Research Articles (School of Nursing)

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    Nurse prescribing and dispensing in South Africa: gaps in the current legislative framework
    (AOSIS (Pty) Ltd, 2024) Crowley, Talitha; Gray, Andy Lofts; Geyer, Nelouise
    Nurse prescribing and dispensing are central to ensuring universal health access in South Africa. To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health There is a necessity for prompt legislative revisions to address identified deficiencies
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    Nurse prescribing and dispensing in South Africa: gaps in the current legislative framework
    (AOSIS (Pty) Ltd, 2024) Crowley, Talitha; Gray, Andy Lofts; Geyer, Nelouise
    Nurse prescribing and dispensing are central to ensuring universal health access in South Africa. To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health There is a necessity for prompt legislative revisions to address identified deficiencies
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    Nicotine and cardiovascular health: when poison is addictive – a WHF policy brief
    (Ubiquity Press, 2024) Dorotheo, E. Ulysses; Naidoo, Pamela; Arora, Monika
    Nicotine is universally recognized as the primary addictive substance fuelling the continued use of tobacco products, which are responsible for over 8 million deaths annually. In recent years, the popularity of newer recreational nicotine products has surged drastically in many countries, raising health and safety concerns. For decades, the tobacco industry has promoted the myth that nicotine is as harmless as caffeine. Nonetheless, evidence shows that nicotine is far from innocuous, even on its own. In fact, numerous studies have demonstrated that nicotine can harm multiple organs, including the respiratory and cardiovascular systems. Tobacco and recreational nicotine products are commercialized in various types and forms, delivering varying levels of nicotine along with other toxic compounds. These products deliver nicotine in profiles that can initiate and perpetuate addiction, especially in young populations. Notably, some electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP) can deliver concentrations of nicotine that are comparable to those of traditional cigarettes. Despite being regularly advertised as such, ENDS and HTP have demonstrated limited effectiveness as tobacco cessation aids in real-world settings. Furthermore, ENDS have also been associated with an increased risk of cardiovascular disease. In contrast, nicotine replacement therapies (NRT) are proven to be safe and effective medications for tobacco cessation. NRTs are designed to release nicotine in a slow and controlled manner, thereby minimizing the potential for abuse. Moreover, the long-term safety of NRTs has been extensively studied and documented. The vast majority of tobacco and nicotine products available in the market currently contain nicotine derived from tobacco leaves. However, advancements in the chemical synthesis of nicotine have introduced an economically viable alternative source. The tobacco industry has been exploiting synthetic nicotine to circumvent existing tobacco control laws and regulations. The emergence of newer tobacco and recreational nicotine products, along with synthetic nicotine, pose a tangible threat to established tobacco control policies. Nicotine regulations need to be responsive to address these evolving challenges. As such, governments should regulate all tobacco and non-medical nicotine products through a global, comprehensive, and consistent approach in order to safeguard tobacco control progress in past decades.
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    Management of the third stage of labour by basotho traditional birth attendants
    (AOSIS (Pty) Ltd, 2024) Fobo, Keneuoe N.; Kovane, Gaotswake Patience; Minnie, Catharina S.
    Background: Historically and to date, women still give birth at home with the support of elderly, experienced women who live within their communities. In Lesotho, traditional birth attendants (TBAs) are sometimes the only option for pregnant women living far from facilities. Women are vulnerable during the third stage of labour; therefore, correct management is crucial to limit undesirable outcomes. Postpartum haemorrhage and postpartum sepsis remain the leading direct causes of maternal mortality. Aim: This study aimed to explore and describe how Basotho TBAs manage the third stage of labour. Setting: The study was conducted in Lesotho, at Bolahla and Sejakhosi. These villages have the highest number of women giving birth at home. Methods: An explorative and descriptive design with a qualitative approach was used. Semistructured interview guide was utilised to conduct individual in-depth interviews about how the TBAs manage the third stage of labour and their support needs concerning this phase. The TBAs were purposively sampled. The data were analysed thematically. Results: Four themes emerged: challenges TBA experience in the management of the third stage of labour, management of the placenta by Basotho traditional birth attendants, support during the management of the placenta by Basotho traditional birth attendants, and management during emergencies. Conclusion: This study demonstrated that if TBAs are supported, they can contribute to the health of the mother and baby. Contribution: This study’s findings can be valuable to healthcare professionals to understand better how TBAs in Lesotho manage the third stage of labour and the support they need.
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    Adolescent girls’ sexual and reproductive health information needs and barriers in Cape Town
    (AOSIS (Pty) Ltd, 2024) Holtman, Natheerah; Bimerew, Million; Mthimunye, Katlego
    Adolescent sexual and reproductive health (SRH) pertains to the mental and physical state of youth and encompasses their capacity to abstain from unintended pregnancies, unsafe abortions, sexually transmitted infections (stis), including HIV/AIDS, and all types of sexual assault and coercion (Abdurahman et al. 2022). A survey of 70 developing countries indicated that adolescent girls had unmet needs related to SRH services, which resulted in unintended pregnancy and other socio-economic consequences (Woog et al. 2015). Approximately 16 million adolescent girls younger than 19 years give birth each year, accounting for about 11% of all births, with 2 million of these girls being under the age of 15 years (Bałanda-Bałdyga et al. 2020). Although these pregnancies occur across all brackets of socio-economic status and countries (Bałanda-Bałdyga et al. 2020), approximately 95% of adolescent pregnancies were from developing countries, especially in Africa (Odimegwu & Ugwul 2022). Sub-Saharan Africa had the highest prevalence of fertility among young women, and more than 82% of these pregnancies were unintended (Mjwara & Maharaj 2018).
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    Factors influencing nursing students’ learning in a clinical skills laboratory
    (OpenJournals Publishing AOSIS (Pty) Ltd, 2024) Hoffman, Catherine M.; Willemse, Juliana
    Background: Achieving competence in clinical skills requires various resources and preparation time for undergraduate nursing students. Intentional opportunities should be created for student nurses to experience meaningful encounters in the clinical skills laboratory (CSL) to broaden their knowledge and competence. Therefore, factors that influence the competence in clinical learning in a CSL were explored. Aim: This study aimed to explore and describe the perceptions of nursing students regarding factors influencing their learning in a CSL. Setting: The study was conducted at a School of Nursing at a university in the Western Cape province. Methods: A qualitative descriptive design was adopted. Purposive sampling was used to select participants for this study based on specific inclusion and exclusion criteria. Following the attainment of ethical clearance, 10 focus group interviews were undertaken to explore the perceptions of nursing students regarding factors influencing their learning in a CSL. The focus group sessions continued until data saturation was established. Data were analysed using a thematic analysis process. Results: Three major themes emerged from the data analysis that was explored to make the following recommendations: physical environment, psychosocial environment and organisational environment. Conclusion: The results of this study highlighted the necessity for implementing interventions to enhance specific elements within the CSL, aiming to foster high-quality clinical learning experiences for nursing students. Contribution: Areas were identified within the CSL environment that requires enhancement to ensure the provision of quality clinical learning, thereby enabling student nurses to attain clinical competence.
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    Perceptions of incivility in a nursing school at a university in south africa – cross-sectional study. “incivility in nursing education – is it a problem?”
    (Elsevier Ltd, 2024) Fürst, Laetitia; Heradien, Zenobia; Abubu, Janiere
    Respectful civil behaviour of nurses is key to nursing practice and can directly affect quality of patient care. Reports of international studies on incivility in nursing schools is well documented, however little is known about incivility in nursing schools in South Africa. This study aimed to describe the nursing students’ perception of the level and occurrence of incivility in nursing students and faculty at a nursing school at a university in South Africa. A quantitative descriptive cross-sectional survey was conducted. A self-administered questionnaire was used to determine the student nurses’ perceptions of levels and occurrence of incivility among nursing students and faculty. The questionnaire included the Incivility in Nursing Education-Revised (INE-R) scale. A sample of 277 was calculated, and an all-inclusive sampling method was used to target all undergraduate nursing students. Data was analysed using IBM Statistical Package for Social Sciences (SPSS) version 27 and descriptive statistics, 95% confidence intervals were used to describe the data and Independent Samples Mann-Whitney U tests were used to compare gender differences. The questionnaire was completed by 540 (77 %) undergraduate nursing student respondents, between 12 March 2021 and 20 April 2021. Respondents reported low levels of perceived student incivility behaviours (2.07 ± 0.7 [95 %CI 2.0–2.1]), with using a computer, phone, or other media device during class, meetings, activities for unrelated purposes being the highest rated perceived low-level student incivility behaviour (2.52 [95 %CI 2.43–2.62]. Low levels of perceived levels and occurrence of low faculty incivility were reported with respondents rating arriving late for class or other scheduled activities as the highest rated perceived level of low incivility behaviour (1.91 [95 %CI 1.82–1.99]). The highest perceived occurrence for low faculty incivility was being unavailable outside of class (not returning calls or emails, not maintaining office hours) (1.82 [95 %CI 1.74–1.9]. Though some perceived incivility amongst students and faculty in the selected nursing school exist, the occurrence is perceived to be low. Further investigations should explore the impact of uncivil behaviours in academic theory environments, and the impact on individuals in practice.
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    South African nursing students' stress and resilience during the global COVID-19 health crisis
    (Taylor and Francis Ltd., 2024) Steenkamp, Ilze; Chipps, Jennifer
    The study aimed to investigate nursing students' psychological distress and their response to stress during the COVID-19 pandemic. Participants were 370 South African nursing students (female= 75%; mean age= 21.9 years, SD = 3.9 years). Students completed the following scales: Compassion satisfaction and fatigue, Kessler psychological distress, and response to stressful experiences. Findings from the descriptive statistics and inferential statistical analyses indicated that students meeting the criteria for being well were likely to have higher resilience scores. Protective factors such as self-efficacy, active coping, and spirituality suggest higher resilience during COVID-19-related stressful events. Physiological factors such as self-reported medical conditions and lack of sleep were associated with poorer mental well-being. These findings provide a profile of nursing students' coping and adaptation to a community-spread pandemic. From these findings, nursing schools could manage students' well-being by providing needed resources in their current and future work health support programmes.
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    Community service nurses in primary healthcare clinics: Experiences of supervision and support from professional nurses
    (AOSIS, 2022) Zambodla, Ayanda; Williams, Margaret; Ricks, Esmeralda
    Background: Newly qualified nurses in South Africa are required to undertake a compulsory 1-year community service (CS) in a public healthcare facility. They are not yet competent to work alone and require supervision and support from senior professional nurses. Aim: This study aimed to explore and describe the experiences of community service nurses (CSNs) regarding supervision and support from professional nurses at primary healthcare clinics (PHC). Setting: The study was conducted with CSNs who were working in PHC clinics in Nelson Mandela Bay (NMB). Methods: A qualitative, explorative, descriptive and contextual study was conducted using semi-structured interviews with 10 CSNs. Purposive sampling was used. Data were analysed using Tesch’s coding method of content analysis.
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    Training needs of professional nurses in primary health care in the Cape Metropole, South Africa
    (African Journal of Primary Health Care & Family Medicine, 2023) Kordom, Ashley; Daniels, Felicity; Chipps, Jennifer
    Background: In the fast-changing healthcare environment, it is important to ensure that primary health care (PHC) nurses are suitably qualified and have access to appropriate and relevant ongoing education. AIM: The aim of this study was to determine the training needs of professional nurses working in PHC facilities. Setting: The research was conducted in PHC facilities in the Cape Metropole, Western Cape, South Africa. Methods: A quantitative descriptive survey with all-inclusive sampling was used. All professional nurses (N = 303), employed for at least a minimum of 6 months in PHC facilities were included in the study. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire was used to collect the data on professional tasks training needs and open-ended questions for specific PHC contextual training needs. Importance and performance means for each of the TNA subsections and training needs were calculated. Open-ended questions were analyzed using content analysis, identifying training domains and topics in terms of frequency and ranking.
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    Validity and utility of instruments for screening of depression in women attending antenatal clinics in Blantyre district in Malawi
    (AOSIS, 2018) Chorwe-Sungani, Genesis; Chipps, Jennifer
    Screening instruments should be brief, valid and easy to use if they are to be useful in a busy antenatal clinic in low-resource settings. A short instrument can be used in a busy antenatal clinic in combination with a more detailed instrument once referred. This study aimed at assessing the validity of a range of depression screening instruments and to test the utility of combining these instruments for use in antenatal clinics in Blantyre district, Malawi. This was a sensitivity analysis study using a sub-sample of 97 pregnant women drawn from a cross-sectional study (sample size = 480) that was screening for depression in eight antenatal clinics. Data from the cross-sectional study for the 97 pregnant women on the 3-item screener, Edinburgh Postnatal Depression Scale (EPDS), Hopkins Symptoms Checklist-15 (HSCL-15) and Self-Reporting Questionnaire (SRQ), was compared with a gold standard, the Mini International Neuropsychiatric Interview (MINI). Sensitivity, specificity and area under curve (AUC) were calculated to test for validity of the instruments. The utility of various combinations of the instruments was tested using the compensatory, conjunctive, probability and sequential rules.
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    Performance of the 3-item screener, the Edinburgh postnatal depression scale, the Hopkins symptoms checklist-15 and the self-reporting questionnaire and pregnancy risk questionnaire, in screening of depression in antenatal clinics in the Blantyre district of Malawi
    (University of Malawi, 2018) Chorwe-Sungani, Genesis; Chipps, Jennifer
    Screening instruments for antenatal depression vary in performance. This study aimed at assessing the performance of a range of screening instruments in detecting depressive symptoms in antenatal clinics in Blantyre district, Malawi. A cross-sectional study was conducted to screen for depression among women attending 8 selected antenatal clinics in Blantyre district using 3-item screener, Edinburgh Postnatal Depression Scale (EPDS), Hopkins Symptoms Checklist-15 (HSCL-15), Self-Reporting Questionnaire (SRQ) and Pregnancy Risk Questionnaire (PRQ). The instruments were administered to a random sample of 480 pregnant women. Data were analysed using SPSS 22.0 testing for performance differences in proportions of screen positives and how screen positive results might differ by particular variables.
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    Perceptions of nurses on TB with HIV adherence counselling skills in a health sub-district, Cape Town: A qualitative study
    (AOSIS, 2022) Ticha, Victoire; Bimerew, Million; Phetlhu, Deliwe R.
    People living with HIV (PLHIV) co-infected with Tuberculosis (TB) account for one in three HIV-related deaths. Retention in care and adherence to medication remain key behaviours that PLHIV co-infected with TB must adopt to achieve better health outcomes. Nevertheless, TB with HIV adherence-counselling services provided by nurses designed to enhance these behaviours remain inadequate. Additionally, limited information is found in the literature on the perceptions of nurses regarding their TB with HIV adherence counselling skills pertaining to PLHIV co-infected with TB.
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    Mothers' perceptions of female genital mutilation
    (Oxford University Press, 2014) Ahanonu, Ezihe; Victor, O.
    The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics and a chi-square test was used to test for association between variables. Findings showed that the mothers held ambivalent beliefs about the practice.
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    Towards the development of a community-based model for promoting cervical cancer prevention among Yoruba women in Ibadan Nigeria: Application of PEN-3 model
    (Taylor and Francis Group, 2019) Olanlesi-Aliu, A. D; Martin, P. D; Daniels, F. M
    Through the identification of the barriers to the uptake of prevention services for cervical cancer and ways topromote prevention of cervical cancer in the community, this research study purposed the development of a community-based model for promoting cervical cancer prevention among Yoruba women living in Ibadan, Nigeria. An exploratory, descriptive design was used to collect data from 20 health workers and four policy makers using semi-structured interviews and key informant interviews respectively. The PEN-3 cultural model developed by Airhenbuwa in 1998guided the exploration of the barriers to the uptake of available prevention services for cervical cancer, and the ways topromote the prevention of cervical cancer. Three interrelated and interdependent primary domains, namely cultural identity,relationships and expectations, and cultural empowerment, form the basis of the PEN-3 model. Cultural identity emphasisesthe subjective responses in relation to the community and cervical cancer prevention.
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    Objective structured clinical examination: Do first-year nursing students perceive it to be stressful?
    (AOSIS, 2023) Emebigwine, Dorothee Line Adibone; Linda, Ntombizodwa S.B.; Martin, Penelope
    The Objective Structured Clinical Examination (OSCE) is widely accepted as an effective means of assessing clinical competence and nursing skills. There is, however, little existing knowledge on how first-year nursing students perceived stress during their first OSCE. To determine the perception of stress; to identify the perceived factors causing stress; and to determine the perceived incidence of stress. A descriptive, survey was conducted on a sample of 82 first-year nursing students using the Perceived Stress Scale (PPS).
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    Outcomes of births attended by private midwives in the Gauteng Province of South Africa: A retrospective cohort study
    (Elsevier, 2023) Jordaan-Schlebusch, Christ´el; Minnie, Catharina Susanna
    Midwives are important role players in providing women-centred care for low-risk pregnant women. South African women use either public or private health care services during pregnancy and birth. As the public sector is overburdened, women do not receive a high level of continuity of care there. The private sector is mainly obstetrician-led and intervention-driven. Private midwife-led care is available in South Africa, but is limited to the major cities. No evidence could be found about the outcomes of private midwife-led care in South Africa. The objective reported in this paper was to compare the outcomes of and interventions during births attended by private midwives in Gauteng with the latest Cochrane review on midwife-led care. A retrospective cohort design was used to audit the birth registers of private midwives in Gauteng, focusing on outcomes and interventions as in the most recent Cochrane review on midwife-led care.
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    Nursing informatics skills relevance and competence for final year nursing students
    (AOSIS, 2022) Chipps, Jennifer; le Roux, Loretta; Agabus, Jakobina
    The increasing use of technology in nursing practice requires nursing students to be competent in nursing informatics with an attitude of acceptance of technology in the healthcare environment. The objectives of the study were to determine final year nursing students’ perceptions and skills in nursing informatics and their attitudes towards computerisation in nursing practice.
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    Contextual factors influencing self-management of adolescents and youth living with HIV: A cross-sectional survey in Lesotho
    (MDPI, 2023) Nagenda, Mapaseka Chabalala; Crowley, Talitha
    HIV treatment outcomes of adolescents and youth living with HIV (AYLWH) are lagging. One way to improve outcomes is through supporting AYLWH to acquire self-management skills. Although self-management is associated with improved health outcomes, condition-specific, individual/family, and social/environmental contextual factors influence self-management. We aimed to describe factors influencing the self-management of AYLWH in Lesotho. Methods: A cross-sectional survey design was used. AYLWH (n = 183) aged 15–24 were conveniently sampled from two HIV treatment sites in Lesotho. Participants completed self-report questionnaires in English or Sesotho. Participants (89.1% female) had high HIV self-management scores (mean 92.7%, SD 5.3%) that corresponded with treatment outcomes (98.9% adherent and 100% viral load < 1000 copies/mL). This might be attributed to condition-specific factors, including once-daily doses (100%) and longer duration of treatment (81.4% on ART for more than 10 years).
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    Nursing students’ experiences of clinical assessment at a university in South Africa
    (AOSIS, 2023) Donough, Gabieba
    Nursing education includes both classroom and clinical teaching. The clinical teaching was explored through this research. The successful training of the undergraduate nursing students can be attributed to effective clinical teaching and supervision and is determined by both training requirements and services provided. Although there have been several researches on clinical supervision, there is still a dearth of information of the realities of supervision regarding assessment of undergraduate nursing students. The authors’ original thesis formed the foundation of this manuscript. This study aimed to explore and describe nursing students at the undergraduate level experiences regarding clinical supervision.