo nakuba lezi zifo kade zingekho ohlelweni lwezempilo yomhlaba. Abantu abacishe babe ama-90% abadinga i-MHS abayitholi emazweni anengenisomali eliphansi nelimaphakathi. Inhloso yocwaningo wukuphucula uhlaka olugxiliswe ekukwazini ukuhlinzekela impilo yangokomqondo kubantu abaphila negciwane lesandulela ngculazi kweZempilo ezihamba Phambili eLesotho. Kusetshenziswe indlelakwenza engxube. Sekukonke, izinhlumibuzo ezingama-88 ezabuyiswa ababephendula nezimposamibuzo ezingama-50 zenziwa. Okutholakele ocwaningweni lwekhwantithethivu nowekhwalithethivu kweseka kwaphinda kwasetshenziselwa ukuthuthukisa uhlaka olugxile ekukwazini, okuzokwenza kwenzeke ukuhlinzeka izinsiza zokugula ngokomqondo kubantu abanezinkinga zokugula ngokomqondo kanye negciwane lesandulela ngculazi abasonakekelweni oluphambili. Imininingo yekhwantithethivu yacutshungulwa kusetshenziswa iphakheji yesofthiwe eyiyo, okuyi-SPSS uhlobo 26. Imininingo yekhwalithethivu yahluzwa kusetshenziswa uhlelokusebenza olubizwa nge-Nvivo nokuhluza uhlaka lwezindikimba. Ama-92 % ababambiqhaza babedinga uhlaka olugxiliswe ekukwazini ukuze bakwazi ukulawula ngempumelelo izinkinga zokugula ngokomqondo kubantu ababonakala benezinkinga ngokomqondo kanye negciwane lesandulelangculazi kodwa iningi (69.7%) lababambiqhaza banolwazi olungenele olumayelana nempilo yokomqondo. Uhlaka olugxile ekukwazini lwathuthukiswa ukusiza abasebenzi bezempilo ukuba balawule ngempumelelo abantu abanenkinga yokugula ngokomqondo nabanegciwane lesandulelangculazi. Njengamanje, izinsizakusebenza zempilo yokomqondo ezindaweni zokunakekela eziphambili eLesotho zisaswelekile. Kunokuntuleka kolwazi olumayelana nempilo yokomqondo ezisebenzini zezempilo, impilo yokomqondo yayingeyona into ephambili ezweni njengoba izisebenzi bezifundiswa ngezempilo yokomqondo emakolishi, kodwa zingasebenzi ngalokho emsebenzini wabo wansuku zonke. Ukuba khona kohlaka olugxiliswe ekukwazini kwabonakala kuyisidingo esikhulu kubasebenzi bezempilo ukulawula izinkinga zokugula ngokomqondo. Ucwaningo oluningi lugcizelele isidingo sokudidiyela imisebenzi yokwelapha ukugula ngokomqondo nezinsizakusebenza zokwelapha igciwane lesandulela ngculazi njengoba kuhlobene. Kodwa, eLesotho bekuseyinkinga enkulu lokhu ngesikhathi sokwenziwa kocwaningo.
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.

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