Masters Degrees (Nursing)

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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.
Describing mothers’ compliance to Kangaroo Mother Care at a selected hospital in Southern Malawi.
(2016) Mathias, Christina Tiyankhulenji.; Gumede, Emelda Zandile.
Background: Studies have shown that Kangaroo Mother Care (KMC) is one of the low-cost, effective measures practiced in low income settings to enhance the survival of low birth weight babies. Since its development in 1979 in Bogota, Colombia by Dr. Rey as an incubator alternative in caring for low birthweight (LBW) babies, KMC practice has shown numerous empirically evident advantages over LBW babies’ lives. The success of KMC rests on key players, namely, the mother. However, there are limited investigations of compliance to Kangaroo Mother Care in Malawi targeting key players in KMC practice. Therefore, full involvement in KMC practice by mothers is of significance in facilitating LBW survival in order to yield high LBW babies’ survival rate through total involvement of mothers as significant players. Aim of the study: The aim of this study was to describe mothers’ compliance to Kangaroo Mother Care at a selected hospital in Southern Malawi. A descriptive, quantitative research study was conducted on N=50 KMC mothers who were practising KMC at QECH in Malawi. Data was collected using a questionnaire, which comprised of demographic data and questions pertaining to KMC knowledge, practice and compliance. The data was analysed by SPSS version 24. A central hospital in the Southern Malawi, which is the main teaching hospital for the University of Malawi, College of Medicine. Findings: The study results show that all the KMC mothers had prior knowledge to KMC, which enhanced their KMC compliance. Although 21 (42%) of the KMC mothers initiated KMC late, due to a lack of support from the nurses and family members, 34 (68%) of the KMC mothers were compliant to KMC, as they practised continuous KMC during their hospital stay, and they noticed KMC benefits on their LBW babies, including increased body weight gain. Four (8%) of the KMC mothers managed to put their babies in KMC position for less hours in a day, due to a lack of support in putting the baby in KMC position, and as a result, their LBW babies did not gain any weight, and no other KMC benefits were noticed. Nevertheless, 45 (90%) of the KMC mothers were very eager to continue with KMC practice at home, and 41 (82%) of the mothers emphasised continuing with KMC follow-up care. Due to KMC compliance, mothers witnessed good KMC outcomes, and as such, they were keen on recommending KMC to others. Key Words: LBW globally, LBW in Sub-Saharan countries, KMC practice in Sub-Saharan countries, neonatal mortality, MDGs and SDGs, KMC protocol, KMC compliance and KMC in Malawi.
Exploring unit manager’s experiences with community service nurses in selected nursing units in KwaZulu-Natal.
(2016) Sewkarran, Vashni.; Kerr, Jane.
Background: Community service for nurses was introduced in January 2008, after it was legislated in the Nursing Act (55 of 2005). Unit managers assist these nurses during their transition process, from community service nurse, to professional nurses, but are confronted with many challenges. A number of these challenges include various committee meetings, resource allocations, staff supervision and development. Consequently, they are torn between their multiple roles (Dutton, Baker, Crickmore, Hudson, Marshburn, & Rose, 2012:1-6). Aim: The aim of this study was to explore the unit manager’s experiences with community service nurses in selected nursing units in KwaZulu-Natal. Method: The study adopted an exploratory, descriptive and contextual approach in which individual semi-structured interviews were conducted following a qualitative approach. The target population was all the unit managers in a district, a district/ regional, a regional/ tertiary and in specialized health care facilities. Purposive sampling was used to select the study subjects. The sample size included all the unit managers who met the inclusion criteria. Semi-structured interviews were undertaken with ten unit managers in four health care facilities. Interviews were transcribed verbatim, and analysed using content analysis. Results: The results revealed that unit managers welcomed community service nurses. The major concern was that they lacked knowledge as to why community service for nurses was implemented, and how to manage these nurses. The findings further revealed that the unit managers in different health care facilities are doing what they feel is right and required during that year of remunerated community service. Recommendations: Management in health care facilities should provide training for unit managers and professional nurses in acting positions regarding roles and responsibilities of community service nurses as part of their orientation and in-service training program. It is recommended that each institution has specific policies, procedures and an orientation program, such as, allocation policy, job description and performance appraisal to guide unit managers in respect of community service nurses’ supervision. Furthermore, the relevant stakeholders should aim at improving current orientation, mentorship and preceptorship programs for community service nurses Conclusion: From the shared perceptions of the unit managers, although the findings cannot be generalised, this study showed that the unit manager’s experiences with community service nurses in the selected nursing units was very similar. It is recommended that a document outlining the specific scope of practice and acts and omissions for community service nurses be put in place for the benefit of the unit managers. Unit managers need to be supported by nursing management.
Exploring undergraduate nursing students’ perceptions on being change agents in a community-based transformative learning programme at a nursing education institution in KwaZulu-Natal.
(2018) Mncina, Violet Iris.; Mtshali, Ntombifikile Gloria.
Background The World Health Organization advocates for the strengthening of the healthcare system to improve the quality and efficiency of health service delivery. Transformative learning is associated with producing graduates who are change agents and in possession of leadership abilities to influence change in the healthcare system. The undergraduate nursing education programme of interest in this study adopts a community-based and problem-based curriculum, which uses a competency-oriented approach since 1994.Developing students as change agent’s is one of the competencies in the undergraduate nursing education. Purpose of the Study The purpose of this study is to explore undergraduate nursing students’ perceptions of being change agent in a community-based transformative learning programme at a nursing education institution in KwaZulu-Natal. Methods An exploratory qualitative approach is adopted in this study. The research setting is a nursing department in a selected university in KwaZulu-Natal. The sample includes 2nd, 3rd and 4th year nursing students registered in a Bachelor of Nursing programme. The participants were purposively selected because of their exposure to competency-oriented, community and problem learning. A total of 15 participated in focus group interviews. Ethical clearance was obtained from the University of KwaZulu-Natal Ethics Board: Protocol number is HSS/1910/016M, and ethical principles are observed throughout the study. Issues of quality are addressed through observing the four elements of trustworthiness; credibility, dependability, transferability and conformability. Results/Findings from the Study The findings of the study reveal that students understand the concept ‘change agents’ as people who possess the following characteristics: problem solvers, action-oriented researchers, health advocates, as well as advocacy and an empowering role. This is shown as a result of exposing them to a community-based learning setting for experiential learning while providing service to under-resourced communities. The findings further reveal that the development of students as change agents follows a process comprising of a progressive curriculum, shifting from traditional to an innovative curriculum. The educational environment in schools embraces democracy with social accountability values abetted in the development of students as change agents. The conditions that prepare students to be developed as change agents are related to students, facilitators, institutions and community. The consequence of developing students as change agent’s results in producing empowered students, raises awareness on student’s health issues, develops self-reliant communities and further reveals widening access to disadvantaged communities as well as having benefits to the faculty. Recommendations It is recommended that students should be made aware early in the programme on competencies as they are expected to be change agents at the end of the programme and how the learning experiences in the programme are used to shape these competencies. There should be a structured way of monitoring the development of the required competencies as early as from first year so as to provide the necessary support timeously. The use of innovative teaching strategies will assist students to develop critical thinking skills, communication and creative skills, thus becoming change agents. Educators should introduce learners to the theory of transformative learning and should provide necessary tools for students to be able to develop critical analytical reflection in the changing world so as to become better change agents. The use of transformative learning Programmes including community based education could be used to shape the nursing education Policies that will enhance the development of students as change agents. Further research can enlightened policy makers to use transformative learning in order to prepare students as change agents thus improving the quality on patients outcomes. Further research is recommended with diverse participants comprise academics, community members and other stakeholders involved in developing students as change agents, with as this study presents only the views of the students as it was for a mini thesis Key words: Agents of change, Change Agents, Transformative learning, Community-based education
An exploration of nursing students’ experiences of a community-based health promotion and illness prevention programme in a selected school of nursing in KwaZulu-Natal.
(2017) Uwitonze, Agathe.; Pakkies, Edith Ntefeleng.; Mchunu, Gugu Gladness.
Background Health promotion constitutes a priority in the World Health Organization’s agenda of health for all (WHO, 2014b). Therefore, nursing students should be introduced to the principles of health, illness prevention and health promotion early in their course of training. They need to develop competencies required for their career as well as to improve the health and wellbeing of the community. Purpose The purpose of this study is to explore nursing students’ experiences of a community-based health promotion and illness prevention programme in a selected school of nursing in KwaZulu-Natal. Methodology A qualitative, exploratory, descriptive research design is used to investigate the experience of seventy second-year nursing students in the Bachelor of Nursing programme at a selected school of nursing who were exposed to a community based health promotion and illness prevention programme. Data was collected through focus group discussions and content deductive analysis was used to analyse data. Findings The findings of the study are presented and discussed according to the four main themes that emerged during the data analysis: (1) community accessibility (2) safety in the community environment (3) learner support, and (4) skills development. Each of these themes have sub-themes that are presented and discussed, facilitating a full insight into the experiences of the participants in this programme. Conclusion Satisfying personal experience enhanced students’ clinical skills, especially in building the confidence and expertise required by health promotion and illness prevention programmes. Students’ participation in this programme developed capabilities such as: creativity; the identification of community health issues; the promotion of a greater sense of community responsibility; the ability to engage in group discussions; the envisaging of professional goals and the encouragement of a sense of connection with the community.
Promoting clinical scholarship in the clinical arena.
(2017) Almaze, Jean-Paul Bryan.; Emmamally, Waheeda.; Brysiewicz, Petra.
Background: Across healthcare, the importance of clinical scholarship has been increasing in the clinical arena. Applying clinical scholarship in daily nursing practice is vital. Aim: The aim of the study was to explore and describe clinical scholarship in order to develop recommendations to promote clinical scholarship in the clinical arena. Methodology: The study was conducted at a university in South Africa and adopted a sequential explanatory mixed-methods approach. Data collection was done in two phases. Phase One, the quantitative phase, focused on questionnaires involving eighty-one clinical specialist nursing students (CSNS). Phase Two focused on individual interviews with CSNS and clinical experts. Data saturation was reached after interviewing eight CSNS and four clinical experts. The interviews were analysed using latent-content analysis. Findings: Quantitative findings revealed that funding was the most common barrier to clinical scholarship. Re-examining criteria for promotion and reward all forms of scholarship was identified as preferred solutions to clinical scholarship. Qualitative findings revealed nine categories that of: academic excellence, importance of research to practice, scholarship overlooked, poor communication, resources, encouragement of scholarship activity scholarship culture, responsive teaching and attibutes in teaching clinical scholarship. These were further divided into subcatogories. Recommendation: In order to promote and develop CS, nurses should embrace a culture of CS as a fundamental principle in clinical practice. Further to that, the academic institution and clinical arena should support each other to promote nurses’ progress on the CS front, and resources should be made available to encourage nurses to pursue a CS track. Conclusion: The CSNSs and CEs are enthusiastic supporters of CS. Their support expressed a positive perspective towards clinical scholarship, where a synergy between academia and clinical management is needed to promote a CS culture.
Exploring adolescents’ perceptions regarding youth-friendly sexual and reproductive health services in a selected Community Health Centre (CHC) in uMgungundlovu District.
(2017) Hlatshwayo, Kwenzile Lungile.; Dube, Barbara Makhosazane.
Background One of the key concerns globally is the sexual and reproductive health of adolescents, especially in developing countries and regions like sub-Saharan Africa, where the largest number of deaths is due to the Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS), (World Health Organization, 2014). According to the WHO, 2014, an estimated 16 million girls between the ages of 15 and 19 years give birth every year, and most of these girls come from low- and middle-income countries. Purpose The purpose of this study was to explore adolescents’ perceptions regarding youth-friendly sexual and reproductive health services in a selected community health centre (CHC) in uMgungundlovu District in the KwaZulu-Natal province of South Africa. Methodology A quantitative research design, utilising a survey, was chosen for the study. A non-probability convenient technique was selected. A sample of 169 adolescents was included in the study using the convenience sampling method. Findings The study revealed that healthcare staff generally has positive attitudes towards rendering sexual and reproductive health services to adolescents in the selected CHC. Recommendations The recommendations arising from this research, therefore, focus on nursing practice and the formulation of policies for addressing adolescents’ perceptions regarding youth-friendly sexual and reproductive health services, and the involvement of youths in its delivery if one is already in place. Nursing education regarding the inclusion of adolescent youth-friendly sexual and reproductive health in the curriculum, as well as further which will focus more on male adolescents’ perceptions.
Exploring reasons for the high staff turnover amongst professional nurses at the Mandeni sub-district primary healthcare facilities.
(2017) Msomi, Babhekile Rejoice.; Kerr, Jane.
Introduction Primary healthcare (PHC) facilities are the first level of health care, therefore it is essential that these services are always accessible to the local community. The South African healthcare system has adopted a primary healthcare approach aiming to achieve health for all South African citizens. This is the reason why PHC services are rendered free of charge in all public clinics in South Africa. However, professional nurse turnover is impacting negatively on accessibility as well as quality of services rendered in the rural PHC clinics. Therefore, this research seeks to explore the reasons for high staff turnover amongst the professional nurses and to increase access of PHC services to the community and improve quality of services delivered by these clinics. Aim To explore the reasons for high staff turnover amongst professional nurses at the Mandeni sub-district PHC facilities. Method A qualitative exploratory study was conducted in seven PHC clinics and one Community Health (CHC) clinic was selected. Five professional nurses, including one operational manager were selected purposely. Data was collected using unstructured interviews. The main research question for this study was: “Why have you decided to leave employment at the PHC clinic?” Results The study’s findings revealed that professional nurses were overworked due to high patient load, lack of support from the management, favouritism, poor working conditions, professional nurse shortage, unmanageable subordinates, intimidation at the workplace, ever complaining community, financial problems, family responsibilities, poor work schedules and doing on-call duties, and lack of resources like poor water supply.

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