Research Articles (School of Nursing)

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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; Phetlhu, Deliwe Rene
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.
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.
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; Tokwe, Lwandile; Ntanjana, Siphelele; Weyers, Leonie; Van Wyk, Brian Eduard; 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 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; Tokwe, Lwandile; 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.
Using machine learning to predict resilience among nurses in a South African setting
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Chipps, Jennifer; Cromhout, Amanda; Tokac, Umit
Nursing is a stressful profession. Stress can affect the mental health of nurses. A positive response to stress, resilience, is known to be a protective factor against mental health issues. This study aimed to use machine learning with secondary data from five survey studies, conducted between 2022 and 2023, to identify factors predicting high versus low levels of resilience in South African nursing samples from the Western Cape Province, South Africa. The sample included (1134 records (male = 250, 22.0%, female = 874, 77.1%, and other = 10 (0.9%) included all data on all categories of nursing staff (student nurses (567, 50%), professional registered nurses (315, 27.8%), and non-professional nurses (246, 21.7%) who completed a survey using a response to stress scale. We used random forest analysis, demographic variables, years of experience, and a brief 4-item screen of resilience to predict resilience. The model yielded limited added value from demographic groupings in this model, but the brief screening had an overall classification accuracy of 86.41% (95% CI: 0.810; 0.908).
Digital health readiness – insights from healthcare leaders in operational management: a cross-sectional survey
(BioMed Central Ltd, 2025) Steenkamp, Ilze; Chipps, Jennifer; Peltonen, Laura Maria
Background: Developing countries’ public health systems struggle with digital health implementation, and reports of low digital health readiness exist within the workforce. This study investigates the perceived digital health readiness of healthcare leaders in operational management to implement digital health tools. Methods: A cross-sectional survey using the E-Ready 2.0 scale was used to measure digital health readiness (n = 329) in 11 hospitals in the Western Cape, South Africa (September 2023 – March 2024). Descriptive statistics summarised respondent characteristics and the E-Ready 2.0 subscales: conditions for change at the workplace and among individuals, support and engagement from management, colleagues’ readiness, consequences for the status quo and workplace attitudes. Statements scoring 60% or more were considered to have higher readiness. Chi-square and Mann–Whitney U tests were used to examine associations between demographic variables and subscale statements. Results: A total of 143 healthcare leaders responded (56.1% response rate) (n = 114 nurses [79.7%], n = 29 medical doctors [20.3%]). The average age was 46.4 ± 10.0 years. Overall, higher levels of readiness (above 70%) were observed with statements related to workplace attitudes, whereas conditions for change at the workplace and among individuals showed lower readiness (below 50%). Conclusion: Despite significant investment in digital health tools, there remains limited digital health readiness among those responsible for leading these implementations. © The Author(s) 2025.
HIV policy implementation challenges: experiences of HIV managers in primary healthcare facilities in the Western Cape
(AOSIS (pty) Ltd, 2026) Akimanimpaye, Furaha; Crowley, Talitha; Titus, Verinia
Background: Implementing HIV policy involves translating policy goals into practical action. In the Western Cape, South Africa, the lack of clear guidelines has challenged the consistent implementation of HIV policies at primary healthcare (PHC) facilities. Objectives: This study aimed to explore HIV managers’ experiences regarding the challenges of HIV policy implementation at PHC facilities within the Northern Tygerberg sub-district, Cape Metropole, Western Cape. Method: An exploratory, descriptive, qualitative design was employed. Purposive sampling was applied to select HIV managers (n = 10) with experience in policy implementation. Data were collected through semi-structured interviews and analysed using thematic analysis. Results: Four themes emerged from the study, reflecting the challenges experienced by HIV managers during the implementation of HIV policies at PHC facilities, including human resource challenges, staff knowledge and attitudes, system readiness, and training. Conclusion: Effective implementation of HIV policy remains essential to the national HIV response. While significant targets have been achieved, ongoing systemic challenges continue to hinder optimal policy execution and the delivery of services. Contribution: The study highlights the critical need for stronger human resource systems, improved training platforms, and enhanced facility infrastructure to ensure effective HIV policy implementation and better health outcomes for individuals living with HIV.
Nurse educators’ competence and use of digital education technology at selected nursing education institutions in Nigeria
(Elsevier Ltd, 2025) Owoeye, Isaiah Dada; Chipps, Jennifer-Anne; Daniels, Felicity
The use of digital education technology has permeated educational settings and its use has become compelling for educators in nurse training. The competence of educators is however paramount for the appropriate use of the technology in the teaching and learning process. The study aimed to explore the pedagogical competence and use of digital education technology among nurse educators in Nigerian nursing education institutions. Qualitative methods were followed and in-depth interviews using one broad question and probing questions. Twelve nurse educators were purposively sampled across five nursing education institutions. Interviews were recorded, transcribed, and imported into Atlas.ti version 23 software for data analysis. Ethical clearance was obtained from the Research Ethics Committee of the University of the Western Cape. Most participants were female. Participants’ average age was approximately 41 years and their experience approximately 11 years. The data generated seven themes and twenty two categories related to pedagogical, digital and ethical competence as follows: Characteristics, qualities, and or roles of nurse educators; student roles and responsibilities in the learning process; educators’ understanding, philosophy, use and experience, and learning needs related to digital education technology; use of digital education technology in clinical education and administration in the current and future digital era; digital education technology utility; educators and students’ competence and use of digital education technology; and promotors and inhibitors of ethical competence. Students and educators used digital education technology in the teaching and learning process, but educators are lagging with an urgent need for digital literacy, provision of devices, and skills to address ethical issues for users in education
Infection prevention knowledge related to central line infections and ventilator-associated pneumonias: A survey of Finnish intensive care units
(Elsevier Inc., 2025) Salanterä, Sanna; Terho, Kirsi; Löyttyniemi, Eliisa Susanna
Background: Health care-associated infections pose a significant risk for the patients in intensive care due to the use of medical instrumentation required for care. Methods: We conducted a cross-sectional, nationwide survey on awareness of recommended infection prevention practices involving central venous catheters and invasive ventilators in intensive care units. Results: A total of 810 (50% of those surveyed) nurses and physicians participated in the survey. We found that 8% of the respondents had good knowledge of infection prevention in central venous care, while 24% had good knowledge of ventilator-associated pneumonia prevention practices. Discussion: The overall level of knowledge measured with this nationwide survey was suboptimal. The level varied between units, and depending on individual questions for particular professions. The displayed knowledge may have partially been based on tradition rather than on up-to-date evidence-based guidelines. Conclusions: Educational training in evidence-based infection prevention is needed for practical implementation to be improved. © 2025 Association for Professionals in Infection Control and Epidemiology, Inc.
Understanding self-management in teaching and learning: a concept analysis for nursing education
(Elsevier Ltd, 2026) Crowley, Talitha; Kokuro, Mercy; van der Merwe, Anita S
Background The concept of self-management has been examined in healthcare and other sectors such as education, but its definition and uses in nursing education remain unclear. Aim To explore the concept ‘self-management’ in healthcare and teaching and learning literature and apply these insights to nursing education. Design Concept analysis. Methods The eight steps of concept analysis according to Walker and Avant were used. PubMed, EBSCOhost, Medline, Google Scholar, Science Direct and PsycINFO were searched up to 2022 with an updated search in 2024. Content-rich articles on self-management were included if they: (a) discussed the theoretical or conceptual foundation of self-management, (b) were healthcare or education related, (c) were written in English and (d) had the full-text available. Data on attributes, antecedents and consequences were extracted and analysed using thematic analysis. Results Thirty-three articles were included with nine attributes, categorised as personal (self-motivation, self-regulation, self-evaluation, self-efficacy, individual action and skills, self-monitoring, environmental management, continuous task) and combined (partnership). Antecedents were the individual capacity to learn, external motivation, access to learning resources, teaching and learning strategies, and support from educators, family and friends. Consequences were improved quality of life, enhanced coping abilities, empowerment, engagement in self-management behaviours, increased self-efficacy, self-control, satisfaction, independence, self-directedness, and accountability. Negative outcomes may arise from avoiding help due to overconfidence in self-management abilities. Conclusion In combining all nine attributes, a clear definition and understanding of self-management in the teaching and learning context are formulated which can assist nursing students in becoming effective self-managers.
Alcohol and substance use and associated risk factors in nursing undergraduates at a South African university
(AOSIS (pty) Ltd, 2025) Kovane, Gaotswake Patience; Mayers, Pat M
Background: The use of substances by university nursing students is a significant public health challenge and may impact their professional conduct and compromise the quality of patient care. Aim: The study aimed to investigate alcohol and substance use by undergraduate nursing students, and the associated risk factors, at a university in the Western Cape province, South Africa. Setting: The study was conducted at a university in the Western Cape province, South Africa. Methods: A quantitative, descriptive survey design was used. A convenience sample of second-, third-and fourth-year nursing students completed a self-report online questionnaire. Descriptive statistics, Chi-square tests and multivariate linear regression were used to analyse the data. Results: A total of 212 questionnaires were completed. Most respondents (81%; n = 171) were female. The substances most used were tobacco (24.1%), alcohol (64.6%) and cannabis (marijuana) (23.7%). Few students had used ‘hard’ recreational drugs. Female students were more likely to have used alcohol and drugs over the 12 months preceding the study. Conclusion: To limit alcohol and drug use of nursing students, nursing education institutions need to increase efforts to raise awareness, include relevant curriculum content and provide appropriate support. Contribution: This study highlights the substance use risks and behaviours of undergraduate nursing students. Nursing students, as future health professionals, need to be empowered to make informed choices about the use of alcohol and other substances and need to be supported by university policies, appropriate education and counselling services.

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