bluuebunny/crossref_metadata_2025 huggingface dataset:
The value of the pre-hospital learning environment as part of the emergency nursing programme
Authors: Van Wyk Sonett , Heyns Tanya , Coetzee Isabel
Published: April 2018

Background: Professional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary.Objective: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme.Methods: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of selfreported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews.The data was analysed using content analysis.Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies.Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.
Editorial comments HealthSAGesonheid 2015 publication
Authors: Poggenpoel Marie
Published: April 2018

No abstract available.
Nurses' experiences of inpatients suicide in a general hospital*
Authors: Matandela Mirriam , Matlakala Mokgadi C.
Published: April 2018

When suicide occurs, it is regarded as an adverse event. Often, little attention is given to the nurses who cared for the patients prior to the adverse event. Instead the affected nurses are expected to write statements and incident reports about the adverse event. The aim was to explore the experiences of nurses who cared for patients who successfully committed suicide whilst admitted at a specific general hospital in Gauteng Province, South Africa. A qualitative exploratory research was conducted. Data were collected through in-depth interviews with a purposive sample of six nurses and content analysis was done. Nurses experienced feelings of shock; blame and condemnation; inadequacy and feared reprisal. This study suggests a basis for development of support strategies to assist the nurses to deal with their emotions following experience of adverse events.
Has the increase in the availability of generic drugs lowered the price of cardiovascular drugs in South Africa?
Authors: Bangalee Varsha , Suleman Fatima
Published: April 2018

Background: This research focuses on pharmaceutical competition in South Africa where concurrent pricing legislation is being implemented without monitoring the consequences on generic drug competition and usage.Objective: To examine the relationship between originator drug prices and the number of generic brands within the cardiovascular class of drugs and to compare South African prices with international reference prices.Method: Data on private sector drug prices was sourced from the South African Medicine Price Registry. The relationship between the median proportional price and the number of brands in the therapeutic class was analysed using correlation analysis. International reference prices were obtained from the Management Sciences for Health International Drug Price Indicator Guide (2012 edition).Results: A weak correlation between originator and generic drug prices and the number of available brands was observed, the exception being diuretic drugs. The median prices per strength of the originator generic were still higher than the most expensive generic version manufactured by any other company, the exception being telmisartan. Comparison of price ratios between the originator drug, lowest priced generic and international reference price values revealed that the originator drug prices had a median price ratio of 20.99 (interquartile range 7.31—53.46) and the lowest priced generics had a median price ratio of 4.28 (interquartile range 2.10—8.47).Conclusion: Increased generic competition is not a predictor of lower drug prices. The study also concludes that the current South African pharmaceutical policies have not yet achieved the lowest prices for drugs when compared internationally.
“Just live with it”: Having to live with breast cancer related lymphedema
Authors: Maree Johanna E. , Beckmann Dalene
Published: April 2018

An exploratory qualitative research approach was selected for this study aiming to explore how people living with breast cancer related lymphedema experience this complication. Unstructured interviews were conducted with nine purposively selected participants. Living with breast cancer related lymphedema was not easy. Participants were not informed of the possibility of developing lymphedema and felt let down by the medical professionals they consulted. They had to face the physical, psychological and practical consequences without the continuous support of a knowledgeable therapist. Managing the lymphedema was a challenge as they could not afford the necessary treatment and theself-care items. In addition, treatment failure resulted in them feeling exploited and using various treatment options. Nurses should maintain a high level of suspicion of breastcancer related lymphedema, assess patients for lymphedema and refer them to a therapist specifically trained in the management of this debilitating condition.Hierdie studie ondersoek die belewenis van mense met borskanker verwante limfedeem.‘n Kwalitatiewe eksploratiewe navorsingsontwerp is gekies en ongestruktureerde onderhoude is met nege doelgerig gekose persone gevoer. Limfedeem kompliseer die lewe en die proefpersone het die nie maklik gevind om daarmee saam te leef nie. Hulle is nie ingelig oor die moonlikhied om limfedeem te ontwikkel nie en was van mening dat hulle deur die medici wat hulle behandel het in die steek gelaat is. Die proefpersone moes die fisiese, psigologiese en praktiese gevolge van limfedeem sonder die bystand van ‘n kundige terapeut te bowe kom. Die hantering van die limfedeem was ‘n uitdaging aangesien hulle nie die behandeling en self-sorg artikels kon bekostig nie. Die slegte resultate van behandeling het tot gevolg gehad dat die proefpersone uitgebuit gevoel het en ook verskillende behandelingsopsies gevolg het. Verpleegkundiges moet ‘n hoë vlak van bewustheid ten opsigte van limfedeem handhaaf, pasiënte hiervoor beraam en na ‘n terapeut wat in limfedeem spesialieer verwys.
Referral criteria for school-based hearing screening in South Africa: Considerations for resource-limited contexts
Authors: Mahomed-Asmail Faheema , Swanepoel De Wet , Eikelboom Robert H.
Published: April 2018

Background: School-based hearing screening is likely to be the first opportunity to identify childhood hearing loss in South Africa. Criteria for school-based hearing screening requires balancing the targeted degree of hearing loss while ensuring that referral rates are sufficiently low for a cost-effective and sustainable programme. The study aim was to investigate the effect of screening intensity (loudness) levels on the referral rate and to establish the effect of an immediate rescreen in reducing the referral rate.Methods: A within-subject study was conducted in two phases. Phase 1: compared the referral rate in a counterbalanced sequence at screening levels of 20 dB HL, 25 dB HL and 30 dB HL across 1, 2 and 4 kHz for 135 children. Phase 2: determined the effect of an immediate rescreen on referral rate for 337 children screened at 25 dB HL. If a further referral was obtained on rescreen, diagnostic audiometry was subsequently conducted.Results: Referral rate was reduced to 6.7% from 17% when using 25 dB HL as opposed to 20 dB HL as screening intensity. Referral rate was reduced to 4.4% when employing 30 dBHL as screening intensity. An immediate rescreen reduced the overall referral rate by more than one-third. Diagnostic audiometry confirmed that almost half (47%) of the referred children had a hearing loss.Conclusion: A screening intensity of 25 dB HL andimmediate rescreen reduces the referral rate significantly and will limit the burden of the screening programme on health care resources.
Mothers' perceptions of their premature infant's communication: A description of two cases
Authors: Pascoe Michelle , Bissessur Divya , Mayers Pat
Published: April 2018

Background: Survival rates of premature infants have increased due to advances in medicine. Premature infants however, remain at risk for developmental delays including communication difficulties. The bonding and attachment experiences of premature infants and their parents are often challenged, further placing these infants at risk for communication difficulties. This study firstly aimed to explore mothers' perceptions of their premature infants' communication. The second aim was to explore the mothers' perceptions of their own role in the communication development of their infants.Methods: A descriptive, longitudinal study was conducted with two mother—infant dyads.Three visits took place in the first year of life. Subjective maternal reports were obtained through semi-structured interviews.Results: Differences in the two mothers' perceptions were noted. The mothers described helping their infants to communicate through physical contact and talking. Risk and protective factors for early communication development are discussed in relation to the findings.Conclusion: The findings support the need for a healthy mothereinfant relationship in the first few months of life. Health professionals should support premature infants and their families after discharge in order to help them interact with their infants and encourage attachment and bonding.
Perception and attitude of healthcare workers towards the use of a female condom in Gaborone, Botswana
Authors: Mashanda-Tafaune B. , Monareng L. V.
Published: April 2018

Background: Although the female condom (FC) is viewed as an effective female controlled barrier contraceptive device that can be used by women to prevent them from contracting the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), other sexually transmitted infections (STIs) and unwanted or unintended pregnancy, the perception and attitude of healthcare workers (HCW) plays a key role in its effective use and distribution amongst women.Objectives: To identify and examine factors that influences the perception and attitude of HCWs towards the use and distribution FCs.Method: A quantitative, explorative and descriptive design was used to conduct the study based on the Health Belief Model (HBM) as a conceptual framework. A pre-tested questionnaire was utilised in June 2013 to collect data from a convenience sample of 164 HCWs with a 100% return rate. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 13.0 and Statistical Analysis Systems (SAS) version 9.2.Results: The results showed that 64.0% (n = 105) of the respondents perceived unavailability of FCs as contributing to lack of adequate use. Only 31.7% (n = 52) [95% CI: 24.7—39.4] of them reported to be using the FC. There was an association with increasing use of a FC with age (Fischer's exact = 0.05), marital status [Fischer's exact ¼ 0.037] and training [c2 = 53.3;p < 0.05]. The results revealed that lack of knowledge and training on the use of a FC might prevent its effective use and distribution.Conclusion: The results showed evidence that the FC was a safe method of contraception and protection against STIs and that it empowers women to make decisions related to sexuality. However, awareness campaigns, increased availability of FCs and training of HCWs are essential to enhance positive perception and attitudinal change to reduce sexual risks related infections and poor quality of life for women.
A HIV stigma reduction intervention for people living with HIV and their families
Authors: Pretorius Johanna B. , Greeff Minrie , Freeks Fazel E. , Kruger Annamarie
Published: April 2018

Background: The diagnosis of HIV is life-changing that requires people not only to deal with the disease but also to cope with the stigma attached to HIV. People living with HIV (PLWH) as well as their close family members (CFM) are stigmatised; however, CFM also stigmatise PLWH. This interaction affects the relationship between PLWH and their CFM.Aim: To explore and describe the experiences of PLWH and CFM during and after a community-based HIV stigma reduction intervention in both an urban and rural setting in the North-West.Method: A qualitative description approach through in-depth interviews was used in both settings. Purposive sampling was used for the PLWH and snowball sampling for the CFM. Data was analysed using open coding.Results: Both urban and rural groups gained a richer understanding of HIV stigma and how to cope with it. The relationships were enriched by PLWH feeling more supported and CFM realising how they stigmatised PLWH and that they should be more supportive. Leadership was activated in PLWH and CFM through the stigma reduction project that they participated in.Conclusion: No significant differences were found between rural and urban communities, thus the intervention can be implemented with similar results in both settings. The intervention showed positive outcomes for both PLWH and CFM. Bringing PLWH and CFM together during an intervention in an equalised relationship proved to be useful as PLWH felt more supported and CFM showed much more compassion towards PLWH after the intervention.
Knowledge, perceptions and practices of pharmacovigilance amongst community and hospital pharmacists in a selected district of North West Province, South Africa
Authors: Joubert M.C. , Naidoo Panjasaram
Published: April 2018

Background: Pharmacovigilance (PV) as a means of ensuring drug safety is an essential component of the process ensuring that the risk of drug use does not outweigh the benefit. Pharmacists are valuable in collecting PV information, but not many studies explored the knowledge, perceptions and practices of both community and hospital pharmacists towards the practice of PV.Objectives: The aim of the study was to explore the knowledge, perceptions and practise of PV amongst the pharmacists in a selected district of North West Province, South Africa.Method: A cross sectional study was conducted amongst pharmacists in a selected district of the North West province, using a pre-tested questionnaire. Descriptive statistics were used to analyse the results including ANOVA testing.Results: One hundred and two pharmacists (68.9%) completed the questionnaire. Although familiar with the concept of PV, pharmacists knowledge scores were low. Pharmacists agreed that PV is a useful tool, but perceived the PV authorities to be distant and remote. Although more than 90% indicated that all adverse drug reactions should be reported, only 44.1% indicated that they have reported adverse drug reactions (ADRs). Only 6.7% of pharmacists were satisfied with feedback received from authorities after reporting an ADR. Barriers were cited that prevented them from reporting ADRs. Over 80% indicated they would participate in further PV training.Conclusion: The majority of pharmacists are familiar with the concept of PV, but less than half reported any ADR. They are willing to participate in PV processes but are unsure what their exact role playing should be. More than half indicated that they would like to see improvements to the current PV system in South Africa. The majority are prepared to undergo further education to improve their PV knowledge.
Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in woman
Authors: Branco Kim C. , Moodley M.
Published: April 2018

Purpose: This study serves to determine the effectiveness of either chiropractic spinal manipulative therapy to the thoracic spine or stretch and strengthening exercises (stretching the pectoralis major muscle and strengthening the rhomboid, middle and inferior trapezius muscles) versus the combined treatment of chiropractic spinal manipulative therapy to the thoracic spine in conjunction with stretch and strengthening exercises.Method: A randomised study design with thirty female participants between the ages of twenty and  thirty nine was selected. Group 1 (n = 10) received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 (n = 10) received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 (n = 10) received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. The study consisted of seven consultations for Group 1 (they received treatment once a week for six weeks) and for Groups 2 and 3 there were nineteen consultations (they received three treatments a week for six weeks). Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1, and the first, tenth and nineteenth consultations for Groups 2 and 3. On the seventh consultation (for Group 1) and nineteenth consultation for Groups 2 and 3, only data collection was done. Objective data were obtained by using the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal) view photographs at the beginning of the initial and final consultations.Results: Statistical analysis revealed significant statistical changes for the intragroup results for all three groups. No significant statistical difference was found between the groups for the inter-group analysis.Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the participants' posture. Therefore, in conclusion, Groups 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but Group 2's treatment protocol, consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises, will yield the best results.
Knowledge of appropriate blood product use in perioperative patients among clinicians at a tertiary hospital
Authors: Yudelowitz Bradley , Scribante Juan , Perrie Helen , Oosthuizen Eddie
Published: April 2018

Background: Blood products are an expensive and scarce resource with inherent risks to patients. The current knowledge of rational blood product use among clinicians in South Africa is unknown.Purpose of research: To describe the level of clinicians' knowledge related to all aspects of the ordering and administration of blood products from the South African Blood Services for peri-operative patients at a tertiary hospital.Method: A self-administered survey was distributed to 210 clinicians of different experience levels from the departments of Anaesthesiology, General Surgery and Trauma, Orthopaedic Surgery and Obstetrics and Gynaecology at the study hospital. The questions related to risks, cost, ordering procedures and transfusion triggers for red cell concentrate (RCC), fresh frozen plasma (FFP) and platelets.Results: A total of 172 (81.90%) surveys were returned. The overall mean for correctly answered questions was 16.76 (±4.58). The breakdown by specialty was: Anaesthesiology 19.98 (±3.84), General Surgery and Trauma 16.28 (±4.05), Orthopaedic Surgery 13.83 (±4.17) and Obstetrics and Gynaecology 15.63 (±3.51). Anaesthesiology performed better than other disciplines (p < 0.001) and consultants out-performed their junior colleagues (p < 0.001). Seventy percent correctly identified triggers for RCC transfusion and 50% for platelets. Administration protocols were correctly defined by 80% for RCC and FFP just over 50% for platelets. Thirty eight percent of respondents deemed infectious and non-infectious risk sufficient to obtain informed consent. Knowledge of costs and ordering was below 30%.Conclusion: Clinician's knowledge of risks, resources, costs and ordering of blood products for perioperative patients is poor. Transfusion triggers and administration protocols had an acceptable correct response rate.
The correlation between motor proficiency and physical activity in Senior Phase learners in the Potchefstroom area
Authors: Van Niekerk Lizl-Louise , Du Toit Dorita , Pienaar Anita E.
Published: April 2018

Background: One of the risks associated with low physical activity levels is the insufficient development of motor proficiency, which in turn has an impact on participation in physical activity and sport during adolescence.Objectives: To determine the relationship between motor proficiency and physical activity levels in adolescent Senior Phase learners in Potchefstroom, South Africa. No literature exists on the relationship between motor proficiency and physical activity levels among South African adolescents.Method: A total of 239 13- to 14-year-old learners were assessed using the Bruininkse Oseretsky Test of Motor Proficiency 2 (BOT-2) for motor proficiency, and the International Physical Activity Questionnaire (IPAQ) for physical activity levels. Data analysis included descriptive statistics, Spearman correlation coefficients and effect sizes.Results: Statistically and practically significant correlations were found between the total BOT-2 score and the physical activity levels of the total group, as well as the boys and the girls respectively. Fine motor coordination correlated with physical activity levels in the girls, while manipulation coordination correlated with the physical activity levels of the total group and the boys. The body coordination skill of jumping in place and the strength test items showed strong correlations with physical activity in all the groups.Conclusion: The motor skills of Senior Phase learners, especially coordination and strength skills, should be developed and maintained in the Physical Education curriculum to enhance physical activity levels.
Maximum potential cost-savings attributable to generic substitution of antipsychotics 2008 to 2013
Authors: Husselmann D. , Joubert R. , Burger J. R. , Lubbe M. S. , Cockeran M.
Published: April 2018

Background: Schizophrenia is a costly illness to treat, especially during a time of escalating medicine inflation costs, putting a large economic strain on patients, their families and the community. Treatment, however, can become more affordable through generic substitution.Objective: To determine the maximum potential cost-saving through generic substitution for both originator and more expensive generic items while observing the prescribing patterns of antipsychotics.Method: Antipsychotic medicine usage was analysed retrospectively during the study period 2008 to 2013 using data obtained from a nationally representative Pharmaceutical Benefit Management Company. The study population consisted of 4410 patients with ICD-10 codes (F20-F20.9) who had paid claims for an antipsychotic reimbursed from their prescribed minimum benefits. Active ingredients were identified using the MIMS classification system. Maximum potential cost savings were determined by substituting all originator and more expensive generic antipsychotic items with the cost of the least expensive generic antipsychotic item available.Results: Through generic substitution, a total potential cost-saving of ZAR4 642 685.45 could be possible from 2008 to 2013. Average cost per items increased from ZAR600.53 ± ZAR435.00 (median ZAR 539.82) in 2008 to ZAR1 196.59 ± ZAR 942.16 (median ZAR 940.72) in 2013 and had a significant effect on patients' contribution, which increased with 726.94% from 2005 to 2008. Psychiatrists prescribed the majority of antipsychotics. Although generic items claimed increased by 60.31% during the study period, psychiatrist still favoured non-generic prescribing (40.63%).Conclusions: Potential economic benefits can be generated with generic substitution.
Critical thinking ability of 3rd year radiography students
Authors: Pieterse Tracey , Lawrence Heather , Friedrich-Nel Hesta
Published: April 2018

Background: Developing the critical thinking skills of student radiographers is imperative in an era of rapidly advancing technology. The status of the students' ability to demonstrate critical thinking skills needed to be explored for the Department of Radiography at a comprehensive university to determine if a more explicit curriculum was needed to facilitate these skills.Aim: The aim of this article is to present results of a study conducted to determine the critical thinking ability of 3rd year radiography students at a Comprehensive University in South Africa.Method: The research study used a descriptive exploratory design to collect both quantitative and qualitative data. Quantitative data was collected by scoring the participants ability to think critically when answering clinical scenarios posed in the form of vignettes given to the students under assessment conditions. The qualitative data was generated by in-depth field notes made inductively by the researcher.Results: The findings of this study indicated that the majority of participants demonstrated a minimal ability to think critically.Conclusion: The study results imply that in order to improve critical thinking skills of student radiographers, there is a need for curriculum adjustment, to nurture and encourage these skills. It is recommended that facilitators adopt methods to integrate these skills in the curriculum.
A concept analysis of young adults; Perception of HIV Counselling and Testing
Authors: Risenga Patrone R. , Davhana-Maselesele Mashudu
Published: April 2018

Aim: The aim of the study was to investigate perceptions of young adults regarding HIV Counselling and Testing (HCT) and the factors contributing to either negative or positive perceptions towards the programme. This article is a report of a concept analysis of young adults' perceptions of HCT that were collected during the study.Background: Perception forms the core of HIV Counselling and Testing (HCT) use by young adults, because it is from these perceptions that young adults will decide to follow an HCT programme or not, depending on how they perceive the programme. HCT as an entry point in HIV and AIDS services should be accessible and young adults' perceptions towards the programme be promoted in order to assist them to develop positive perceptions towards the programme, which will enhance its uptake.Data sources: A literature search was undertaken using internet search engines, different journals, websites and electronic literature indexes. A sample of 60 documents met the criteria. The inclusion criterion was any article addressing perceptions in psychology, social sciences, nursing and education were reviewed.Review method: A concept analysis was conducted according to the steps of Rodger andKnafl (2000); Walker and Avant (2005) and Wilson (1963).Results: Perception has been defined as a constructive process that relies on a top-down processing. This entails that people make inferences about what they see and try to make a best guess as to what the object is all about. Attributes for perception were defined as intensity and physical dimension of stimulus, past experiences, and attention factors such as readiness to respond to the stimulus, motivation and emotional state of the subject. Consequences include increasedHCTuptake by young adults, a positive lifestyle, a reduction in the spreading of HIV and AIDS and lowered HIV statistics amongst young adults.Conclusion: The study findings related to HCT and perceptions paved the way towards a further understanding of HCT as an entry programme in HIV/AIDS services or programmes in relation to young adults. The ability of young adults to use their auditory senses to hear the nurses talk about HCT and HIV, the ability to see the attitudes displayed by HCT counsellors, and their perceptions with regard to lack of privacy, together with a lack of treatment for HIV made young adults to perceive HCT programme as being of less importance to them.
Utilisation of mobile health by medical doctors in a Zimbabwean health care facility
Authors: Marufu Chester , Maboe Kefiloe A.
Published: April 2018

Background: Mobile Health is the utilisation of mobile devices like cellphones and tablets for the delivery of health care. It is an up and coming intervention promising to benefit health services. Recent mobile health studies have tended to focus on mHealth for data collection and surveillance rather than on actual patient care. This paper highlights the potential and the challenges of mHealth use in the delivery of health care services.Objectives: This paper focused on determining the use of mHealth and identifying and describing the opportunities and the challenges faced by the medical doctors in using mHealth at a specific health care facility in Zimbabwe.Methods: A quantitative, descriptive, cross-sectional and analytical design was used to determine the rate of utilisation of selected mHealth “patient identification and treatment activities” by medical doctors. A structured questionnaire was used for data collection form 104 respondents. The number of the returned complete and usable questionnaires was 42. No sampling technique was done because the whole population was of interest to the researcher, accessible and available during data collection.Results: Fifty percent (50%) of the respondents indicated, lack of knowledge and unawareness in using mHealth to support chronically ill patients. The majority of the respondents (83.3%) believed that mHealth presented opportunities to improve health care delivery. The majority of the respondents (95%) indicated the potential for its future use.Conclusion: Given the challenges that were encountered mHealth program to be officially launched for mHealth use and the users to be developed on its utilisation.
Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein
Authors: Van Zyl Laurisa , Nel Carla , Du Toit Martie , Joubert Gina
Published: April 2018

Background: Information regarding lifetime exposure to potentially traumatic events is critical in the management of various psychiatric disorders. Recent South African research suggests high levels of trauma exposure in the general population, however, the prevalence and type of potentially traumatic events among tertiary psychiatric patients are unknown.Objective: The study aimed to explore and describe the extent and nature of reported potentially traumatic events and associated variables in adult patients referred for psychological services at the Free State Psychiatric Complex (FSPC), Bloemfontein.Methods: In this cross-sectional study, demographic information, diagnostic morbidity and co-morbidity, and presence and type of reported trauma exposure reported by patients during the initial assessment were obtained from files of adult patients seen during a one-year period (2010) at the out-patient unit and the in-patient affective ward at the FSPC. Data were captured on data record forms by the researchers and analysed by means of descriptive statistics, univariate analysis and logistic regression (SAS version 9.1).Results: Of the 192 adults (71.9% White and 67.2% female) referred for psychological services,75.5% were diagnosed with mood disorders, 17.2% with anxiety disorders, 22.4% with substance-related disorders and 20.9% with cluster B personality disorders or traits. A total of 145 (75.5%) reported past trauma exposure. The most frequently reported types of trauma exposure were traumatic death/injury of a loved one (37.0%), physical assault (24.5%), witnessed/threatened violence (19.3%), and sexual assault (17.7%). Women were more likely to have been exposed to trauma than men (OR 4.02, 95% CI 1.87–8.62), in particular to traumatic death of a loved one (OR 3.13), physical assault (OR 4.08), or sexual assault (OR 5.43).Conclusions: The findings of this study contribute to current data regarding the prevalence of exposure to trauma and its possible association with mental illness. The importance of comprehensive trauma exposure screening in routine psychiatric interviewing practices is highlighted.
An elderly, urban population: Their experiences and expectations of pharmaceutical services in community pharmacies
Authors: Janse van Rensburg Alta , Kotze Irma , Lubbe Martie S. , Cockeran Marike
Published: April 2018

Objective: The aim of this study was to determine the pharmaceutical services experiences of an elderly, urban population in relation to their expectations in community pharmacy.Design: and setting: The study was a cross-sectional descriptive empirical study and was conducted by means of a structured questionnaire, designed and administered by there searcher, in face-to-face interviews at an old age residence in the participants' own dwellings (N = 242). The management of this specific village approached the researcher about healthcare concerns for their residents and granted permission for this study to be conducted.Main outcome and results: The sample population of elderly patients (n = 67) had a higher expectation of community pharmacists, in terms of pharmaceutical services, than what they had experienced. Significant differences were found in all aspects examined. Effect size, amongst others, revealed that expectations were not met in discussions about the effect of other medicines on their chronic medicine (d = 1.94); whether they had any medicines left from previous issues (d = 1.77) and questions regarding existing chronic conditions (d = 1.69). There was an association between questions, regarding the use of chronic medicines at pharmacies and at other healthcare professionals (d =0.26), as well as the supply of written information at pharmacies and other healthcare professionals (d = 0.42). The study reveals that this population has expectations of their community pharmacists that are not met.Conclusions: Pharmacists can be active members of the healthcare team and restore their professional image in the eyes of the community, if they renew their attitudes, have confidence in their abilities and understand their role in patient care. The community pharmacist should focus on the health-related quality of life of the individual patient and identify the immediate healthcare needs of their unique community, with specific reference to vulnerable populations like the elderly. Pharmacists should establish themselves as the go-to healthcare professional.
Evidence-based recommendations to facilitate professional collaboration between allopathic and traditional health practitioners
Authors: Van Rooyen Rachel M. , Pretorius Blanche , Tembani Nomazwi M. , Ten Ham-Baloyi Wilma
Published: April 2018

Background: Globally, and in South Africa, there is an increased demand for consulting both traditional and allopathic health practitioners. As both health practitioners are working within the same communities, their respective practices could complement or undermine the health of consumers using both health services. Professional collaboration between traditional and allopathic health practitioners is therefore desirable and requires collaboration between the systems, which is currently legislated by the Traditional Health Practitioners Act 22 of 2007. However, in the Eastern Cape, no evidence-based recommendations were found that facilitated the collaborative relationship between the two health practitioner groups.Purpose of the research: To develop evidence-based recommendations aimed at facilitating professional collaboration between allopathic and traditional health practitioners for the benefit of patients.Methodology: Descriptive evidence-based recommendations to enhance professional collaboration between both groups of health practitioners were developed based on focus group interviews with allopathic practitioners (n = 10) and individual interviews with traditional health practitioners (n = 18) (traditional health practitioners (n = 14) and traditional healers who are also allopathic health practitioners (n = 4)) practising in the Amathole District in the Eastern Cape, South Africa. Dickoff et al.'s (1968) Survey List wasused as a conceptual framework.Results: Collaboration was hampered by allopathic practitioners demonstrating negative attitudes by not referring patients to traditional practitioners based on lack of knowledge and mutual understanding of each other's practices. Suggestions for collaboration made by both groups resulted in the development of two distinct sets of evidence-based recommendations.The first set of recommendations aims to enhance professional collaboration between both groups of health practitioners. This is done through facilitating mutual understanding based on respect and acceptance between the different practitioners. The second set of recommendations aims to enhance professional collaboration through facilitating open communication between different practitioners.Conclusion: These evidence-based recommendations can be used to facilitate professional collaboration between allopathic and traditional health practitioners resulting in mutual understanding and open communication, enhancing team work in a multi-professional environment, and ultimately leading to improved patient care.
Exploring resilience in nurses caring for older persons
Authors: Benadé Petronella , Du Plessis Emmerentia , Koen Magdalena P.
Published: April 2018

Background: A shortage of nurses caring for older persons is experienced due to adverse working conditions. Resilience might empower nurses to persevere while caring for older persons. Research regarding the resilience of nurses caring for older persons is scarce.Objectives: The objectives were to explore and describe the strengths and coping abilities of nurses caring for older persons and to formulate recommendations to strengthen their resilience.Methodology: An explorative, descriptive qualitative research design was used. An allinclusive sample of nurses caring for older persons in an urban setting in the North West Province, South Africa, participated in the study. During phase one, demographic information was obtained, and narratives were written (n = 43). Four focus group interviews were conducted in phase two (n = 17) and recommendations were formulated in phase three. Content analysis was used.Principal results: Participants experienced adverse working circumstances while caring for older persons and they needed resilience to balance the emotional nature of the work, work ethics, staff shortages, physical demands of the work and the dependency of the older persons. These nurses used personal, professional, contextual and spiritual strengths to handle adverse working conditions.Conclusions: By applying their personal, professional, contextual and spiritual strengths, nurses could further enhance these strengths and possibly their resilience. The participants' identified strengths were used to formulate recommendations to strengthen resilience of nurses caring for older persons.
Movement as a critical concept in model generation to attain wholeness
Authors: Downing Charlene , Poggenpoel Marie , Myburgh Chris
Published: April 2018

Movement is an integral aspect of daily living. Movement allows the human being to express, find meaning and reflect a part or the whole of the unfolding of the stories of their lives. The essence of the dialogue is the movement towards caring and healing between the professional nurse and the individual.The purpose of this research is to develop, describe, evaluate and provide guidelines for the operationalisation of a model as a framework of reference for nursing to facilitate the individual faced with mental health challenges as an integral part of wholeness. A model was generated to facilitate the engagement of self through movement, which contributes to and manifests in a mindful way of living to promote mental health as an integral part of wholeness. The findings of the study are applicable to the world of nursing practice, nursing education and research.
Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa
Authors: Malatji Moloko , Ally Hafisa , Makhene Agnes
Published: April 2018

Background: Staffing patterns refers to the number and types or categories of staff assigned to the particular wards in a hospital. Staffing patterns that accommodate imbalanced patient to nurse ratios can affect nursing staff negatively. The negative experiences increased emotional stress, physical exhaustion, high nurse turnover and consequences of poor patient outcomes. The high patient to nurse ratios and the profitability factor of private hospitals virtually dictates the type of staffing patterns that are used in these wards. As such, the current staffing patterns appear to require nursing staff to work longer shifts as well as overtime work without a choice, the consequences of which are the effects highlighted above.Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards.Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study.Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns.Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.
Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town
Authors: Solomons Nasheetah , Kruger Herculina Salomé , Puoane Thandi Rose
Published: April 2018

Background: Chronic non-communicable diseases (CNCD) have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide.Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate inCNCDs intervention programmes in their community was explored.Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47participants using a question guide. Summative content analysis was used to analyse the data.Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes.Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.
Experiences of registered nurses caring for patients with an open abdomen in an intensive care unit in Gauteng
Authors: Chipu Mpho G. , Kearns Irene , Nel Wanda E.
Published: April 2018

The researcher observed that nurses prefer not to nurse patients with an open abdomen as they fear that the abdominal contents will protrude. The purpose of the study was to explore and describe the experiences of registered nurses taking care of patients with an open abdomen in intensive care in an academic hospital in Gauteng, and to provide recommendations for registered nurses when taking care of patients with an open abdomen. The research design used was a qualitative, exploratory, descriptive and contextual design. Focus group interviews were conducted with each group comprising six participants. The research question was: What are the experiences of registered nurses caring for patients with an open abdomen in an intensive care unit? What recommendations can be made to assist registered nurses in taking care of patients with an open abdomen in an intensive care unit? The data was analysed using Tesch's method. Three themes emerged: Difficulty in nursing care, complications such as fistula and infections, and poor hospital administration. Recommendations for assisting registered nurses in taking care of patients with an open abdomen were then made based on the findings of the four focus group interviews. Ethical principles and measures of trustworthiness were adhered to throughout the research study.
Factors influencing recruitment and retention of professional nurses, doctors and allied health professionals in rural hospitals in KwaZulu Natal
Authors: Haskins J. L. , Phakathi Sifiso A. , Grant Merridy , Horwood Christiane M.
Published: April 2018

Introduction: In South Africa fewer health professionals (HPs) work in rural areas compared to urban areas, despite rural communities having greater health needs. This study explores factors influencing recruitment and retention of three categories of HPs in KwaZulu-Natal and has implications about how to retain them in rural areas.Methods: A cross-sectional, descriptive survey was conducted in 8 hospitals, 5 rural and 3 urban, in one district in KZN in 2011. Data were collected on single day in each hospital and all HPs on duty were requested to participate. We compared responses from rural and urban based HP as well as professional nurses (PNs), doctors, and allied HPs.Results: 417 questionnaires were completed: 150 from HPs in rural and 267 from HPs in urban hospitals. Perceptions of living/working in rural areas is negative and the quality of health care provided in rural areas is perceived as poor by all categories of HP. Rural-basedHPs were more likely to report living apart from spouse/partner (72.1% vs 37.0%, p < 0.001)and children (76.7% vs 36.9%, p < 0.001), and living in hospital accommodation (50.8% vs 28.9%; p < 0.001).Conclusions: Decisions made by HP about where to work are complex, multifactorial and should be tailored to each category of health professional.