Research Articles (School of Nursing)

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Maternal health literacy programmes to improve self-care of pregnant women in Africa a scoping review
(Women's Health and Action Research Centre, 2026) Noncungu, Thabani M; Sibindi, Thandi; Chipps, Jennifer; Crowley, Talitha
Midwives are uniquely positioned to implement health literacy programmes, yet there is limited synthesis of existing midwife-led health literacy programmes for pregnant women in Africa. This scoping review maps the evidence on health literacy programmes to improve the self-care of pregnant women in Africa. Eight articles, published between 2015 and 2025, were included across African countries from six electronic databases, such as MEDLINE and one search engine: Google Scholar. Maternal health literacy programmes varied in mode of delivery, duration, components, and outcomes. Most programmes used a group antenatal care model, a combination of face-to-face and digital health tools, and focused on improving functional, interactive, and critical health literacy. Maternal health literacy programmes in African countries seem to be under-researched. More research is needed to strengthen the outcomes of programmes such as usability and acceptability, knowledge and awareness, and clinical outcomes. In addition, longer-term research is necessary to assess the implementation and sustained impact of these programmes. African Journal of Reproductive Health.
From trust to betrayal: imposter nurses and nursing quackery in Nigeria, their threat to patient safety, and the role of professionalism: a cross-sectional survey
(John Wiley and Sons Inc, 2026) Ajibade, Benjamin Olusola; Owoeye, Isaiah Dada; Ogunniyi, Abiola
Background: Nursing quackery; the unlicensed practice of nursing by unqualified individuals poses a major threat to patient safety and nursing integrity in Nigeria. Despite a regulatory council, systemic enforcement failures continue to enable imposters to operate countrywide. Aim: To examine perceptions of nursing quackery in Nigeria, assess registered nurses' professional values, professionalism, trust, and ethical practice, and identify predictors of quackery awareness. Methods: A cross-sectional survey of 618 registered nurses recruited across all six Nigerian geopolitical zones used multistage sampling. Data were collected using the Nigerian Nursing Professionalism and Quackery Assessment Tool (NNPQAT), adapted from the Nurses' Professional Values Scale-Revised (NPVS-R), Hall's Professionalism Scale, the Trust in Nurses Scale, and the Ethical Behaviour Rating Scale. Chi-square tests, Spearman's rho correlations, and multiple linear regression were performed using SPSS version 29. Results: Participants demonstrated high professional values (M = 4.76, SD = 0.44), professionalism (M = 4.76, SD = 0.58), ethical practice (M = 4.84, SD = 0.59), and trust (M = 4.53, SD = 0.59). Quackery awareness was widespread (M = 4.53, SD = 0.58); 96.1% agreed quackery threatens patient safety and 97.1% agreed it damages public trust. Awareness did not vary by region (χ2 = 2.25, p = 0.814) or facility type (χ2 = 0.18, p = 0.915). Ethical practice (ρ = 0.421, p < 0.001) and trust (ρ = 0.361, p < 0.001) were the strongest correlates. Regression identified ethical practice (β = 0.541, p < 0.001) and trust (β = 0.215, p < 0.001) as the only significant predictors (R2 = 0.511); years of experience, professionalism, region, and facility type were non-significant. Conclusions: Nigerian registered nurses exhibit strong professional values, yet quackery persists as a system-level failure rooted in regulatory weakness rather than individual professional deficit. Ethical practice functions as professional vigilance, heightening sensitivity to quackery. Strengthening Nursing and Midwifery Council of Nigeria (NMCN) enforcement, investing in ethics education, and developing public awareness campaigns are essential to protect patients and preserve professional integrity.
Climate change awareness, motivation, and behaviours among primary health care nurses in South Africa: findings from the adapted CHANT survey
(Elsevier Masson s.r.l., 2026) Sibindi, Thandazile; Chipps, Jennifer-Anne; Crowley, Talitha
Climate change increasingly affects global health, with low- and middle-income countries (LMICs) facing recurrent droughts, heatwaves, and extreme weather events that strain primary health care (PHC) systems. Nurses, as frontline providers, are critical for managing climate-sensitive conditions and promoting resilience. Evidence on nurses’ climate-health engagement in LMICs remains limited. To assess awareness, motivation, and behaviours related to climate change among primary health care (PHC) nurses in the Western Cape, South Africa, using a contextualised Climate, Health, and Nursing Tool (CHANT). A descriptive cross-sectional survey was conducted in 38 PHC facilities. An all-inclusive sampling approach yielded 128 professional nurses. Data were collected via a self-administered questionnaire adapted for local context. Descriptive statistics and non-parametric tests were applied. Most respondents (76.2%) were aware of climate change, primarily through television (75%) and social media (60.9%). Two-thirds (66.7%) had experienced extreme weather events, and 74.6% had managed climate-sensitive conditions, notably respiratory illnesses. Concern and motivation were high (90%), and 70% believed mitigation is possible; however, 51.6% perceived the issue as complex, and 25% felt overwhelmed. Climate-friendly behaviours were more frequent at home (15–77%) than at work (12–45%), and only 9% engaged in climate communication with policymakers. Despite strong concern and motivation, workplace climate actions remain limited. Strengthening nurses’ sustainability knowledge and institutional support is essential for advancing climate-resilient PHC systems.
Experience of participation in a whatsapp support group for empowering newly graduated nurses during transition in the Western Cape, South Africa
(AOSIS (pty) Ltd, 2026) Abiodun, Rita O; Daniels, Felicity; Chipps, Jennifer Anne N; Pimmer, Christoph
Background: Transitioning from academic study to professional practice is a critical and often challenging phase for newly graduated nurses. Providing structured support during this period is essential for fostering confidence, competence and professional growth. Objectives: This study aimed to explore the experiences of new nurse graduates from a university in the Western Cape following their participation in a WhatsApp peer support group designed to facilitate their transition to practice. Method: A qualitative, exploratory descriptive design was used. A 12-week WhatsApp-based intervention was implemented, with weekly discussions on predetermined topics related to professional development. Twelve participants took part in in-depth interviews after the intervention – four through an open call and eight through individual invitations – until data saturation was reached. Data were collected using an interview guide and were analysed thematically. Results: Four major themes emerged: (1) information sharing empowered participants and enhanced professional development; (2) a supportive community of practice was formed; (3) the online presence of moderators fostered engagement; and (4) participants experienced personal growth through skill development and relevant discussions. Conclusion: The study demonstrated that a structured online peer support intervention can effectively promote empowerment, professional confidence and collaboration among newly graduated nurses. Contribution: This research contributes to the growing body of evidence on the use of digital platforms – specifically WhatsApp – for facilitating professional transitions and continuous learning. It provides practical insights for designing supportive, technology-enhanced learning environments in nursing education and practice.
Woman, companion and midwife interpersonal dynamics during childbirth: a phenomenological study in South African midwife-led birth units
(Elsevier Ltd, 2026) Rala N.M.; Minnie C.S.; Matthews A.; Shopo K.D.
Background Supportive interpersonal relationships during childbirth are essential to the delivery of quality midwifery care, particularly in a midwife-led setting. However, little is known about how midwives, birthing women, and companions co-experience and interpret their supportive interpersonal relationships in resource-limited, midwife-led settings. Aim To explore how midwives, birthing women, and companions experience and make meaning of their interpersonal relationships during childbirth in selected Midwife-led Birth Units (MLBUs) in the Eastern Cape Province, South Africa. Methods An interpretative phenomenological analysis (IPA) approach was used. Semi-structured interviews were conducted with 12 purposively sampled participants (four midwives, four birthing women, and four companions). Data were analysed using a systematic, idiographic process to develop experiential themes at the personal and group levels. Findings Four key themes were identified: A. The Role of the Companion in Childbirth Support; B. Midwives' Attributes and Behaviours; C. Trust, Safety, and Collaboration in Childbirth; and D. Antenatal Care as a Foundation for Building Relationships. Participants emphasised how positive interpersonal relationships promoted calmness, cooperation, and emotional safety, while negative interactions led to anxiety, silence, and feelings of abandonment. Conclusion The study highlights the importance of interpersonal relationships in shaping women's childbirth experiences. Supportive companions and positive midwives' behaviours fostered calmness, trust, and cooperation during labour. In contrast, negative interactions and poor communication led to anxiety, silence, and feelings of abandonment among women. Antenatal care was identified as an important opportunity to build trust and establish supportive relationships between women and healthcare providers. Strengthening respectful, compassionate, and collaborative maternity care practices is essential for improving women's childbirth experiences and the quality of care.
Climate change awareness, motivation, and behaviours among primary health care nurses in South Africa: findings from the adapted CHANT survey
(Elsevier Masson s.r.l., 2026) Sibindi, Thandazile; Chipps, Jennifer-Anne; Crowley, Talitha
Background: Climate change increasingly affects global health, with low- and middle-income countries (LMICs) facing recurrent droughts, heatwaves, and extreme weather events that strain primary health care (PHC) systems. Nurses, as frontline providers, are critical for managing climate-sensitive conditions and promoting resilience. Evidence on nurses’ climate-health engagement in LMICs remains limited. Objective: To assess awareness, motivation, and behaviours related to climate change among primary health care (PHC) nurses in the Western Cape, South Africa, using a contextualised Climate, Health, and Nursing Tool (CHANT). Methods: A descriptive cross-sectional survey was conducted in 38 PHC facilities. An all-inclusive sampling approach yielded 128 professional nurses. Data were collected via a self-administered questionnaire adapted for local context. Descriptive statistics and non-parametric tests were applied. Results: Most respondents (76.2%) were aware of climate change, primarily through television (75%) and social media (60.9%). Two-thirds (66.7%) had experienced extreme weather events, and 74.6% had managed climate-sensitive conditions, notably respiratory illnesses. Concern and motivation were high (90%), and 70% believed mitigation is possible; however, 51.6% perceived the issue as complex, and 25% felt overwhelmed. Climate-friendly behaviours were more frequent at home (15–77%) than at work (12–45%), and only 9% engaged in climate communication with policymakers. Conclusion: Despite strong concern and motivation, workplace climate actions remain limited. Strengthening nurses’ sustainability knowledge and institutional support is essential for advancing climate-resilient PHC systems.
Utilisation of digital educational technology amongst undergraduate nursing students in the Western Cape
(AOSIS (pty) Ltd, 2026) Bimerew, Million; Ticha, Victoire; Chipps, Jenifer
Background: Despite increased integration of digital technologies in higher education, nursing students face major barriers in resource-limited settings. Aim: The study investigated the utilisation of digital educational technologies amongst undergraduate nursing students in the Western Cape. Setting: The study was conducted at the school of nursing at a higher education institution in the Western Cape. Methods: A descriptive cross-sectional survey design with a self-administered questionnaire was used to collect data from a sample of 253 participants. Descriptive analysis was conducted to determine the frequencies and percentages; the mean score and Chi-square test were conducted to determine the association between the variables. Results: Nearly 90% of participants had experience in the use of digital educational technology, 94.5%, learning management system and Facebook, and 93.7% used PowerPoint, communication and collaboration tools. The gender differences in technology use are consistent with the literature. The results suggest female respondents' frequent use of social networks. Male respondents reported more frequent use of bibliographic and web conferencing technologies. Although overall use was very low, gender remains an important factor in understanding technology use. In contrast, blogs, discussion forums and immersive technologies were amongst the least utilised educational technologies. Conclusion: Most nursing students use basic digital tools like learning management systems, Facebook and PowerPoint, but advanced tools such as blogs, forums and immersive technologies are underused, revealing a gap in digital competence that limits collaborative learning and clinical simulation. Contribution: This study provides evidence on digital technology use amongst undergraduate nursing students, showing frequent use of basic tools but limited engagement with advanced, interactive technologies.
Nurses’ knowledge of hypertension care and associated factors in the northern region of Ghana
(AOSIS (pty) Ltd, 2026) Adzitey, Sylvia P; Akimanimpaye, Furaha; Crowley, Talitha
Background: Hypertension is the main risk factor for cardiovascular-related morbidities and mortalities. Nurses play a pivotal role in hypertension care, encompassing screening, detection, management, patient education and self-management counselling. Aim: This study assessed nurses' knowledge of hypertension care and associated factors in the Northern Region of Ghana. Setting: Tamale Metropolis of the Northern Region of Ghana. Methods: A descriptive cross-sectional study was conducted among nurses. Using a census approach, 410 eligible nurses working in hypertension care across the study hospitals were invited to participate. Of these, 266 consented and completed a self-reported validated questionnaire. The IBM Statistical Package for the Social Sciences programme version 30 was used to process the data and perform descriptive and inferential statistics. Results: The mean hypertension care knowledge score was 51.47± 11.76. About 4 had good knowledge, 57.1 average knowledge, and 38.7 had poor knowledge. While nurses demonstrated good knowledge of accurate blood pressure measurement (82.4), their knowledge of hypertension diagnosis (35.1) and management (48.8) was poor. The following were significantly associated with overall knowledge of hypertension care: hospital of practice (p = 0.021), age (p = 0.007), nursing category (p = 0.002), qualification (p = 0.001), years of practice in the present unit (p = 0.021) and hypertension in-service training (p = 0.027). Conclusion: This study revealed significant gaps in nurses' knowledge of hypertension care and highlighted the need for continuous professional development to bridge knowledge gaps and sustain clinical competence. Contribution: The study provided evidence on nurses' knowledge of hypertension care in Ghana, which can inform the development of tailored interventions to improve management and patient outcomes.
Classroom to crisis: exploring nursing students’ preparedness for emergency unit placements in the Western Cape
(AOSIS (pty) Ltd, 2026) Daniels, Felicity; Sipamla, Nomahlubi
Background: Emergency nursing is complex, fast-paced, often unpredictable and focuses on the management of acute medical conditions or injured patients of all ages. It involves rapid assessment, prioritisation, timely interventions, resuscitation and stabilisation of the patient to reduce morbidity and mortality. This requires nurses to gain specific emergency care knowledge and skills. Objectives: The study investigated the experiences of student nurses in a Bachelor of Nursing programme regarding their theoretical and clinical preparation and readiness for placement in emergency units. Method: Qualitative, exploratory-descriptive methods were used. Thirty-four student nurses from a university in the Western Cape were purposively selected and participated in focus group discussions. Inductive thematic analysis was used. Results: Four themes and twelve categories were generated. The findings indicated that student nurses were inadequately prepared both theoretically and clinically for practice in emergency units. Several factors contributed to the planning and implementation challenges, leading to students’ lack of preparedness. Conclusion: Despite changes in the requirements of the South African Nursing Council for clinical placement of undergraduate students in emergency units, work integrated learning in these units would benefit graduate nurses intending to further their studies in critical and emergency care nursing. However, learning outcomes are required to ensure that student nurses have access to specific emergency care knowledge and clinical skills. Contribution: Highlights student nurses’ need for orientation, clinical supervision and debriefing sessions by competent critical and emergency care nurses, and professional counselling when needed.
Nurses’ perceptions of obstacles to treatment adherence counselling for individuals with coinfections of HIV and TB in Cape Town Metropolitan community health centres
(John Wiley and Sons Ltd, 2026) Ticha, Victoire; Bimerew, Million S.; Phetlhu, René Deliwe
One out of every three HIV-related deaths occurs in people who are coinfected with TB. To improve health outcomes, people coinfected with HIV and TB should continue to practice two crucial behaviours: staying in care and taking their medications as prescribed. Barriers to TB and HIV treatment adherence counselling as a tool to strengthen holistic care. However, the literature lacks an in-depth exploration of nurses’ perspectives on the perceived obstacles to treatment adherence counselling for individuals with HIV and TB coinfection in Cape Town metropolitan community health centres. The Social Cognitive Theory underpinned this study. The study investigated the perceived obstacles that nurses in community health centres in the Cape Town metropolitan region faced when providing treatment adherence counselling to patients coinfected with HIV and TB. Using a qualitative exploratory study design, nurses caring for people living with HIV and with TB were purposively selected. Semistructured interviews were used to collect data. All interviews were audio-recordedusing a digital voice recorder with participants’ permission, and verbatim transcripts were produced. We used ATLAS.ti 8 electronic software to manage the qualitative data, which were analysed thematically. Findings: Health system barriers, which included human resource constraints, increased workload, time and space limitations, unsupportive attitudes from nursing staff, inadequate capacity building, and absence of regular updates on HIV and TB adherence counselling. Patient-related barriers: Patients experienced pill burden and adverse medication side effects, and the negative impact of social grants on treatment adherence. Community-related barriers: Stigma and discrimination from the community towards people living with HIV coinfected with TB, limited knowledge among some patients, sharing of medication and substance use, and lack of community-level interaction with healthcare workers, including nurses, are the contributing factors to poor adherence counselling. Copyright
Lived experiences of nursing students and educators on self-management in teaching and learning in Ghana: an interpretive phenomenological study
(SAGE Publications Inc., 2025) Kokuro, Mercy; Crowley, Talitha; Merwe, Anita Serdyn van der; Young, Cornelle
Introduction: As students enter nursing education, they shift away from parental control and school support, taking responsibility for themselves and their academic performance. This independence requires self-management abilities. However, few studies have explored the experiences of nursing students and educators on self-management in the teaching and learning. Objective: The study aimed to understand the lived experiences of self-management in teaching and learning context from the perspectives of nursing students and educators from different nursing colleges in Ghana. Method: A qualitative interpretive phenomenological approach was used. Individual in-depth interviews were conducted with 17 first- and third-year nursing students and eight nurse educators. Verbatim transcriptions were analyzed using the steps of the interpretive process and the hermeneutic circle, with continual review and analysis between the parts and the whole. Results: This study explored self-management in the teaching and learning context among nursing students, revealing four major themes: strategizing for progress and success, nurturing health and well-being, developing self-belief, and partnering with others, each with associated subthemes. The findings indicate that self-management elements are deeply interconnected and interdependent. Strategizing for progress and success involves time management, goal setting, self-discipline, and continuous self-evaluation. Nurturing health and well-being is essential for a sound mind and body through self-care. Developing self-belief, including confidence and self-assurance, is key to academic success. Both students and educators emphasized partnering with others, highlighting collaborative learning and support networks as crucial to self-management in nursing education. Conclusion: These themes provide valuable insights for nursing students, educators, and institutions by shedding light on their experiences with self-management in teaching and learning. By understanding these perspectives, educators and institutions can implement innovative teaching approaches that effectively support students in developing self-management skills.
Experiences of nurses in exploring and managing preoperative anxiety and information needs of patients at district hospitals in Ashanti region, Ghana
(BioMed Central Ltd, 2026) Dankyi, Sawan; Bimerew, Million S.; Dartey, Anita Fafa
Background : Experiences of nurses in exploring and managing the information needs of patients who are scheduled to undergo surgery show that patients develop anxiety, which makes the procedure uneasy and complicated due to changes in some physical symptoms, such as blood pressure, and psychological symptoms, such as sleeplessness and irritability. Nurses working in surgical wards should be able to detect anxious patients and determine the factors causing anxiety. The aim of this study was to explore the experiences of nurses in exploring and managing the preoperative anxiety and information needs of patients at district hospitals in Ashanti Region, Ghana. Methods : This study was conducted at five district hospitals in the Ashanti Region of Ghana. Exploratory design was used to explore the experiences of nurses in exploring and managing preoperative anxiety and information needs of patients. A purposive sampling technique was used to recruit 11 participants for the study. Three of them were recruited from one district hospital, while two each were from the remaining four district hospitals. All the interviews were audio-recorded with permission from the participants and transcribed verbatim. Data analysis was performed via thematic analysis. Findings : The study revealed three themes: preoperative patient display, assessment of patients’ preoperative anxiety and information needs and providing needed information. Conclusion : Nurses should avoid relying solely on their previous experiences and perceptions and instead focus on providing patients with the specific information necessary to alleviate preoperative anxiety. Clinical trial number: Not applicable.
Behind the scrubs: psychological distress and resilience among nurses
(AOSIS (Pty) Ltd, 2025) Chipps, Jennifer; Steenkamp, Ilze; Padmanabhanunni, Anita; Brysiewicz, Petra; Cromhout, Amanda
Background: Nurses are exposed to high levels of stress in the workplace. During the coronavirus disease 2019 (COVID-19) pandemic, levels of stress were exacerbated, impacting on nurses’ mental health. Aim: The aim of the study was to investigate psychological distress and resilience, and how nurses with different levels of education responded to stress. Setting: The study was conducted in three hospitals (a psychiatric hospital, a general district hospital and a dedicated COVID-19 hospital) in the Western Cape province, South Africa. Methods: A survey was conducted with frontline nurses (N = 167 [71.8%]) in three hospitals in the Western Cape using six validated self-administered scales. Results: Respondents reported high levels of moral distress related to time (3.42/6, ± 1.6) and protection during COVID-19 (1.3/3, ± 0.7). Mild-to-moderate levels of fear of COVID-19 (19.4/35, ± 8.2) and a moderate perception of vulnerability to disease (60.7/105, ± 19.9) contributed to nurses’ stress. High levels of psychological distress, especially during COVID-19 compared to current levels (27.2 vs 18.8; W = 8.9, p = < 0.001), with high levels of resilience (73.2/88, ± 17.9) were reported. Enrolled nurses reported significantly higher levels of stress during the pandemic. Conclusion: Post COVID-19, there was reduction in the respondents who reported severe levels of psychological distress, highlighting the impact of the pandemic on nurses’ mental health and the need to build resilience. Contribution: This study enhances understanding of the factors that result in psychological distress in nurses and how nurses with different levels of education respond to stress.
Attitudes of community health nurses towards postnatal home visitation: a study in the Ashanti Region of Ghana
(MDPI, 2025) Agyeman-Duah, Yvonne; Bimerew, Million
Enhancing maternal and newborn care is a key priority for governments worldwide. World leaders have taken deliberate steps to improve these essential services, with an emphasis on postnatal care, including home visits for mothers and their newborns. However, in the Ashanti Region and across Ghana, challenges surrounding the delivery and effectiveness of postnatal home visits remain a significant concern. This study aimed to assess the attitudes of Community Health Nurses towards postnatal home visitation in selected districts of the Ashanti Region. A quantitative survey approach was used to gather data from 100 CHNs randomly selected from 10 regional districts. Structured questionnaires were used to gather quantitative data from CHNs. Findings from the study were analysed using descriptive and inferential tests. The study results indicated that most of the CHNs were young adults, 35 years of age (79%), with the majority having 3–5 years of work experience. The respondents generally demonstrated a negative attitude towards PNHV as they believed it was an extra workload, time-consuming, and unnecessary. A Pearson chi-square test indicated strong significant association between CHNs’ attitude towards the components of the attitude scale and years of experience as well as their age. In conclusion, the study revealed that even though CHNs are expected, as part of their job description, to embark on home visitation activities, most of them have a negative attitude towards this professional duty. There should be conscientious, novel ways to ignite the interest of these essential service providers to help improve infant and maternal health.
Pilot testing of a digitally enabled, peer supported self-management intervention for adolescents and youth living with HIV in the Western Cape, South Africa
(Taylor and Francis Ltd., 2026) Crowley, Talitha; Ntanjana, Siphelele; Weyers, Leonie; van Wyk, Brian; Petinger, Charné
Adolescents and youth living with HIV (AYLHIV) face increased health risks and need targeted support to optimally engage in treatment. The Supporting Adolescents to be Resilient and Thrive (S-SMART) programme is a digitally enabled, peer-supported self-management intervention designed to enhance psychosocial and treatment engagement outcomes among AYLHIV. This pilot study evaluated the feasibility and acceptability of S-SMART among AYLHIV aged 15–21 years who received HIV treatment at two public primary care clinics in the Cape Town Metropole, South Africa. Thirteen AYLHIV received smartphones, mobile data, and access to the S-SMART app from September to December 2024. The pilot programme for S-SMART included activities, peer group sessions, and coaching by four peers living with HIV. Focus groups were conducted before (n = 17) and after (n = 12), to assess usability and their user experiences. Activity and programme completion was > 95%. Participants found the app user-friendly overall, though some faced issues with navigation, language and understanding certain content. Engagement was strengthened through peer support and facilitation. While the programme promoted psychosocial empowerment, HIV-related challenges such as stigma and disclosure fears need ongoing support.
Experiences of nurses in exploring and managing preoperative anxiety and information needs of patients at district hospitals in Ashanti region, Ghana
(BioMed Central Ltd, 2026) Dankyi, Sawan; Bimerew, Million; Dartey, Anita Fafa
Background : Experiences of nurses in exploring and managing the information needs of patients who are scheduled to undergo surgery show that patients develop anxiety, which makes the procedure uneasy and complicated due to changes in some physical symptoms, such as blood pressure, and psychological symptoms, such as sleeplessness and irritability. Nurses working in surgical wards should be able to detect anxious patients and determine the factors causing anxiety. The aim of this study was to explore the experiences of nurses in exploring and managing the preoperative anxiety and information needs of patients at district hospitals in Ashanti Region, Ghana. Methods : This study was conducted at five district hospitals in the Ashanti Region of Ghana. Exploratory design was used to explore the experiences of nurses in exploring and managing preoperative anxiety and information needs of patients. A purposive sampling technique was used to recruit 11 participants for the study. Three of them were recruited from one district hospital, while two each were from the remaining four district hospitals. All the interviews were audio-recorded with permission from the participants and transcribed verbatim. Data analysis was performed via thematic analysis. Findings : The study revealed three themes: preoperative patient display, assessment of patients’ preoperative anxiety and information needs and providing needed information. Conclusion : Nurses should avoid relying solely on their previous experiences and perceptions and instead focus on providing patients with the specific information necessary to alleviate preoperative anxiety.
Comparison of treatment outcomes of adolescents on HIV treatment before and during the coronavirus disease 2019 pandemic in Cape Town, South Africa: a retrospective cohort study
(AOSIS (pty) Ltd, 2026) Crowley, Talitha; Khan, Nazreen; Van Wyk, Brian
Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems, posing risks for adolescents living with HIV (ALHIV) in resource-limited, high HIV-prevalence settings. These disruptions threatened antiretroviral therapy (ART) adherence, viral load suppression (VLS) and retention in care (RiC). Aim: This study aimed to compare treatment outcomes of ALHIV on ART in the Khayelitsha and Eastern Substructure (KESS) before and during the COVID-19 pandemic. Setting: The study was performed in KESS, Cape Town, South Africa. Methods: A retrospective cohort analysis was conducted among ALHIV aged 10–19 years receiving ART at public health facilities, pre-COVID-19 (before 01 March 2020) and during COVID-19 (01 March 2020–31 December 2021). Sociodemographic, clinical, and treatment data were analysed. Descriptive and inferential statistics compared outcomes and determined factors associated with VLS (< 1000 copies/mL) using SPSS v.30. Results: Data from 1702 ALHIV (pre-COVID-19) and 2733 ALHIV (during COVID-19) were analysed. Viral load suppression declined from 82.1% to 64.8%, while full VLS (< 50 copies/mL) from 70.8% to 53.7% (p = 0.065). Antiretroviral therapy adherence fell from 96.4% to 70.0% (p < 0.001), and RiC 80.3% to 76.3% (p < 0.001). In multivariate analysis, higher CD4 count, and consistent ART adherence predicted VLS. Conclusion: Antiretroviral therapy adherence and VLS rates among ALHIV declined during COVID-19. Adolescent-centred healthcare delivery models are needed to ensure continuity of HIV treatment during public health emergencies. Contribution: This study provides local evidence on the pandemic's impact in a high-burden South African context. By quantifying declines in ART adherence, RiC, and VLS, it highlights ALHIV vulnerabilities and the need to strengthen adolescent-responsive, resilient healthcare systems.
Developing a program to train nurses in exploration and management of pre-operative anxiety and information needs of patients (PEMPAINP)
(Australian College of Perioperative Nurses, 2025) Bimerew, Million; Chipps, Jennifer-Anne; Dankyi, Sawan
Objective: The objective of the study was to develop a program to train nurses to explore and manage pre-operative anxiety and information needs of patients. Methods: A panel comprising 15 experts was purposively selected and engaged through the Delphi technique to formulate the training program. Data collection was executed over three rounds, employing both focus group discussions and self-administered questionnaires, to achieve consensus among the experts regarding the draft training program. Results: Among the 15 participants, a majority identified three critical components for training nurses in assessing pre-operative anxiety and patient information needs – ‘standard pre-operative interventions’ (12 participants, 80.0%), ‘communicative skills’ (13 participants, 86.7%) and ‘establish rapport’ (13 participants, 86.7%). In terms of managing information needs, all 15 participants (100.0%) agreed on the importance of ‘evaluating information on patient and family’, while 12 participants (80.0%) endorsed the significance of ‘being innovative’ and adopting a ‘multidisciplinary approach’.Conclusions: The training program has been meticulously crafted to encompass content crucial for enhancing the knowledge and competencies of surgical ward nurses in assessing and managing pre-operative anxiety and addressing the informational needs of patients.
Health literacy of undergraduate students at a university in the Western Cape: a survey
(AOSIS (pty) Ltd, 2025) Crowley, Talitha; Bimerew, Million; Noncungu, Thabani; Akimanimpaye, Furaha; Hoffman, Jeffrey; Bimray, Portia; Melesse, Mussie; Kutumbuka, Benjamin; Chipps, Jennifer
Background: Health literacy is critical in the lives of young people such as university students to ensure that they can access information about health risks and implement appropriate health promotion and disease prevention strategies. Aim: This study aimed to investigate the health literacy of undergraduate students by describing the level of health literacy, personal and situational factors influencing health literacy, and health care utilisation. Setting: The study was conducted at a university in the Western Cape. Methods: A quantitative descriptive survey was used (N = 953). Data were collected using a paper-based questionnaire that included demographic variables, the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) and questions on healthcare utilisation and overall health. Descriptive analysis was conducted. Results: Over two-thirds of the respondents were classified under ‘problematic health literacy’ (n = 372, 39.0%) or ‘inadequate literacy’ (n = 274, 28.8%). Only 220 respondents (23.1%) had ‘sufficient’ health literacy, and only 87 (9.1%) achieved an ‘excellent’ rating. Respondents who searched for health information (p = 0.006) accessed healthcare (p = 0.014) in the last 6 months had significantly higher levels of health literacy and this was associated with a better overall health rating (p < 0.001). Conclusion: The study highlighted significant gaps in health literacy among university students, particularly in the domains of disease prevention and health promotion, indicating the need for targeted intervention. Contribution: The study provides useful information on the current health literacy of young adults (university students) that can be used to plan health promotion activities.
Preferences of South African adolescents living with HIV in the Western Cape Province regarding the use of digital technology for self-management
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Weyers, Leonie; Crowley, Talitha; Tokwe, Lwandile
Adolescents living with HIV (ALHIV) face significant challenges in self-managing their chronic condition. Digital health technology (DHT) has become increasingly common and understanding ALHIVs’ preferences is essential for developing interventions tailored to this unique population. This study aimed to explore the preferences of ALHIV regarding the use of DHT for self-management. A qualitative research approach with an exploratory and descriptive design was used. Participants were recruited using a purposive sampling method. Data were gathered through six nominal focus groups with 29 participants at two Community Health Centers in the Western Cape Province, South Africa. The participants were ALHIV aged 15–24 years. Discussions focused on current technology usage and the ranking of desired DHT features. The transcripts were analyzed using thematic analysis. Three main themes emerged: (1) everyday usage of digital technology where participants frequently used digital devices for communication, social media, and finding information; (2) the role of digital technology in self-management; a strong interest in digital technology that provides medication reminders, health education, and peer support; and (3) factors influencing digital technology, including the cost of data, limited connectivity, and issues of privacy related to participants’ HIV status. The ALHIV showed a strong willingness to use digital platforms for health information, reminders, and peer support, although concerns about connectivity, data cost, and privacy remain. These findings underscore the need for flexible, user-centered approaches when designing DHT interventions for self-management in South Africa.

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