Health SA Gesondheid

Academic help-seeking behaviour and barriers among college nursing students

Million S. Bimerew, John P. Arendse — Wed, 15 Jan 2025 00:00:00 +0000

Background: First-year college student’s smooth transition and academic success influenced by academic help-seeking behaviour. Academic help-seeking behaviour is largely affected by many factors, including demographic factors, self-esteem and the use of sources for academic learning.

Aim: The study investigated academic help-seeking behaviour and barriers among first-year college nursing students.

Setting: The study was conducted at a nursing college in the Western Cape province of South Africa.

Methods: A cross-sectional descriptive survey design with a self-administered questionnaire was used to collect data from 130 first year nursing college students. Descriptive statistics and bivariate analysis were computed using Statistical Packages for Social Sciences (SPSS).

Results: More than 77.7% used course materials and books to help with academic learning, 50% of students sought help from their teachers. Only 24.6% and 17.7% of students used YouTube and computers respectively. In all items measured help-seeking is not a threat to self-esteem, teachers and parents did not have unrealistic expectations of their academic performance. Language is significantly associated with (p < 0.001) academic help-seeking behaviour.

Conclusion: Most students mainly used informal sources for academic learning. Help-seeking was not a threat to self-esteem. The language barrier is significantly associated with academic help-seeking behaviour. The nursing college should provide a coordinated academic language support, academic consultation and counselling services for academically stressed first-year nursing students.

Contribution: The findings highlighted language as a barrier to academic help-seeking. The study provides insight to strengthen the language and academic support for academic learning for first year nursing students.

A scoping review on natural cholesterol lowering supplements sold in South African pharmacies

Hyeon Bok Lee, Razeeya Khan, Muhammed Vally, Ané Orchard — Wed, 15 Jan 2025 00:00:00 +0000

Background: Dyslipidaemia is defined as elevated total or low-density lipoprotein (LDL) levels or low levels of high-density lipoprotein (HDL). Patients may often make use of natural cholesterol lowering supplements (NCLSs) available at the pharmacy; however, limited information on these supplements is readily available. Pharmacists should be knowledgeable about NCLSs to ensure that the use of these supplements is supported by evidence and to provide appropriate advice to patients for desirable therapeutic outcomes.

Aim: This study aimed to identify the NCLSs being sold in South African pharmacies and review the scientific evidence for each of the ingredients in these NCLSs.

Methods: Seventeen NCLS products were identified, and the Joanna Briggs Institute (JBI) scoping review methodology was used to conduct a literature review of NCLSs.

Results: From the ingredients reviewed it is evident that co-enzyme Q10, probiotics and sterols have sufficient evidence supporting their use. However, there is still limited scientific evidence available to validate the remaining ingredients.

Conclusion: Further research on NCLSs will provide practising pharmacists and practitioners with a guide of the evidence available on the various ingredients in NCLSs.

Contribution: This study provides a review of the available literature on the NCLSs being sold in the pharmacies across South Africa to provide pharmacists with a collated document of the evidence behind these popular supplements to assist them in making
evidence based informed decision regarding natural products for cholesterol.

Traditional health practitioners’ understanding of spirit possession in Gauteng province, South Africa

Ellen M. Thobakgale, Roinah Ngunyulu, Mavis Mulaudzi — Wed, 15 Jan 2025 00:00:00 +0000

Background: Traditional health practitioners (THPs) understand spirit possession as a cultural or religious spirit occupying a person, while the mental healthcare providers understand it as a mental illness. The different understanding is based on manifestations that mimic that of mental illness, such as seeing and hearing things that others cannot see or hear. Spirit possession holds different meanings in different cultures and religions that could be either beneficial or detrimental. Furthermore, spirit possession is understood as a channel of communication between the living and the dead or God or a supernatural phenomenon in which a spirit owns a person.

Aim: This study explored and interpreted THPs’ understanding of spirit possession in Gauteng province, South Africa.

Method: Hermeneutic phenomenology study explored and interpreted the THPs’ understanding of spirit possession in Gauteng province. In-depth individual interviews were conducted with 12 THPs who were selected through snowball sampling techniques. Data
analysis followed Heidegger’s and Gadamer’s philosophies and Van Manen’s six steps of the analytic approach.

Results: The findings revealed that THPs understood spirit possession as spiritual illness, ancestral calling and demonic spirit or witchcraft.

Conclusion: Traditional health practitioners’ understanding of spirit possession could promote mental health and prevent mental illness by providing support to a spirit-possessed person and referral to mental healthcare services.

Contribution: This study contributed that not all manifestations presented by persons with spirit possession are actual and clear-cut mental illness, but could be unwritten cultural and/or religious illnesses that needs cultural and religious services also.

Nurse prescribing and dispensing in South Africa: Gaps in the current legislative framework

Talitha Crowley, Andrew L. Gray, Nelouise Geyer — Wed, 15 Jan 2025 00:00:00 +0000

Background: Nurse prescribing and dispensing are central to ensuring universal health access in South Africa.

Objective: 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.

Method: This is a discussion article.

Results: 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.

Conclusion: There is a necessity for prompt legislative revisions to address identified deficiencies.

Contribution: The contribution of this article lies in its advocacy for changes to the regulatory framework to further enable nurses to deliver safe and comprehensive health care.

Challenges of clinical accompaniment amongst undergraduate nursing students: University of KwaZulu-Natal

Seaka Ramoeletsi, Boikhutso Tlou — Wed, 15 Jan 2025 00:00:00 +0000

Background: Clinical accompaniment is an activity predominantly supervised by the clinical facilitator to develop the skills of the students. In South Africa, clinical accompaniment aims to develop the skills of the students to equip them in delivering efficient health services to the patients. Previous studies revealed that students experienced challenges and were negatively affected due to inadequate clinical accompaniment in the learning practice.

Aim: The aim was to determine the challenges faced by University of KwaZulu-Natal (UKZN) undergraduate nursing students during their clinical accompaniment.

Methods: An observational cross-sectional study design, with an analytic component was implemented. Questionnaires were used to collect data. Of the 400 registered nursing students, 245 were undergraduates; of these, 241 consented to participate in this study. Data captured into SPSS Statistics Package V28. ANOVA were used in comparing challenges amongst participants. A p-value less than 0.05 was considered significant.

Results: A total of 241 participants responded to the questionnaires, which yielded a response rate of 98.4%. This study comprised first-year (32.4%), second-year (32.8%) and third-year (34.9%) students. There was no remarkable difference in terms of challenges amongst study participants (1st; 2nd; 3rd), p=0.592.

Conclusion: This study revealed the challenges faced by undergraduate nursing students during their clinical accompaniment.

Contribution: Study results might assist in developing effective guidelines to resolve the challenges encountered by students.

Corrigendum: Knowledge, attitudes and practices of oral health workers regarding COVID-19 and its vaccine

Zara Chothia, Ntombizodwa R. Nkambule, Ahmed Bhayat, Mpho Morule — Wed, 15 Jan 2025 00:00:00 +0000

No abstract

Challenges related to the implementation of the CCMDD programme in Sekhukhune clinics

Ragosebo P. Sekopa, Robert T. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: Implementation of the central chronic medicines dispensing and distribution (CCMDD) programme in most of Sekhukhune primary health care (PHC) has been challenging. This raised questions as to reasons for the CCMDD programme and its good intentions and benefits eventually creating challenges in the Sekhukhune district PHC facilities.

Aim: This study aims to describe the challenges related to the implementation of the CCMDD programme in Sekhukhune district clinics.

Method: The qualitative research approach and its explorative and descriptive research designs were used in this study. Data were acquired through one-on-one semi-structured interviews and then analysed thematically.

Results: Findings of the study revealed that shortage of staff, lack of communication, defaulters, negative impact of the CCMDD programme and lack of training as challenges to the implementation of the CCMDD programme in Sekhukhune district clinics.

Conclusion: Sekhukhune public clinics have challenges concerning the implementation of the CCMDD programme; therefore, it is very crucial to provide proper training about the programme to all PHC facility staff members to improve the CCMDD implementation.

Contribution: The study would provide suggestions to implement the CCMDD programme by correcting the process of enrolling clients, the methods of packaging and dispensing the medications, sending SMSs, as well as delivery to the pick-up points.

Challenges related to the implementation of the CCMDD programme in Sekhukhune clinics

Ragosebo P. Sekopa, Robert T. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Aim: This study aims to describe the challenges related to the implementation of the CCMDD programme in Sekhukhune district clinics.

A Delphi study on the management of female infertility by homeopaths in South Africa

Robyn Anderson, Janice Pellow, Tebogo Tsele-Tebakang, Elizabeth Solomon — Wed, 15 Jan 2025 00:00:00 +0000

Background: Infertility affects millions of people worldwide and has a negative social and psychological impact on the lives of infertile couples. Homeopathy offers an alternative treatment option for female infertility; however, there is currently no research describing how homeopaths manage this condition in their practice.

Aim: To determine homeopathic practitioners’ approaches to managing female infertility.

Method: The electronic Delphi technique consisting of three rounds was used to establish consensus among homeopaths. Twelve registered homeopaths with a minimum of 5 years of clinical experience in managing female infertility participated, 11 of whom completed the study. In round one, participants elaborated on interventions found beneficial in clinical practice for female infertility. Responses were qualitatively analysed to create a structured list of items; participants rated their level of agreement with these items on a 5-point Likert scale in the second and third rounds. Consensus was determined for items that reached an agreement level of 75% or more.

Results: Thirty-two statements achieved expert consensus, which were placed into the following categories: homeopathic treatment, dietary and lifestyle modifications, supplementation and referrals.

Conclusion: The results of this study provide a baseline depicting the homeopathic approach to treating female infertility. Several research gaps have been identified and further studies are necessary to explore these interventions to improve future patient care.

Contribution: This study highlights the various approaches used by homeopathic practitioners in the management of female infertility.

The use of traditional and complementary medicine by cancer patients in SSA: A scoping review

Ammaarah Sheik Adam, Varsha Bangalee, Frasia Oosthuizen — Wed, 15 Jan 2025 00:00:00 +0000

Background: The rate of traditional and complementary medicine (T&CM) use is increasing worldwide, including among cancer patients who are often willing to try alternate therapies. Despite T&CM popularity in sub-Saharan Africa (SSA), there are limited data on its use with conventional treatments.

Aim: This scoping review aims to describe the prevalence of use, reasons for use, most common types of T&CM used, patient satisfaction with T&CM and disclosure of T&CM use to physicians among cancer patients in SSA.

Methods: A systematic literature search was conducted for articles published from 2013 to 2022 across four databases: PubMed, ScienceDirect, Google Scholar and EBSCOhost. A scoping review approach was used to map relevant literature. Forty-six articles were assessed based on their titles and abstracts. After full-text screening, 10 articles were included.

Results: Average T&CM use was calculated to be 66.7%. Reasons for T&CM use included: to improve psychological well-being, boost the body’s immunity and provide symptomatic relief. An average of 21.2% of T&CM users informed their physician. Nine articles addressed patient satisfaction with T&CM. An average of 39.1% of patients reported general T&CM satisfaction.

Conclusion: The use of T&CM is common among cancer patients. It is important for healthcare providers to expand their knowledge in order to counsel patients and avoid potential hazards when combining T&CM with conventional treatments.

Contribution: These findings highlight commonly used T&CM and provide insight on the portion of cancer patients informing their doctors about T&CM use. This information will help understand the attitude cancer patients have towards T&CM.

The effect of coronavirus disease 2019 vaccination on pregnant women: A scoping review

Mildred M. Malamule, Rodwell Gundo, Mavis Mulaudzi — Wed, 15 Jan 2025 00:00:00 +0000

Background: Globally, reports have shown that pregnant women refuse to receive the coronavirus disease 2019 (COVID-19) vaccine. This has posed a significant concern given the global impact of the COVID-19 pandemic.

Aim: This study aims to explore the current evidence on the effect of COVID-19 vaccination on pregnant women.

Method: A scoping review was conducted using Levac et al.’s five-stage framework. Relevant articles were searched in the Web of Science, PubMed, Scopus and EBSCOhost (CINAHL) databases. The identified articles were screened based on predetermined inclusion and exclusion criteria. Data from the selected articles were charted and summarised into meaningful units.

Results: Twelve articles from developed countries were included in the review. Studies have reported that COVID-19 vaccination during pregnancy is generally safe and does not increase the risk of pregnancy complications. There was no significant difference in delivery outcomes between vaccinated and unvaccinated women. Neonatal outcomes were not affected by the vaccination. However, one study identified a potential risk of spontaneous abortion between 6 and 9 weeks of gestation among vaccinated women.

Conclusion: Coronavirus disease 2019 vaccination is considered safe during pregnancy. While some studies have identified potential associations with certain conditions, the overall benefits of vaccination outweigh the risks. Continued monitoring of the safety and effectiveness of COVID-19 vaccines during pregnancy is recommended. Pregnant women should consult healthcare providers to make informed decisions regarding vaccination.

Contribution: The findings of this review may assist in alleviating anxiety and reducing vaccine hesitancy among pregnant women

Management guidelines for pregnant women living with epilepsy: An integrative literature review

Sumeshni Birbal, Frasia Oosthuizen — Wed, 15 Jan 2025 00:00:00 +0000

Background: Epilepsy affects more than 50 million people worldwide, with a significant number of safety-related concerns arising in pregnant women. Precise management needs to include a vast array of stepwise protocols; however, no studies have been conducted to
compare current South African guidelines to international norms.

Aim: The aim of this integrative literature review was to identify discrepancies, if any, in the current protocols for treating pregnant women with epilepsy within the public sector of South Africa when measured against global standards.

Method: An integrative literature review was conducted using the Whittemore and Knafl method. The following databases and search engines were used: PubMed, EBSCOhost, Science Direct, Medscape, African Journals Online, Cochrane Library, Google scholar, Google and MedlinePlus. The study included qualitative literature from all levels of evidence from 2006 to 2023. The data were evaluated using the PRISMA flow chart and analysed using the Cooper method. On completion of critical appraisal, 22 articles met the inclusion criteria and were analysed thematically.

Results: The review identified several areas that can be enhanced to improve patient management and outcomes such as therapeutic drug monitoring and targeted dosing, folic acid supplementation, the use of antepartum vitamin K, high-resolution ultrasounds,
elimination of sodium valproate in women of childbearing potential, monotherapy and endorsing frequent obstetrician visits.

Conclusion: The study validated many differences between guidelines used in South Africa and internationally. Some of the prominent findings included areas focused on patient medication, screening, physician visits and pharmacovigilance.

Contribution: The findings can be used to enhance and provide evidence-based recommendations in the areas that are not well developed within the current guidelines.

Epidemiological pattern of rape cases managed at a regional hospital in South Africa

Chika K. Egenasi, Mathew A. Benedict, Anthonio O. Adefuye, Lynda U. Madu — Wed, 15 Jan 2025 00:00:00 +0000

Background: South Africa has one of the highest incidences of rape globally. Understanding the epidemiological pattern of rape is needed to inform the design of effective intervention programmes for rape prevention and management of alleged rape cases.

Aims: To investigate important epidemiological patterns associated with rape in Kimberly, Northern Cape Province, South Africa.

Setting: The Robert Mangaliso Sobukwe Hospital (RMSH) forensic unit.

Methods: A descriptive, retrospective cross-sectional clinical audit of rape cases.

Results: The majority (93.3%) of the alleged rape victims were women, with a mean age (SD) of 21.6 years (11.3); the male population made up 6.7% of the cases, with a mean age (SD) of 10.5 years (6.9). The highest incidence of alleged rape in the male population was seen in the age group ≤ 16 years (81.8%) and for women 17–30 years (50.3%). Most of the incidents occurred at the perpetrators’ homes (42.7%); on the days Fridays (14.6%), Saturdays (29.9%) and Sundays (23.2%); at night up to midnight 20:00–23:59 (32.9%) (p = 0.01) and involved threats of violence (55.5%). The majority (56.0%) of the perpetrators were known to the victims.

Conclusion: Important information about the victims and circumstances in which rape occurs as reported herein can be used to inform the design of effective intervention programmes for sexual crime prevention and management in Kimberly, South Africa.

Contribution: This study helped to advance knowledge and understanding of the epidemiological pattern associated with rape in Kimberley, Northern Cape Province of South Africa.

Psychologists’ experiences with telepsychology during the COVID-19 pandemic in South Africa

Anne S. Raju, Helene E. le Roux, Paul J. Pretorius, Omololu Aluko — Wed, 15 Jan 2025 00:00:00 +0000

Background: During the COVID-19 pandemic, South African psychologists started to use telepsychology to continue providing services. However, diverse factors may influence psychologists’ decisions regarding the use of telepsychology.

Aim: To investigate South African psychologists’ experiences with using telepsychology during the COVID-19 pandemic.

Setting: Health Professions Council of South Africa (HPCSA)-registered psychologists practising in South Africa.

Methods: A quantitative, cross-sectional study was conducted. Psychologists were invited to complete an online survey on the REDCap platform. Convenience sampling was used for respondent selection (n = 179). The study explored demographic variables, telepsychology use, changes in psychotherapy format, guidelines, ethical considerations, training, socioeconomic factors, and individual patient and psychotherapist factors. Descriptive statistics, including categorical variables (frequencies and percentages) and numerical variables (medians and percentiles) were utilised for the data analysis. A bivariate analysis with backward selection was subsequently used, and significant variables were integrated into the logistic regression model.

Results: Most respondents (84.8%) used telepsychology, with 72.8% considering it a positive experience. Private psychologists used electronic means for delivering services significantly more than public sector psychologists. The public sector psychologists had more challenges relating to changes in the therapeutic format, additional training requirements and technology access.

Conclusion: During the COVID-19 pandemic, psychologists turned to telepsychology as a valuable tool for providing services while navigating the unique challenges it presented.

Contribution: This study provides insights into the utility of telepsychology in the South African context during COVID-19. It underscores the experiences, importance of guidelines, and needs regarding training and technology access among psychologists.

Informational continuity by skilled birth attendants during antenatal care in Lesotho

Angelina Zhangazha, Doreen K.M. Kaura, Anneline E. Robertson — Wed, 15 Jan 2025 00:00:00 +0000

Background: Informational continuity (IC) is one of the four approaches that enables integrated people-centered health services. IC enables the availability of all health and psychosocial information of the pregnant women at all health encounters. World Health Organization (WHO) recognised that ineffective IC results in fragmented health care and duplication of services. Hence, IC may assist in the reduction of maternal morbidity and mortality.

Aim: The purpose of this study was to explore and describe the experiences of skilled birth attendants (SBAs) with IC during the antenatal period

Setting: Three primary healthcare centers in Maseru district, Lesotho.

Methods: A qualitative descriptive phenomenological design was used with purposive sampling to choose nine participants.

Results: Four themes emerged; Theme one: SBAs and pregnant women information communication, theme two: Information communication between the SBAs, theme three: information collection during ANC and theme four: guidelines used during ANC to standardise care. Several challenges regarding information communication form the sources of information, transition of information, information between caregivers and women which demonstrated the frustration between the women and the SBAs during ANC leading to ineffective care coordination.

Conclusion: Enabling IC during ANC enables effective data collection from the sources of information, transition of information during care giving within and between health facilities.

Contribution: Effective informational continuity enables effective care coordination in ANC in Lesotho.

Healthcare providers’ knowledge, attitudes and practices on smoking cessation intervention in the Northern Cape

Wed, 15 Jan 2025 00:00:00 +0000

Background: Clinicians are crucial in encouraging smokers to quit through behavioural or pharmacological smoking cessation interventions. Smokers quit better with professional help. The level of healthcare providers’ (HCPs) knowledge, attitudes and counselling skills related to effective smoking cessation support in the study area remains uncertain.

Aim: The study aimed to determine HCPs’ knowledge, attitudes and practices (KAP) on smoking cessation intervention strategies in the Sol Plaatje district, Northern Cape.

Setting: Sol Plaatje’s 13 district municipality clinics, Kimberley, Northern Cape.

Method: A descriptive, cross-sectional analytical study involving healthcare workers in the above setting.

Results: A total of 165 HCPs, including medical officers, professional nurses, enrolled nurses and assistant-enrolled nurses working in primary healthcare clinics, were invited to participate in the study, with 156 completing the questionnaires. About 53.9% had no knowledge of South African tobacco smoking cessation guidelines, while 87.2% knew the importance of counselling patients about smoking and its impact on quitting. The majority of them did not know the medicines recommended for tobacco treatment in South Africa. About 89.7% expressed that smoking cessation counselling is an important part of their jobs. However, less than half indicated that they make follow-up arrangements for those attempting to quit.

Conclusion: The study revealed gaps in KAP regarding smoking cessation among the respondents, necessitating the need for continuing education on the existing smoking cessation guidelines among these HCPs.

Contribution: The results of this study will help to improve smoking cessation intervention knowledge among health providers.

Professional nurses supporting learners during professional socialisation in Limpopo province

Julia L. Mafumo, Takalani R. Luhallma, Maria S. Maputle — Wed, 15 Jan 2025 00:00:00 +0000

Background: Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support.

Aim: The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation.

Setting: Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care.

Methods: An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working
in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch’s open coding system was used to analyse data.

Results: Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation.

Conclusion: The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements.

Contribution: The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

Student nurses’ practices and willingness to teach relatives breast self-examination in Nigeria

Joel O. Aluko, Olayinka A. Onasoga, Regis R. Marie Modeste, Odinaka B. Ani — Wed, 15 Jan 2025 00:00:00 +0000

Background: Breast cancer is the most common cancer and the leading cause of cancerrelated -death for women worldwide. Breast self-examination (BSE) is an essential, low-cost, and simple tool for detecting breast cancer early. Employing the idea of ‘charity begins at home’ by involving student nurses in teaching BSE to relatives will improve early detection.

Aim: To assess nursing students’ practice and willingness to teach BSE to their relatives.

Setting: A college of nursing and midwifery in one state under North-Central Nigeria.

Methods: A cross-sectional descriptive design was employed. Through incidental sampling technique 197 respondents were selected from the first to the third year. Data were collected using a structured questionnaire. Descriptive and inferential analyses, with a p-value of 0.05 were conducted.

Results: Respondents indicated where they learned about BSE. There were 98.5% respondents who had heard about BSE, and 89.8% of them had good practice of BSE. However, a quarter did not teach BSE to relatives. There were no statistically significant associations noted.

Conclusion: Most of the nursing students were aware of BSE and knew how to perform it, although a quarter did not teach BSE to their relatives. Therefore, it may be necessary to sensitise nurses to cultivate the habit of teaching BSE to relatives and women in the community.

Contribution: It is crucial to provide nurses with the skills and knowledge required to carry out BSE effectively, as well as teach women how to perform it on themselves, to improve breast cancer detection rates in Nigeria.

Corrigendum: The moderating effect of gender on physical activity participation and physical fitness in children

Howard Gomwe, Lesego Phiri, Chioneso Show Marange — Wed, 15 Jan 2025 00:00:00 +0000

No abstract

Utilisation of partogram at a district in the North West Province, South Africa

Suzan K.M. Mabasa, Molekodi J. Matsipane, Ushotanefe Useh — Wed, 15 Jan 2025 00:00:00 +0000

Background: The partogram or partograph is a tool used to monitor the progress of labour and serves as a diagnostic tool for labour-related abnormalities such as prolonged labour, cephalopelvic disproportion (CPD) and obstructed labour. Appropriate utilisation of the partogram aids health caregivers with early diagnosis and facilitates clinical judgement and interventions to prevent complications of abnormal labour. The partogram is thus a mandatory tool to be utilised to monitor the progress of labour for intrapartum care in South Africa.

Aim: This study aimed to assess and describe the utilisation of the partogram in a district of the North West Province.

Setting: The study was conducted in the private rooms of facilities rendering maternity services in the district.

Methods: A quantitative cross-sectional descriptive design was employed. A purposive sampling was used to select healthcare facilities, and simple random sampling was employed to select plotted partograms. Data were collected using a checklist and analysed using
Statistical Package for Social Sciences software version 22.

Results: A total of 279 partograms were analysed. The average partogram utilisation was 20% correct and 80% substandard or not recorded. All files had partogram documents included.

Conclusion: A large percentage (80%) of the partograms were not completed according to the World Health Organization (WHO) standards. There was a concern about high proportions of unrecorded parameters such as monitoring of foetal and maternal conditions, and the progress of labour.

Contribution: The findings and recommendations of the study could improve partogram utilisation in maternity care.

Nurses’ knowledge, attitudes, and practices about rehabilitation of patients after heart valve surgery in Namibia

Lilian S. Masule, Kristofina Amakali, Wilma E. Wilkinson — Wed, 15 Jan 2025 00:00:00 +0000

Background: A cardiac rehabilitation programme is a medically supervised intervention to assist patients in recovery after heart surgeries and to prevent potential complications. Nurses should have the knowledge, a positive attitudes, and good practices to improve patient quality of life during the recovery process.

Aim: This study aimed to describe the knowledge, attitudes, and practices of the nurses regarding cardiac rehabilitation for patients after heart valve surgery.

Setting: The study setting was Windhoek Central Hospital, Cardiac Unit, in Windhoek, Namibia.

Methods: A quantitative and descriptive research design was used for convenient nonprobability sampling of (N = 23) nurses who consented to participate in the study. Data were collected through self-administered questionnaires and analyzed using SPSS Version 26.
Descriptive statistics were used and Fischer’s Exact test for associations of variables was performed.

Results: The study results showed a high level of knowledge, good attitudes, and poor to fair practices toward cardiac rehabilitation. However, the respondents demonstrate a lack of knowledge about the indications, and benefits of cardiac rehabilitation, negative attitudes
regarding counselling of patients on sexual activities, and poor practice regarding exercises and counseling of patients and caregivers on cardiac rehabilitation. Furthermore, there is a positive relationship between the respondents’ older age, senior rank, and having been trained I cardiac conditions and their knowledge, attitudes and practices regarding some core components of cardiac rehabilitation with P-value < 0.050.

Conclusion: There is a need for a cardiac rehabilitation programme to improve nurses’ attitudes and practices toward cardiac rehabilitation.

Contribution: Understanding the gap in knowledge, attitudes, and practices among the nurses regarding cardiac rehabilitation would guide the Ministry of Health and Social Services (MoHSS) in the implementation of the cardiac rehabilitation for patients after heart valve surgery.

Cultural barriers to male partners’ involvement in antenatal care in Limpopo province

Kenneth V. Nesane, Fhumulani M. Mulaudzi — Wed, 15 Jan 2025 00:00:00 +0000

Background: Participation of male partners in antenatal care (ANC) is a complicated process that involves social and behavioural transformation. It necessitates that males take a more active part in reproductive health. Men’s participation in prenatal care has been linked to beneficial health outcomes such as enhanced maternal health outcomes across the world. However, culture has been identified as a barrier to male partners’ participation in prenatal care.

Aim: The aim of the study was to explore and describe the cultural barriers to male partner involvement in ANC.

Setting: The study focussed on selected clinics and hospitals under Vhembe District, Limpopo province.

Methods: Qualitative, exploratory, descriptive, and contextual research design was used in this study. Qualitative data were collected through individual semi-structured interviews and Focus Group Discussions (FGDs). A thematic analysis approach was used to analyse the collected data from semi-structured interviews and FGDs.

Results: The findings revealed three themes: cultural beliefs and practices that affect male partners’ involvement in ANC; gender-related barriers that affect male partners’ involvement in ANC; and socioeconomic barriers to male partners’ involvement in ANC.

Conclusion: The study’s findings revealed that certain cultural beliefs and practices are a stumbling block to male partners’ involvement in antenatal healthcare.

Contribution: Culturally based developed strategy might help in improving the knowledge and practices of male partners in ANC.

Pain medication misuse in the South African spinal cord injury context

Mokgadi K. Mashola, Elzette Korkie, Diphale J. Mothabeng — Wed, 15 Jan 2025 00:00:00 +0000

Background: Pain after spinal cord injury (SCI) is debilitating and has been reported to be difficult to treat, despite pharmacological interventions. Pain medication misuse (PMM) and associated individual factors among people with spinal cord injury (PWSCI) are scarce.

Aim: To determine PMM and the associated factors in PWSCI.

Setting: Homes of community-dwelling manual wheelchair users with SCI in South Africa.

Methods: Community-dwelling PWSCI (n = 122) were consecutively sampled and the Pain Medication Questionnaire (PMQ) was used to determine PMM. Descriptive statistics, Fisher’s exact test, independent t-tests, and simple linear regression tests were performed using SPSS v27. Testing was conducted at the 0.05 level of significance.

Results: Eighty-five per cent of the participants reported the presence of pain and 48.1% of them used pain medication. Forty-four percent of people who used pain medication scored ≥ 30, indicative of serious aberrant drug-taking behaviours. Opioids were mainly used for
neuropathic pain and in combination with other types of medications such as anticonvulsants and non-steroidal anti-inflammatories (44.0%). Pain severity and the type of pain medication were found to be predictors of PMM (p < 0.01 respectively).

Conclusion: Pain relief after SCI remains difficult to achieve, with an evident high risk of PMM, which may lead to long-lasting side effects, dependency, or overdose.

Contribution: This study has shown the need for the assessment of the potential risk of dependency before prescribing pain medication, particularly opioids to PWSCI.

Allopathic medicine practitioners’ experiences with non-disclosure of traditional medicine use

Lindiwe Gumede, Pauline B. Nkosi, Maureen N. Sibiya — Wed, 15 Jan 2025 00:00:00 +0000

Background: A pertinent issue impacting patient treatment outcomes is the nondisclosure of traditional medicine (TM) use to Allopathic medicine practitioners (AMPs). For years, TM has been a controversial practice, with patients often using it alongside allopathic medicine without disclosing their use. It is imperitive to learn and understand the experiences of AMPs regarding the disclosure of TM use in Gauteng province to enable them to provide the best possible treatment outcomes for patients who use TM.

Aim: This study aimed to explore the experiences of AMPs regarding non-disclosure of TM use in Gauteng province.

Setting: This study was conducted in four district hospitals where outpatient care and services are rendered in Gauteng Province.

Methods: An interpretive phenomenological analysis (IPA) design was followed. Fourteen purposefully sampled AMPs participated in face-to-face, one-on-one, and semi-structured interviews. Interpretive phenomenological analysis in Atlas.ti was conducted.

Results: Three themes emerged: bedside manner of AMPs; stigmatising TM use; and individual belief systems. The belief of patients’ disclosure hesitancy because of fear of judgment by the AMPs underpinned these themes.

Conclusion: Allopathic medicine practitioners are aware that patients who use TM could feel guilty and stigmatised. They acknowledged that patients use TM because of cultural and ethnic reasons, which should not be disregarded.

Contribution: The study highlighted that patients do not disclose their TM use because of AMPs’ attitudes, stigmatising TM use, and their prejudices against the cultural beliefs of patients. Allopathic medicine practitioners should establish good communication with patients by providing patient-centred communication to facilitate disclosure of TM use.

COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Wed, 15 Jan 2025 00:00:00 +0000

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake.

Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans.
Setting: Community setting in five districts in KwaZulu- Natal province.

Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis.

Results: Participants had a median age of 29 years (IQR: 23–39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% – 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust
in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35–49 years: OR: 0.28, 95% CI: 0.18–0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07–0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11–0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10–1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1–4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27–7.02, p = 0.01) were more likely to be vaccine hesitant.

Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed.

Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.

Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia

Epafras Anyolo, Kristofina Amakali, Hans J. Amukugo — Wed, 15 Jan 2025 00:00:00 +0000

Background: Cervical cancer is among the top causes of cancer-related deaths among women globally.

Aim: The aim of the study was to assess the attitudes of women of reproductive age towards cervical cancer services in the Otjozondjupa region, Namibia.

Setting: The setting of this study was the Otjozondjupa region, one of the 14 regions of Namibia.

Methods: A quantitative, cross-sectional, descriptive study was used. The data were collected with a questionnaire from a stratified sample of 381 out of the 37066 study population of women of reproductive age across four districts of the region. Descriptive data analysis was performed using Statistical Package for social Science version 25.

Results: The findings revealed that most respondents (83.1%) had an overall neutral attitude towards the screening, prevention, and treatment of cervical cancer; they were not concerned about the risk of cervical cancer and would not practice health-seeking behaviours regarding cervical cancer services.

Conclusions: The respondents were indifferent with regard to prevention, screening, and management services for cervical cancer, implying that they would not use available cervical cancer services.

Contributions: Attitudes of women of reproductive age towards cervical cancer services were highlighted. Subsequently, an educational programme for nurses to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia, was developed. Guidelines were developed to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age.

Registered nurses’ knowledge and practice of preoperative fasting and medication administration

Justin C. King, Adele de Goede, Janet Bell — Wed, 15 Jan 2025 00:00:00 +0000

Background: Knowledge of fasting or Nil Per Os (NPO) guidelines is an essential component of nursing care in the preoperative period.

Aim: To describe registered nurses’ (RNs) knowledge and management of the preoperative NPO period.

Setting: Selected surgical wards in a tertiary hospital in the Western Cape, South Africa.

Methods: Quantitative descriptive, cross-sectional study utilising a structured questionnaire. The population consisted of RNs working in selected surgical wards. Convenience sampling was used and adequate knowledge was determined as ≥ 90%.

Results: The response rate was 100%. Of the 68 participants, 48 (70.6%) held a diploma and 20 (29.4%) held a degree as the highest academic qualification achieved. Sixty-one (89.7%) participants knew the correct reason for keeping patients NPO. Sixty-five (95.6%) knew the correct answer for the NPO time for solids while only 27 (39.7%) knew the correct answer for clear fluids. Only 30 (44.1%), 26 (38.2%) and 33 (48.5%) participants, respectively, answered the questions about oral analgesia, oral antibiotics and chronic medication administration during the NPO period correctly. Significantly more degree participants knew the correct
answer for the fasting time for non-human milk (p = 0.005) and more diploma participants would administer chronic medication during the NPO period (p = 0.037).

Conclusion: Inadequate knowledge of NPO times for various fluids and unsatisfactory practice of medication administration for oral and chronic medication require attention.

Contribution: This study highlights the importance that ongoing education is needed to ensure that patients receive the most up-to-date evidence-based care during the NPO period.

Physical activity and diet for Type 2 Diabetes reduction among older people living with HIV in Harare

Nongiwe L. Mhlanga, Thinavhuyo R. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: People living with HIV (PLWH) are ageing, and face increased risk for developing Type 2 Diabetes. Physical activity and diet are effective in reducing Type 2 Diabetes risk. However, there is variation in how older PLWH engage in physical activity and healthy eating.

Aim: To describe older PLWHs’ engagement in physical activity and diet for Type 2 Diabetes risk reduction in Harare

Setting: The study was conducted in five polyclinics in Harare urban district from low socioeconomic areas.

Methods: A qualitative approach and an exploratory descriptive design was used. Twenty-three participants were selected purposively based on the researchers’ judgement of age among PLWH. Data were collected using a semi-structured interview schedule and analysed
using Braun and Clark’s six steps of thematic content analysis. Ethical approval was obtained, and each participant provided informed consent.

Results: The mean age of participants was 62 years. Participants performed varied physical activities through; economic activities, walking, exercise, and domestic chores. Diet included indigenous, unrefined grains, vegetables and fruit, influenced by rural background. Diet consisted of larger proportions of carbohydrates with lesser varying portions of protein and vegetables and fruit. Healthy eating among participants was facilitated by the proximity of markets and family.

Conclusion: Health education to reduce Type 2 Diabetes risk should focus on fostering current physical activities to meet prescribed standards and increasing fruit and vegetable consumption.

Contribution: The physical activity and diet self-care practices among older PLWH are inadequate in reducing Type 2 Diabetes risk, emphasising the need for appropriate health education.

The dhikr and the mental health of the elderly in Aceh, Indonesia

Wed, 15 Jan 2025 00:00:00 +0000

Background: The ageing population in Indonesia is increasing. However, biological and social changes and declines may trigger mental health problems among the elderly. Existing data show that the prevalence of mental health problems (depression) among the elderly in Indonesia is above 15%.

Aim: This study aims to investigate the relationship between the Majelis Zikir (dhikr assembly) and the mental health of the elderly.

Setting: The research was conducted in Aceh Barat District, Aceh Province, Indonesia.

Methods: This study uses a retrospective cohort design. The study sample consists of individuals aged 60 years or older. The total sample size was 114 (57 exposed and 57 unexposed groups). The research instrument was in the form of a questionnaire.

Results: The respondents had an average age of 67.61 years, with more females (63.2%), more educated (67.5%), more unemployed (71.1%) and 61.4% felt that their income was sufficient. The analysis showed that the relative risk value of members of the dhikr assembly was 1.857 (95% CI: 1.266–2.724) and showed a significant relationship between the dhikr assembly and mental health.

Conclusion: Dhikr, as one of the forms of religious activities in Islam, has a positive role in older people’s mental health. Elderly members of the dhikr assembly are likelier to achieve better mental health.

Contribution: The findings in this study can assist healthcare professionals and policymakers in their efforts to maintain and improve the mental health of the elderly through dhikr.

Nursing students’ knowledge and attitudes on sexually transmitted infections prevention at training institution in Namibia

Lonia U. Hamunyela, Hileni N. Niikondo, Monika N. Nakweenda — Wed, 15 Jan 2025 00:00:00 +0000

Background: Insufficient knowledge about sexually transmitted infections (STIs) among nursing students can impact patient care and outcomes. To address this, comprehensive STI education is crucial.

Aim: This study aimed to assess knowledge and attitudes of nursing students regarding STI prevention and control.

Setting: The research was conducted at a nursing training institution in Windhoek, Namibia.

Methods: The research employed a cross-sectional design with 73 participants.

Results: Outcomes revealed that 63.0% had satisfactory knowledge and 79.5% exhibited positive attitudes. A significant association was noted between knowledge and participants’ sex. Male participants displayed poor knowledge (70%). No significant relationship existed
between demographic characteristics and attitudes.

Conclusion: The study concluded lower than expected knowledge regarding STIs among nursing students that implicated patients’ care.

Contribution: Integrating STI education into nursing curricula can improve students’ competences that enhance patients’ care.

Development of collaboration guidelines for nursing education and related healthcare services

Estelle Bester, Neltjie C. van Wyk, Carin Maree — Wed, 15 Jan 2025 00:00:00 +0000

Background: A theory-practice gap in nursing education often occurs, and the staff from the nursing education institution and the associated healthcare services should find ways to improve their collaboration to reduce the gap during the training of nursing students.

Aim: This study aimed to develop context-specific collaboration guidelines for a nursing education institution and associated healthcare services.

Setting: Private hospital in the Gauteng province of South Africa.

Methods: Guidelines were developed from the findings of an integrative literature review. Thereafter, it was contextualised in a qualitative study with focus group discussions (FGDs) involving 9 theoretical lecturers and 10 clinical facilitators.

Results: In the partnership between the nursing education institution and the associated healthcare services, bilateral communication, cooperation between the theoretical lecturers and the clinical facilitators in delivering evidence-based patient care, intensified innovation in teaching and learning practices and an environment conducive to theory-practice integration should be emphasised.

Conclusion: A set of context-specific guidelines was developed to enable the theoretical lecturers and the clinical facilitators to collaborate in supporting nursing students to apply their theoretical knowledge in the development of clinical competencies.

Contribution: The guidelines can be adjusted to suit the context of other nursing education institutions and their associated healthcare services to improve collaboration between theoretical lecturers and clinical facilitators to the benefit students’ skills development in theory-practice integration.

Please help me, I am drowning! The cry of parents of adolescents with a substance use disorder

Meriam M. Shadung, Paul R. Mbedzi, Rebecca M. Skhosana — Wed, 15 Jan 2025 00:00:00 +0000

Background: Substance use disorders (SUDs) are on the rise among adolescents worldwide, including in South Africa, causing a significant challenge to parents. Regardless of the difficulties associated with SUDs in adolescents and their impact on parents, current studies
on substance addiction have focused on diverse fraternities, excluding social work services for parents of adolescents with SUDs.

Aim: To develop an in-depth understanding of social work services provided to parents of adolescents with SUDs.

Setting: The study was conducted in two districts, Capricorn and Waterberg, in Limpopo province, South Africa.

Methods: A qualitative research method using exploratory and descriptive designs was employed. The scheduled interview guides facilitated semi-structured interviews with 11 social workers and 8 parents. For data analysis, Tesch’s eight steps were used.

Results: Six themes emerged from the study: (1) social work interventions for parents, (2) family and community-related obstacles, (3) organisation-related obstacles, (4) substance use intervention strategies received by parents, (5) parents’ coping mechanisms in dealing with adolescents with SUDs and (6) factors hindering access to social services.

Conclusion: The findings show that the government, particularly the Department of Social Development as the custodian of social services, is obliged to develop and design standard guidelines for services to parents of adolescents with SUDs and to provide uniform services to social workers.

Contribution: The study benefits the social work profession, particularly in the field of substance abuse because it generates effective parameters for services for parents of adolescents with SUDs.

Facilitation of the mental health of adolescents abusing substances: A concept analysis

Wed, 15 Jan 2025 00:00:00 +0000

Background: The use and abuse of substances, especially among the youth, continues to be of serious concern within the international community. This behaviour affects them as individuals, their families, the community in which they live, and society at large. Findings from a study conducted by the researcher indicate that adolescents who abuse substances experience a range of emotional, physical, academic and social setbacks, and challenges. Ultimately, the mental health of these adolescents is affected.

Aim: The study aims to identify and define the central concept ‘facilitation of mental health’ of adolescents abusing substances.

Setting: The researcher’s minor dissertation, whereby the lived experiences of adolescents abusing substances were explored. The basic elements, structure and functions were examined and analysed.

Methods: The concept’s basic elements, structure and functions were examined, followed by an analysis and reasoning strategies to define the central concept. The process was implemented over two phases.

Results: The central concept ‘facilitation of mental health’ of adolescents abusing substances was identified and defined using dictionary and subject definitions.

Conclusion: The identification and definition of the central concept is an important part of developing a model as a frame of reference for psychiatric nurses to facilitate the mental health of adolescents abusing substances.

Contribution: The findings of the study would assist in the development of a model as a frame of reference for psychiatric nurses to facilitate the mental health of adolescents abusing substances.

Patient aggression experienced by professional nurses in acute psychiatric ward: South Africa

Wed, 15 Jan 2025 00:00:00 +0000

Background: Aggression of patients in hospital wards has become an endemic problem and professional nurses are particularly at high risk.

Aim: This article presents the types of patient aggression experienced by professional nurses working in an acute psychiatric ward in Vhembe District, South Africa.

Setting: Vhembe District, South Africa.

Methods: A qualitative approach using exploratory, descriptive and contextual research design was used. Four hospitals were purposively selected and 10 professional nurses were conveniently sampled to participate in the study. Individual interviews were used
to collect data, which were then analysed through Tesch Open Coding Method. Measures to ensure trustworthiness and ethical considerations were adhered to throughout the study.

Results: This study shed some light on the professional nurses’ lived experiences regarding the types of aggression from patients in an acute psychiatric ward in Vhembe District. The types of aggression are physical aggression, destructive behaviour and verbal aggression.

Conclusion: The findings show that the types of aggression to which professional nurses are exposed are overwhelming and the consequences are shocking. As a result, the health of professional nurses is compromised. Therefore, this study recommends further studies to determine the kind of support needed by professional nurses working in an acute psychiatric
ward and to investigate the impact of aggression from patients in acute psychiatric ward with regard to the quality of care.

Contribution: This article contributes to the body of knowledge regarding patients’ aggression in acute wards in Vhembe District, South Africa.

Nurses’ obesity knowledge, attitudes and practices in private facilities in Oshana, Namibia

Perseverance Moyo, Rehanna Felix — Wed, 15 Jan 2025 00:00:00 +0000

Background: The prevalence of obesity has been rising globally, and this is leading to an increase in other non-communicable diseases. The level of obesity knowledge among nurses may have an impact on how they treat and perceive obese patients.

Aim: The study aimed to ascertain the knowledge, attitudes and practices of nurses regarding obesity at private healthcare facilities located in Namibia’s Oshana Region.

Setting: A total of four private healthcare facilities in Namibia’s Oshana area served as the study’s sites.

Methods: A quantitative cross-sectional research design using proportional stratified random sampling was used to choose 250 respondents for the study. A questionnaire that respondents self-administered was used to gather the data. The reliability and validity of the questionnaire were determined during a pilot study. IBM Statistical Package for the Social Sciences (SPSS) version 27 was used for data analysis.

Results: Of the participants, about two-fifths had a positive attitude (n = 112; 44.8%), slightly less than two-fifths had good practices (n = 96; 38.4%) and more than one-third had good knowledge (n = 97; 39%). There were differences in knowledge mean scores based on age, occupation, sex and educational level.

Conclusion: The results validate the necessity for healthcare facilities to implement nurse education and mentorship initiatives, as well as to recognise and reward nurses who effectively care for patients with obesity.

Contribution: This study added literature on knowledge, attitudes and practices of nurses in private healthcare facilities in Namibia, as well as factors that influence knowledge levels among the nurses.

Perceptions of interprofessional collaborative practice in South Africa: A systematic review

Nadia Mohamed, Craig W. Peck, Janine Senekal — Wed, 15 Jan 2025 00:00:00 +0000

Background: Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) were developed to address the health needs of communities through collaborative practice across healthcare disciplines. The impact of IPE on IPCP and clinical service delivery in South Africa is not evident, possibly because of the lack of IPCP experiences among healthcare professionals.

Aim: International literature reports facilitators and barriers of IPCP implementation, but there was a need to filter the evidence to identify literature from the South African context regarding the perceptions of healthcare workers’ perceived barriers and facilitators of IPCP.

Setting: South African literature.

Methods: A systematic review was conducted to synthesise evidence from articles published between January 2017 and December 2021. Only qualitative studies targeting health professionals in South Africa who had been exposed to IPCP were included. Consistent with Preferred Reporting Items for Systematic reviews and Meta-Analysis, a multi-database search yielded 424 articles, which were screened for relevance and appraised for quality using the Critical Appraisal Skills Programme (CASP) tool. A thematic synthesis of the findings was conducted by applying ethical principles.

Results: Synthesis of barriers and enablers for IPCP implementation in the South African context included key aspects of healthcare systems, management and team leadership.

Conclusion: The integration of IPCP into clinical practice in South Africa is still limited as healthcare professionals operate in silos.

Contribution: Recommendations of this study include greater integration of services combined with competent management and visionary leadership, together with the incorporation of IPE
into undergraduate professional training programmes.

Nurses’ knowledge regarding recommended practices on using surgical attire in operating theatre

Joshua Alayemi, Wilma ten Ham-Baloyi, Sihaam Jardien-Baboo — Wed, 15 Jan 2025 00:00:00 +0000

Background: To reduce the risk for surgical site infections, nurses in the operating theatre environment must have knowledge of and adhere to recommended practices regarding the use of surgical attire.

Aim: To evaluate the effect of an educational intervention on nurses’ knowledge related to recommended practices regarding the use of surgical attire in operating theatre.

Setting: Operating theatres in two public and two private hospitals in the Eastern Cape province, South Africa.

Methods: An educational pilot study, using a quasi-experimental, two-group pre- and post-test design, was conducted. A convenience sample of n = 85 nurses was purposively allocated to a control group and an intervention group. An existing educational intervention consisting of an interactive training session, brochures based on the Association of periOperative Registered Nurses’ (AORN) guidelines and a summary of these guidelines was implemented for the intervention group, while the control group received only the summary of the guidelines. Data were collected through self-administered pre- and post-test questionnaires from March 2019 to August 2019.

Results: The overall knowledge score for nurses in the intervention group post-intervention improved with a large significance (p ≤ 0.000 and Cohen’s d = 1.26).

Conclusion: The intervention has shown potential to improve the knowledge related to recommended practices of nurses in operating theatres regarding the use of surgical attire.

Contribution: This pilot study encourages the implementation of the intervention on the use of surgical attire but requires further development and a wider implementation to measure its impact, and access to resources, enhancing and sustaining its success.

Radiographers’ conceptualisation of trauma imaging in Gauteng, South Africa

Shabnam Wahid, Shantel Lewis, Yasmin Casmod — Wed, 15 Jan 2025 00:00:00 +0000

Background: Radiographers form part of the healthcare team and are integral in the diagnosis and treatment of trauma patients. Additionally, they are required to provide their services to multiple departments within the hospital, including the emergency department. Healthcare workers who work with trauma patients experience changes in their psychological functioning.
Therefore, diagnostic radiographers may have similar experiences; however, limited studies were found on radiographers’ conceptualisation of trauma imaging.

Aim: The aim of this study was to explore and describe radiographers’ conceptualisation of trauma imaging.
Setting: One-on-one in-depth interviews were conducted virtually with radiographers in both the private and public healthcare sectors in Gauteng, South Africa.

Method: In this qualitative, explorative and descriptive study, 20 radiographers were interviewed virtually through Zoom or WhatsApp video calls or telephone interviews. Participants were asked a central question: ‘What does trauma imaging mean to you?’ Detailed
notes were taken during the interviews, and interviews were audio-recorded. The data was transcribed and underwent thematic analysis. Trustworthiness and ethical principles were adhered to throughout the study.

Results: Thematic analysis identified four themes: (1) COVID-19 pandemic; (2) road accidents; (3) gender-based violence (GBV); and (4) paediatric injuries that participants conceptualised as trauma imaging.

Conclusion: Participants conceptualised trauma imaging as COVID-19, road accidents, GBV and paediatric patients. It was noted that participants’ personal experiences were significant contributors to their meaning-making and responses to trauma imaging.

Contribution: The study has contributed to the understanding of the conceptualisation of trauma imaging from the perspective of diagnostic radiographers.

Experiences of women on the use of Implanon NXT in Gauteng province, South Africa: A qualitative study

Junior M. Ntimani, Moreoagae B. Randa — Wed, 15 Jan 2025 00:00:00 +0000

Background: Maternal-related illnesses and pregnancy-related deaths could be averted using contraceptives, particularly long-acting methods because they improve overall access to family planning because of their benefits, such as fewer visits to the healthcare facility, higher effectiveness and value for money. The introduction of Implanon NXT in the South African
health system raised great concern about the number of women who returned to healthcare facilities for its early removal within a few months of insertion.

Aim: This article focussed on exploring the experiences of women regarding early removal of Implanon NXT insertion.

Setting: The study was conducted in four selected clinics in Region E sub-district, city of Johannesburg.

Methods: A qualitative exploratory approach was followed using semi-structured individual interviews to collect data. Data were analysed using the content analysis method.

Results: The most cited reasons for its discontinuity were that women experienced unpleasant side effects such as amenorrhoea, excessive bleeding and headaches, whilst other women found it to be reliable and convenient.

Conclusion: Contraceptive methods empower women to take control of their lives and to decide on the right time for them to have children. It is, therefore, important to equip women with relevant information about the contraceptive methods so that they can make informed
decisions and choices.

Contribution: The study calls for health promoters to periodically conduct information sessions with women as guided by the National Contraception Policy Guidelines to ensure up-to-date practice.

Factors influencing the utilisation of Youth Friendly Health Services in Blantyre, Malawi

Grace C. Sibande, Rakgadi G. Malapela — Wed, 15 Jan 2025 00:00:00 +0000

Background: Usage of Youth Friendly Health Services (YFHSs) remains unsatisfactory in sub-Saharan Africa despite global agreements on the utilisation of these services among the youths.

Aim: The aim of the study was to identify factors that influence the utilisation of YFHSs in Blantyre, Malawi.

Setting: Four health centres in Blantyre, Malawi.

Methods: A descriptive quantitative research design using multistage sampling was used to randomly sample (N = 293) unmarried youths and collect data using a structured questionnaire. Data were analysed using a computerised statistical package for social
sciences (SPSS) version 26. Chi-square (χ²) was used to test the significance of the association between variables, and the p-value (p < 0.05) was considered significant. Regression analysis was used to examine the influence of independent variables on the utilisation of
the services.

Results: Less than half of the respondents have ever accessed YFHSs (43%). The Chi-square test showed that the following variables had a significant association with utilisation of the services (p < 0.05): gender, age, knowledge, signage, printed health education materials,
provider attitudes and being shy or fear of being seen at the services.

Conclusion: Age, knowledge, signpost, printed health education materials, provider attitudes and being shy or fear of being seen at the YFHSs are factors that influenced the utilisation of the services. Working on these factors would help to increase utilisation.

Contribution: The study findings will help to fill the gap in the provision of YFHSs and thus increase utilisation of the services.

Experiences on the frontline: Qualitative accounts of South African healthcare workers during the COVID-19 pandemic

Angela Kazadi, Jennifer Watermeyer, Sahba Besharati — Wed, 15 Jan 2025 00:00:00 +0000

Background: The COVID-19 pandemic significantly impacted people’s mental health significantly. Frontline healthcare workers (HCWs) were arguably most affected, particularly in low-to-middle-income countries like South Africa. Understanding their experiences is important to inform interventions for social and psychological support for future pandemics.

Aim: This study explored the experiences of frontline HCWs in South Africa during the COVID-19 pandemic.

Setting: The sample included HCWs from various professions and health sectors who worked with COVID-19 patients across South Africa.

Methods: An exploratory descriptive qualitative design was used. Semi-structured interviews were conducted with 11 frontline HCWs recruited via purposive sampling. Data were analysed using principles of inductive thematic analysis.

Results: Four major themes were identified in the data: (1) Working during COVID-19 was an emotional rollercoaster; (2) Working during COVID-19 was physically and mentally exhausting; (3) Participants held negative attitudes towards the Department of Health; and (4) COVID-19 had a transformative impact on the daily life of HCWs.

Conclusion: HCWs’ experiences were diverse and marked by contradictions. Limited psychological support and resources aggravated experiences. However, a positive narrative of hope and gratitude also resonated with participants. Qualitative methodologies provided
depth and insights into the diverse realities of frontline HCWs.

Contribution: This study provides significant insights into the experiences of a diverse group of frontline South African HCWs during COVID-19. It demonstrates a shift in the definition of a ‘frontline’ HCW and highlights the need for greater psychological support and individualised public health interventions during future pandemics.

Reaching consensus on factors impacting optimal use of an orthopaedic emergency theatre in a public hospital

Mamiki Ramokopelwa, Mabitja Moeta — Wed, 15 Jan 2025 00:00:00 +0000

Background: The operating theatre (OT) complex of hospitals represents areas of considerable expenditure with regard to costs and requires maximum use to ensure optimum cost benefit for both patients and the hospital. Inefficient use of an operating theatre room (OTR) may result in hospital wasteful expenditure and frustrations for patients owing to surgery delays,
cancellations and prolonged hospitalisation while waiting.

Aim: The aim of the study was to explore and describe using a consensus method, factors impacting the use of an emergency orthopaedic theatre that can be optimised in a selected public hospital in Gauteng province.

Setting: The study was conducted by a professional nurse and orthopaedic surgeon working in the theatre of a selected public hospital in Gauteng province.

Method: A qualitative, explorative and descriptive design was adopted. Data were collected using a nominal group technique (NGT) among professional nurses and orthopaedic surgeons. Data analysis was done through cross-analysis where participants reached a consensus on the voted ideas from the group.

Results: Consensus was reached and three main themes emerged: (1) inadequate resources; (2) poor organisation and (3) communication.

Conclusion: The optimal use of an emergency orthopaedic theatre is influenced by the availability of resources being human and material, good organisation and clear communication.

Contribution: The study has demonstrated that a variety of factors needs to be considered to optimise the use of an orthopaedic emergency theatre. The management of an OT requires a concerted effort from the nurses and doctors.

South African midwife specialists’ experiences in the utilisation of their knowledge and skills

Kagiso P. Tukisi, Zelda Janse van Rensburg, Wanda Jacobs — Wed, 15 Jan 2025 00:00:00 +0000

Background: Midwifery specialisation was introduced in 1993 as a response to escalating maternal and neonatal mortalities and shortage of physicians in rural parts of South Africa. Basic midwives enrolled into a postgraduate midwifery qualification to extend their knowledge and skills which enabled them to manage complicated obstetric conditions. The postgraduate
midwifery qualification rendered them midwife specialists upon completion of the course. Yet, MS remain underutilised in clinical facilities due to limiting practice regulations and fear of medico-legal litigations, leading to forfeiture of skills.

Aim: The study aimed to explore and describe midwife specialist’ experiences of optimal utilisation of their knowledge and skills in public health facilities in South Africa.

Setting: Public health facilities based in seven provinces in South Africa where MS were employed, formed part of the research setting.

Methods: A qualitative, descriptive and explorative research design was followed using phenomenological approach. Sixteen purposefully sampled midwife specialists participated in four focus group interviews. Data were analysed using Collaizi’s descriptive method.
Findings: Three themes, each with categories, were derived from the data. Research results confirmed midwife specialist’ limited utilisation of knowledge and skills in public facilities. This was associated with the existing practice regulations, restricting midwife specialists to basic midwifery roles.

Conclusion: The lack of practice regulations, particularly for midwife specialists hinders optimal utilisation of their knowledge and skills in the public health facilities.

Contribution: This study highlighted midwife specialist’ barriers in optimally embracing their expert knowledge and skills. Barriers may guide formulation of strategies to facilitate midwife specialist’ knowledge and skills utilisation.

Management of the third stage of labour by Basotho traditional birth attendants

Keneuoe N. Fobo, Gaotswake P. Kovane, Catharina S. Minnie — Wed, 15 Jan 2025 00:00:00 +0000

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.

Optometry student clinical practice at public health facilities: A systematic review

Raserogole F. Segooa, Vanessa R. Moodley — Wed, 15 Jan 2025 00:00:00 +0000

Background: Clinical training, supervision and practice are the most important aspects of health profession education, including optometry. Institutions implore various methods for students to gain access, exposure and experience in different clinical environments, away from their normal academic settings.

Aim: This review aimed to investigate studies and related documentary evidence to determine existing standards and methods for educational institutions in conducting optometry clinical training at the external sites.

Setting: The electronic databases – ProQuest One, Scopus, EBSCOhost, Sabinet, Science Directand Google Scholar – were searched systematically for studies on the implementation of workplace clinical training of undergraduate optometry students.

Methods: The study followed the Joanna Briggs Institute (JBI) systematic review methodology and a systematic search of various electronic databases was conducted for studies on implementation of workplace clinical training. Of the 450 full-text studies searched, 13 studies
were found to be reputable sources of evidence and were included in this systematic review.

Results: Four themes relating to student clinical training emerged, namely, clinical training approaches implemented, expected minimum standards at the training sites, clinical training environment wherein students and supervisors find themselves and clinical competence of the supervisors and students. They encompass important factors to consider in the planning and provision of quality, efficient and effective student clinical supervision at the external training facilities.

Conclusion: There is a dearth of scholarly studies to guide clinical training of optometry training within the public health sector. However, more studies are undertaken in other health disciplines, and they provide generic guidelines, which can be adapted for optometry.

Contribution: The article highlights the need for further studies in optometry student clinical training, focussing on programme designs and standardisation of clinical training in multi-institutional, low-income contexts.

Influence of organisational climate on public service employee physical health

Bianca I. Chigbu, Willie Chinyamurindi, Chioneso S. Marange — Wed, 15 Jan 2025 00:00:00 +0000

Background: The working conditions in the South African public service, notably its challenging environment, pose significant threats to the physical health of employees. Calls exist in understanding how this can be addressed.

Aim: The study investigated the predictors of physical health, accounting for the role of organisational climate and decent work.

Setting: The study was conducted in Bisho in the Eastern Cape province of South Africa.

Methods: An instrument was administered through a survey using a sample of 289 respondents. Descriptive and inferential statistics were used to test the hypothesised relationships.

Results: No significant direct effect existed to show that the sounder an organisational climate, the better the physical health of employees will be (β = –0.014, t = –0.199, p = 0.843, 95% confidence interval [CI] [–0.153 to 0.125]). However, statistically significant evidence existed to show that the more focus on promoting decent work, the better the physical health of employees will be (β = 0.463, p = < 0.001, 95% CI [0.258 to 0.668]). Finally, decent work has a full mediating effect on the relationship between organisational climate and employee physical health (β = 0.105, 95% CI [0.054 to 0.167]).

Conclusion: Public service organisations need to pay attention to the role of its climate and decent working conditions in promoting employee physical health.

Contribution: Interventions are needed centered on improving decent work and the organisational climate as identified predictors of employee physical health.

Student nurse perceptions of family nursing practices in South Africa: A descriptive survey

Geldine Chironda, Petra Brysiewicz — Wed, 15 Jan 2025 00:00:00 +0000

Background: Family nursing practices (FNPs) are gaining momentum in global literature, but the available research has targeted qualified nursing professionals. There are limited studies exploring this phenomenon in undergraduate student nurses in South Africa.

Aim: The study aimed at exploring the undergraduate student nurse perceptions of FNPs.

Setting: The study was conducted at a selected university in KwaZulu-Natal, South Africa.

Methods: A descriptive survey design was used to purposively select undergraduate nursing students. The Family Nursing Practice Scale (FNPS) was used to collect data online. Descriptive and inferential statistics were used to analyse quantitative data. Open ended questions were analysed using content analysis.

Results: Out of 154 participants, 77 responded to the questionnaire, translating to a response rate of 50%. Compared with other studies in literature, student nurses rated their overall FNP as being low (M = 3.43, s.d. = 0.99). A further descriptive analysis revealed better FNPs (2.97) for 3rd year compared to 2nd year (3.90) nursing students with significance differences in the
means (p < 0.0001). While family conflict, maintaining confidentiality, ill prepared and absent family were challenges experienced in FNP, advantages included obtaining detailed information, ability to plan individualised care and enhanced student nurse-family
relationship.

Conclusion: A lower critical practice appraisal and lower perceptions of interaction and reciprocity in the nurse-family relationship were identified. There is need for an inclusive curriculum that promotes and advocates for family nursing within the undergraduate programme.

Contribution: This study highlights the importance of teaching family nursing to undergraduate student nurses.

Experiences of families living with Nyaope users in Tshwane, Gauteng province

Dorcas Nene, Florah Mkhonto, Kebogile E. Mokwena — Wed, 15 Jan 2025 00:00:00 +0000

Background: Nyaope is one of the commonly used drugs in many low socio-economic communities in South Africa. Because of its highly addictive properties, the vast majority of users are not able to quit, which results in long-term difficulties for their families.

Aim: The aim of this study was to explore and describe the experiences of families living with nyaope users in a township in Tshwane Metropolitan Municipality.

Setting: Data were collected at the Social Development Centre, which serves a variety of social needs of families, including the various needs of families whose problems emanate from nyaope use. The family members were recruited from the registry of the centre.

Methods: A qualitative design and in-depth interviews were used to collect data from a sample of family members who were purposively sampled. NVIvo 12 was used for thematic analysis of the data.

Results: Three major themes emerged from the data, these being, consequences of nyaope use on the family, family interventions, and coping strategies.

Conclusion: Although the families have devised interventions and developed coping strategies, nyaope use remains a serious mental health challenge in affected families.

Contribution: The study highlighted the negative impact of nyaope on the social and mental health of the families. The assistance offered at Social Development is broad and general for substance abuse, but does little to mitigate the complex difficulties brought about by nyaope use.

Strategies that enabled access to chronic care during the COVID-19 pandemic and beyond in South Africa

Sheillah H. Mboweni — Wed, 15 Jan 2025 00:00:00 +0000

Background: The COVID-19 epidemic has revealed disturbing information about how chronic diseases are treated globally. Healthcare providers and coronavirus response teams have primarily reported on how individuals with chronic conditions sought care and treatment. However, individuals’ experiences of patients are yet unknown.

Aim: This study aimed to explore those strategies that enabled patients with chronic diseases access to chronic care and treatment during and beyond the COVID-19 pandemic.

Setting: The study was conducted in the predominantly rural district of the Northwest Province, South Africa.

Methods: An explorative qualitative research design was followed. Information-rich participants were chosen using a purposive sampling technique. Individual face-to-face interviews were used to gather data. Data saturation was achieved after interviewing n = 28
people in total. The six steps of Braun and Clarke thematic data analysis were used to analyse the data.

Results: The study revealed three themes, which includes improved healthcare structural systems, shift from traditional chronic care to digital care services and medication refill and buddy system.

Conclusion: The findings of this study revealed a range of effective and noteworthy approaches that facilitated access to treatment and continuity of care. As a result, enhancing telemedicine as well as structural systems such as appointment scheduling, decanting choices, mobile and medication home delivery can improve access to care and treatment.

Contribution: The burden of disease and avoidable death will be eventually addressed by maximising the use of telemedicine and sustaining the new norm of ongoing care through digital and remote care and decanting strategies.

Caregivers’ experiences and practices for malnourished children undergoing tuberculosis treatment in Eswatini

Bhekisisa S. Tsabedze, Debbie S.K. Habedi — Wed, 15 Jan 2025 00:00:00 +0000

Background: Eswatini is one of the countries affected by malnutrition and tuberculosis (TB) and some cases remained untreated. These two conditions are major public health problems.

Aim: This study aimed to explore and describe caregivers’ experiences and practices of children’s nutrition during treatment.

Setting: Baylor College of Nursing Children’s Foundation – Eswatini (BCMCF-SD).

Methods: A qualitative study following a narrative design used purposive sampling to identify 12 caregivers of malnourished children and informed consent obtained. In-depth interview used semi-structured interview guide and digital voice recorder. Field notes were taken, transcribed, translated and analysed using NVivo version 11.

Results: Two themes emerged as home’s nutritional situation and health facility’s nutritional support. The study found that most of the caregivers gave children unbalanced diet, while those less than a year were mixed-fed. Some caregivers reported experience of lost
breadwinners, unemployment and high number of children than what the family could afford. The caregivers’ practices around food by prescription included inadequate supply of the ready-to-use therapeutic food and sharing of prescribed food supplies with other healthy children.

Conclusion: During treatment, children’s caregivers need short health education and support. The Ministry of Health in Eswatini should consider using some comic books to guide that. Moreover, upscale vocational training promotes entrepreneurship and agricultural activities.

Contribution: Association of malnutrition and TB outcomes has provided evidence-based information for more comprehensive integration between nutrition programmes and tuberculosis programmes. The study’s findings contributed to the growing body of knowledge
about the association between malnutrition and diagnosed drug-susceptible TB among children aged from 0 – 15 years.

Screening for dementia and associated factors in older adults from low socioeconomic communities in iLembe, KwaZulu-Natal

Xoli P. Mfene, Basil J. Pillay — Wed, 15 Jan 2025 00:00:00 +0000

Background: Dementia is one of the leading non-communicable causes of disability and mortality in older adults, with recent research showing that it is increasing in low-middle-income countries compared to high-income countries. As such, multidisciplinary efforts are needed to effectively reduce the prevalence and risk of dementia through quick screening, diagnosis, and
management of those with dementia and those at risk.

Aim: The study’s objectives were to estimate the prevalence of dementia and measure the sociodemographic and clinical risks in older adults in low socioeconomic communities.

Setting: The study was conducted among older adults aged ≥ 60 years from the iLembe district in South Africa.

Methods: This cross-sectional, one-phased, household study was conducted to screen for dementia over 8 months between October 2018 and October 2019. Demographic and clinical data were collected using a semi-structured questionnaire. In addition, the Mini-Mental Status Exam, Ascertain Dementia Eight-item questionnaire and Instrumental Activities of Daily Living Scale were administered to a multi-stage cluster sample of 320 participants to ascertain dementia prevalence. Frequencies and multivariate logistic regression were conducted to determine risk factors correlated with dementia.

Results: The prevalence of dementia was 13.4%. Participants aged 80 years and above were 2.73 times more likely to develop dementia than participants younger than 80 years. Those with an education level of Grade 1–7 had a 69% less chance of developing dementia than those without formal education. Single participants showed an almost seven-fold increase in dementia. Lastly, depression increased the risk of dementia by two-fold.

Conclusion: Dementia was probable in over one-sixth of the sample. Dementia risk factors were both modifiable and non-modifiable.

Contribution: Dementia prevalence in South Africa is increasing and therefore it is crucial to develop a dementia plan that is specific to the South African context which will include strategies for early identification of the disease, reducing modifiable risks and strategic management of dementia associated medical conditions such as depression and vascular diseases.

Nurses’ experiences of self-management support for adults with tuberculosis and human immunodeficiency virus coinfection

Eric Tornu, Portia J. Jordan, Michael McCaul — Wed, 15 Jan 2025 00:00:00 +0000

Background: Professional nurses provide self- management support to adults (18 years and older) living with tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection to enable them to mitigate its impact on their lives. However, the experiences of professional nurses providing self-management support to adults with TB-HIV coinfection remain unclear.

Aim: This study explored and described the experiences of professional nurses on the provision of self-management support to adults living with TB-HIV coinfection in Greater Accra, Ghana.

Setting: Three public primary health facilities in Greater Accra, Ghana.

Methods: An exploratory, descriptive qualitative design was used. Twenty-two purposively sampled professional nurses were interviewed face-to-face individually using an interview guide. Interviews were recorded with participants’ permission, transcribed and analysed
thematically using MAXQDA software.

Results: The three themes generated revealed that the: (1) self-management problems of adults living with TB-HIV coinfection included their recurring physical, mental and social problems, (2) the support provided to adults with TB-HIV coinfection included symptom, nutritional,
medication and psychosocial self-management support, (3) the factors related to providing self-management support showed that self-management support was influenced by patient, nurse and health facility-related factors but was feasible, equitable and acceptable to patients and stakeholders.

Conclusion: Professional nurses’ self-management support practice entailed improvising limited resources to address the recurring problems of adults living with TB-HIV coinfection. Nurses require adequate resources to provide comprehensive self-management support.

Contribution: The contextual evidence provides insight into the self-management problems of adults with TB-HIV coinfection and the factors influencing professional nurses’ selfmanagement support.

Experiences of pregnant and parenting students at a university in Gauteng province

Moroti E. Mahlangu, Tshiamo N. Ramalepa, Lucky O. Letswalo — Wed, 15 Jan 2025 00:00:00 +0000

Background: Pregnancy and parenting in tertiary institutions is a worldwide concern. The number of pregnancies among tertiary students is increasing globally. About 16 million young women between the ages of 15 years and 19 years around the world became mothers and two million girls under the age of 15 years are reported to be pregnant every year. South African universities continue to report high rates of student pregnancies, and are looking for solutions to the crisis that female students are facing.

Aim: The purpose of the study was to explore the experiences of pregnant and parenting students.
Setting: At a university in Gauteng province, South Africa.

Methods: A qualitative, exploratory and descriptive design was used in a study that was conducted at a university in Gauteng province, South Africa. Undergraduate pregnant and parenting students were sampled purposively, and the sample size was 15 participants. Semi-structured interviews were used to collect data and data were analysed using thematic
analysis.

Results: The findings of the study produced four themes, namely emotional experience during pregnancy, academic challenges during parenting, experiences during antenatal care, and students’ resilience during pregnancy and parenting.

Conclusion: Pregnant and parenting students require emotional, academic and social support from the university and other stakeholders. The university should offer on-campus medical services such as antenatal care and provide academic support for pregnant and parenting students to help them achieve their academic objectives.

Contribution: This study highlights the importance of developing support programmes that focus on pregnant and parenting students in universities.

A mixed methods study on continuity and care coordination based on the obstetric near miss approach

Samuel M. Mulongo, Doreen Kaura, Bob Mash — Wed, 15 Jan 2025 00:00:00 +0000

Background: The near-miss approach assumes that mothers facing life-threatening conditions such as severe pre-eclampsia and postpartum haemorrhage share common risk factors. Among these women, those who survive (near-miss cases) can offer insights into the determinants, providing valuable lessons for understanding underlying factors.

Aim: To investigate elements of continuity and coordination leading to obstetric near misses.

Setting: A major referral hospital and its referral pathway in Kenya.

Methods: Explanatory sequential mixed-methods design.

Results: Near-miss survivors had lower continuity and coordination of care indices during antenatal visits (COCI = 0.80, p = 0.0026), (modified continuity of care index [MCCI] = 0.62, p = 0.034), and those with non-life-threatening morbidity in the first trimester were more likely to experience a near miss (aOR = 4.34, p = 0.001). Facilities in the western region had a higher burden of near misses compared to the Eastern region. Qualitatively, three deductive themes were identified: sequential coordination, parallel coordination and continuity, along with factors classified as access. In mixed integration, poor continuity indices were explained by quality of interpersonal relationships and woman centredness. Poor coordination was explained by inadequate teamwork between providers in referring and referral facilities and between primary health facilities and the community. Higher near-miss rates in the western region resulted from differences in human and physical resources.

Conclusion: Promoting woman-centred care, teamwork, improving communication and introducing innovative coordination roles like case and care managers can enhance continuity and coordination of maternal healthcare.

Contributions: This study contributes to our understanding of the challenges of continuity and coordination in maternal healthcare in resource-poor settings by applying the WHO operationalisation of continuity and coordination using mixed methodology.

Association of mode of entry to a nursing programme and student success: A two-year retrospective multi-cohort study

Fransisco C. Ntjamba, Daniel O. Ashipala, Yahaya Jafaru — Wed, 15 Jan 2025 00:00:00 +0000

Background: The issue of the mode of entry to nursing programmes and its effect on student success is a key concern among researchers globally. Identifying the mode of entry, which has the potential to improve academic success, decrease the failure rate and lead to the successful completion of a degree, is crucial to increase the nursing workforce.

Aim: The objectives of this study were to assess the association of mode of entry to a nursing programme on student success among undergraduate students.

Setting: The study was conducted at a public nursing education institution (NEIs) in the northeast of Namibia.

Method: A retrospective multi-cohort study was conducted to assess the association of mode of entry on student success. Academic outcomes were analysed, observing two cohorts of nursing students.

Results: Results show that 76.2% (f = 16) of mature-age entry students and 53.7% (f = 29) of direct entry students completed their programme on time. However, 42.1% (f = 8) of access students were expected to return. Female students 56.8% (f = 25) and male students 56.0% (f = 28) completed on time. There was no significant relationship between the mode of entry and completion status with p > 0.05, respectively.

Conclusion: A higher percentage of mature-age entry students was found to complete their studies on time than direct entry and English access entry students.

Contribution: These findings could be used in the revision of student recruitment strategies to select nursing students who are more likely to achieve the best academic outcomes.

Integrating traditional and allopathic child health: A healthcare transformation opportunity

Eugene M. Makhavhu — Wed, 15 Jan 2025 00:00:00 +0000

Background: Numerous forums both domestically and internationally have discussed integration of allopathic and traditional healthcare. In South Africa, using traditional child healthcare is popular practice. If properly controlled, integrating this aspect of traditional
child-health with allopathic healthcare may be advantageous to communities that use both healthcare systems. Allopathic and traditional healthcare remain separate organisations in South Africa despite efforts and discussions to integrate them.

Aim: The study sought to explore the integration of traditional and allopathic child healthcare from the perspectives of children’s caregivers and traditional healthcare practitioners.

Setting: The study was conducted in a semi-urban area in the city of Tshwane.

Methods: An exploratory qualitative research study was conducted using semi-structured interviews to collect data from 11 traditional healthcare practitioners and 15 children’s caregivers who were sampled using snowball and convenient sampling respectively.

Results: The participants expressed their understanding of the usage of traditional healthcare practitioners in the care of children as well as their support for integration, and further indicated its necessity. Religion and its effects in health-seeking behaviour were cited as a factor in why there has not been greater integration between the two healthcare systems.

Conclusion: The undocumented and undisclosed use of traditional healthcare potentially hinders the delivery of therapeutic healthcare. As such, integrating the two systems is essential to ensure patients’ safety.

Contribution: This article highlights understanding of culture congruence and safe child healthcare that may be brought forward by the integration of the two healthcare systems.

Informational continuity by midwives during birth at primary care settings in the Western Cape

Victoria J. Anthony, Anneline E. Robertson, Doreen K.M. Kaura — Wed, 15 Jan 2025 00:00:00 +0000

Background: Informational continuity ensures that all health and psychosocial information of the pregnant women is available at all encounters with healthcare providers. The World Health Organization recognised that ineffective informational continuity during birth contributed to fragmented care and duplication of services, which ultimately influenced the morbidity and mortality rates of the pregnant women.

Aim: The aim of this study was to delve into the midwives’ experiences on informational continuity approaches that enable effective care coordination during birth within the primary health care setting.

Setting: The study setting was two maternity obstetric units (MOUs) in the Western Cape, South Africa.

Methods: A qualitative descriptive phenomenological design was used. Participants were recruited by using purposive sampling. Interviews were audiorecorded, transcribed verbatim and analysed.

Results: Three themes emerged from the findings. Theme one: adequate sharing of information with women during the intrapartum period. Theme two: efficient transition of information among midwives and other healthcare providers during the intrapartum period. Theme three: challenges to informational continuity during the intrapartum period.

Conclusion: Communication with the women as well as with other healthcare providers during birth was effective. However, with minimal challenges, informational continuity was effectuated through communication among the midwives, the pregnant women and other healthcare providers.

Contribution: Informational continuity approaches among the midwives, with the women and between healthcare facilities are a prerequisite to ensure continuity of care and care coordination during birth.

Clinical mentorship of midwifery students: The perceptions of registered midwives

Hafaza B. Amod, Lindani Ndlovu, Petra Brysiewicz — Wed, 15 Jan 2025 00:00:00 +0000

Background: Clinical mentors are experienced practitioners who play an important role in encouraging the professional development of students in clinical areas. The responsibility of clinical mentorship in nursing is often difficult to maintain. However, there is a dire need for clinical mentorship in maternity units, especially in South African hospitals were high maternal mortality rates remain alarmingly high.

Aim: This study aimed to describe the perceptions of registered midwives regarding the clinical mentorship of midwifery students.

Setting: The study occurred in a semi-rural state regional hospital in the eThekwini district, KwaZulu-Natal.

Methods: A qualitative exploratory and descriptive design was conducted using in-depth individual interviews with midwives in maternity units. A purposive and convenient sampling method recruited 17 registered midwives from 3 maternity care areas within a single setting. Interviews were audio-recorded and all data were analysed using qualitative content analysis.

Results: Five categories emanated from this study namely, sharing knowledge and skills; encouraging role model behaviour; promoting self-worth; Is a challenging task; and requiring additional support.

Conclusion: Clinical mentorship has a reciprocal effect on teaching and learning in maternity care areas and encouraged registered midwives to lead as role-models. The process demands competence, professionalism, and leading by example. Despite the confidence, satisfaction and interest in clinical mentorship, registered midwives often find the process challenged by patient care priorities. Therefore, registered midwives require additional support to mentor students in clinical practice.

Contribution: This article shows that clinical mentorship places various challenges on registered midwives and formal mentorship training could be beneficial.

The lived experience of South African men having a premature baby

Jonathan Nell, Kyle Jackson, Michelle Andipatin — Wed, 15 Jan 2025 00:00:00 +0000

Background: Much has been written about fathers, fatherhood and premature babies. However, in the South African context, studies about the experiences of fathers having a premature baby are lacking.

Aim: This study aimed to explore how South African fathers (n = 10) experience having a premature baby using a descriptive phenomenological approach.

Setting: This research study was conducted online using various social media platforms such as WhatsApp, Google Meet and through telephonic conversations.

Methods: A descriptive phenomenological approach that allowed for the distillation and elucidation of common core experiences among fathers who had a premature baby.

Results: The findings demonstrated that the participants experienced intense fears regarding the survival and well-being of their children. They reported experiencing financial difficulties related to hospital bills and experienced being alienated by hospital institutions. Despite these reported barriers, these fathers were adamant in their resolve to support their children and
partners during this challenging time.

Conclusion: The experiences of fathers were riddled with fear, uncertainty, ambiguity and alienation, which placed them in very precarious situations when trying to navigate their role in a more sensitive and enlightened way. Having a premature infant calls into question the
systems that men are positioned within as these systems to a large extent shape these events and how they are experienced.

Contribution: This study is original as no other published studies seem to exist in South Africa that speaks to fathers’ lived experiences of having a premature baby.

Challenges experienced by grandparents caring for AIDS orphans in the Western Cape province, South Africa

Furaha Akimanimpaye, Million S. Bimerew, Deliwe R. Petlhu — Wed, 15 Jan 2025 00:00:00 +0000

Background: There is limited understanding of the difficulties and experiences faced by grandparents who assume the responsibility of caring for AIDS orphans.

Aim: The objective of the study was to investigate and depict the difficulties encountered by grandparents who provide care for AIDS orphans in the Western Cape province of South Africa.

Setting: The study was conducted in the City of Cape Town Metropolitan and the Overberg Municipality.

Methods: The study used qualitative approach with an exploratory-descriptive design. A purposive sampling technique was utilised to select 25 grandparents. Semi-structured interviews were conducted, audio-recorded, transcribed verbatim, and analysed thematically using ATLAS.ti, version 7.

Results: Financial difficulties, a lack of support, HIV and/or AIDS stigma, and dealing with rebellious teenagers were primary challenges affecting the well-being of grandparents.

Conclusion: The study found that while financial challenges were significant, other factors such as poor family support contributed to the decline in the well-being of grandparents caring for AIDS orphans.

Contribution: The study’s results can lead to improved public health programmes that address the identified challenges and health needs of grandparents providing care to AIDS orphans and the orphans under their care.

Contributory factors related to patient safety incidence: A nursing perspective

Gifty Adu, Sibusiso M. Zuma — Wed, 15 Jan 2025 00:00:00 +0000

Background: There are growing concerns about patient safety and quality assurance enhancement in the healthcare setting because of the increase in the incidence of patient harm and adverse events over the years.

Aim: This study explored the contributory factors associated with patient safety practices.

Setting: The study was conducted in two private hospitals in Gauteng province, South Africa.

Methods: A qualitative approach was used to gain an in-depth understanding of the issues pertaining to patient safety incidence. Purposive sampling was used to select professional nurses practicing within the two private hospitals. Thematic analysis was used. The study utilised the Donabedian model of patient safety and quality.

Results: The study revealed that majority of the professional nurses did not understand the concept of patient safety; there was poor communication between the multidisciplinary team. There was poor adherence to patient safety policies.

Conclusion: Patient safety issues remain an issue of concern in public health. There is a need for nurses to be capacitated on the implementation of patient safety programmes as well as improving communication within the multidisciplinary team. Identifying and addressing risk and contributory factors will help reduce the global burden of patient harm.

Contribution: The study has presented the challenges as seen with patient safety and made recommendations on how to improve patient safety from the nursing perspective. It is anticipated that the results of this study may be used to create awareness on patient safety issues. This should promote a good healthcare climate in private healthcare institutions.

Doctors’ perspectives on the quality of medical imaging in public hospitals in eThekwini District

Nkululeko P. Gam, Maureen N. Sibiya — Wed, 15 Jan 2025 00:00:00 +0000

Background: There is a paucity of literature on perspectives of referring doctors about the quality of medical imaging services and this study closes this gap in literature.

Aim: This quality assurance (QA) study aimed to explore the perspectives of doctors on the quality of medical imaging services in selected regional hospitals within eThekwini District of KwaZulu-Natal.

Setting: The study was conducted in four public regional hospitals.

Methods: An exploratory descriptive qualitative research design involving 30 min–45 min of in-depth individual interviews was used. A purposive sampling technique was used to select research participants and hospitals to ensure adequate responses to the research
questions. The sample involved nine participants and was guided by data saturation. Responses were recorded through notes and voice recordings and thematic analysis was used to analyse data.

Results: Three main themes (timeliness of examinations, communication and radiology eports and image quality) and eight subthemes (waiting times, shortage of radiographers, workload, communication between doctors and radiographers, requisition forms,
unavailability of radiology reports, clarity of images and image acquisition protocols) emerged from the data. Challenges experienced were exacerbated by high workload and shortage of radiologists and radiographers. Doctors in the data collection sites were mainly dissatisfied with services provided by the medical imaging departments.

Conclusion: Regular engagements between medical imaging departments and doctors are important in enhancing the provision of quality care to patients. In-service training of radiographers and employment of additional radiographers and finding solutions to mitigate shortage of radiologists are recommended.

Contribution: This quality assurance (QA) study focused on experiences of doctors while many other medical imaging QA studies in South Africa are equipment based. In-service training of radiographers is recommended to improve image quality and communication skills.

Factors affecting HIV prevention communication between professional nurses and high school learners in eThekwini

Thina S. Ngidi, Nongiwe L. Mhlanga, Thinavhuyo R. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: Communication within healthcare settings is crucial for a therapeutic relationship between nurse and patient especially in preventing human immunodeficiency virus (HIV) among adolescent girls. The school health programme in South Africa provides an opportunity to provide HIV prevention services among adolescent girls, however, uptake is low and
effective communication can address this.

Aim: The study’s purpose was to describe factors affecting HIV prevention communication between professional nurses and high school learners in eThekwini Metropolitan Municipality.

Setting: The study was conducted in two high schools in eThekwini Metropolitan Municipality.

Methods: The study used a qualitative approach and a descriptive research design. A semi-structured interview guide was used to conduct face-to-face interviews with 30 participants after ethical approval from the researchers’ affiliated institution and informed consent from participants or their guardians were obtained. Thematic analysis was used to analyse the data.

Results: Participants were aged between 14 years and 17 years. Most (25) participants were female. Three main themes emerged from the study: communication between the school health nurses and high school learners is facilitated by trust, communication is hindered by fear, and infrequent visits by nurses affect communication positively or negatively.

Conclusion: Health education on HIV is essential to prevent HIV among adolescent girls. Effective communication between healthcare providers and adolescent girls facilitates such health education.

Contribution: The uptake of HIV prevention services by adolescent girls can be improved by communication that facilitates the therapeutic relationship which is founded on trust, with frequent visits by nurses.

Prevalence of fatigue and consumption of energy drinks consumption among nursing students studying part-time

Lorato G. Manyeneng, Mogale L. Pilusa — Wed, 15 Jan 2025 00:00:00 +0000

Background: Professional nurses who study part-time are faced with demanding tasks, demanding routine, having to cope with their studies and family commitments. Some nurses try different tactics to cope with their demanding tasks, such as the consumption of energy drinks, to alleviate tiredness and fatigue. Although these energy drinks can alleviate fatigue and boost their energy levels, they have adverse effects to their health such as migraines, insomnia, seizures, arrhythmias and other cardiovascular complications.

Aim: To determine the health effects of energy drinks among nurses studying part-time.

Setting: Selected university in the Gauteng province, South Africa.

Methods: Descriptive, quantitative method that was contextual in nature was used. Self-administered questionnaire was used to collect data from a conveniently sampled population to determine the health effects of the use of energy drinks. Data analysis were done by means of descriptive statistics using the Statistical package for Social Sciences version 26.

Results: Findings indicated that nurses studying part-time experience fatigue (n = 86; 49%). To alleviate fatigue (n = 91; 52%), they use energy drinks.

Conclusion: Use of energy drinks is prevalent among the nurses because of fatigue caused by studying while working. To reduce the use of energy drinks, the participants need study leave and to be supported by their families and employers.

Contribution: The study encourages reduction or prevent the use of energy drinks by nurses who work and study part-time. Participants must use time management as a coping mechanism.

Approaches for prevention of mother-to-child transmission of HIV services during coronavirus disease 2019

Livhuwani Tshivhase, Florence M.Q. Setshedi, Idah Moyo — Wed, 15 Jan 2025 00:00:00 +0000

Background: During the coronavirus disease 2019 (COVID-19) pandemic, there was a reduction in access to prevention of mother-to-child transmission (PMTCT) of human Immunodeficiency virus (HIV) services globally, yet this programme is critical for reducing paediatric HIV incidence. To minimise the impact of COVID-19 and prevent disruptions to the PMTCT service provision, innovative strategies had to be developed and implemented.

Aim: The study aimed to describe the approaches that were developed and utilised during the COVID-19 pandemic in enhancing PMTCT services in Tshwane primary healthcare facilities.

Settings: Three primary healthcare facilities that were providing PMTCT services during the COVID-19 pandemic located in the Tshwane district, Gauteng province, South Africa.

Methods: The study is part of a larger study that focused on the experiences of healthcare workers who were rendering PMTCT services during the COVID-19 pandemic. An interpretative phenomenological analysis (IPA) design was employed to gain insight into the experiences of 16 purposively sampled healthcare workers who were providing PMTCT services during the pandemic in Tshwane district facilities. In-depth individual audio-recorded interviews were conducted with study participants, following a semi-structured interview guide. Data analysis was performed using an IPA framework.

Results: Three superordinate themes emerged: strategies utilised for providing care, community-based initiatives, and support systems to enhance the PMTCT service access.

Conclusion: Strengthening community-based initiatives and support systems is important for the enhancement of the PMTCT programme during and beyond the pandemic.

Contribution: Community-based initiatives are critical in continuity of PMTCT services, reducing HIV incidence, under-five child morbidity and mortality particularly during emergency situations.

Experiences of schizophrenia patients with treatment buddy support during the COVID-19 pandemic

Nomhle Mvunelo, Firoza Haffejee, Yasmeen Thandar — Wed, 15 Jan 2025 00:00:00 +0000

Background: Schizophrenia is a major psychiatric disorder affecting physical, psychosocial, and cognitive functioning. Treatment includes pharmacological and psychotherapeutic interventions. Adherence to prescribed medication is critical but reportedly low, because of side effects, failure to understand instructions, a lack of insight about the condition, cognitive deficits, and financial difficulties. Interventions to promote adherence to medication are required. This study introduced a treatment buddy to provide the patient with virtual support in adherence to medication.

Aim: The aim of this study was to explore the participants’ lived experiences of a treatment buddy support.

Setting: A specialised psychiatric clinic in a resource-constrained district of KwaZulu-Natal, South Africa.

Methods: A qualitative study design, using semi-structured one-on-one interviews, was used to collect in-depth data from 24 participants, suffering from schizophrenia and who had been offered virtual treatment buddy support for 6 months. Data were analysed using thematic analysis.

Results: The intervention improved adherence to medication. Participants indicated that the text messages served as reminders to take their medication daily. An alleviation of associated problems such as sleeping difficulties was observed. Participants were willing to encourage other patients suffering from schizophrenia to join ‘treatment buddy services’.

Conclusion: The virtual treatment buddy support increased awareness of the importance to adhere to antipsychotic medications among patients suffering from schizophrenia and helped to resolve other schizophrenia-related problems experienced by the participants.

Contribution: The study has provided a supportive intervention that can be utilised by mental health institutions to address poor adherence to medication by patients suffering from schizophrenia.

Factors influencing implementation of simulation in nursing and midwifery training in Malawi

Wed, 15 Jan 2025 00:00:00 +0000

Background: The study explored factors influencing implementation of simulation-based education (SBE) in nursing and midwifery education in Malawi.

Aim: This study aimed to identify factors influencing nursing and midwifery educators in selected training institutions and clinical sites.

Setting: The study covered one district and four central hospitals, five professional training institutions, Ministry of Health and Nurses and Midwives Council of Malawi officials.

Methods: Using mixed-methods approach, quantitative data were gathered from 293 participants, including 149 final-year nursing and midwifery students, and 144 clinical instructors. Qualitative data were obtained from 24 faculty members, 11 clinical instructors and two key informants. Researchers conducted 37 in-depth interviews, 10 focus group discussions and eight desk reviews. Descriptive statistics were used to analyse the quantitative data, while content analysis was used for qualitative findings.

Results: Five themes emerged from qualitative data: absence of simulation in regulatory body syllabi, insufficient formal training, demand for knowledgeable clinical instructors, inadequate human and material resources, and resistance to change. Survey results indicated that 83% of the participants had theoretical SBE knowledge but lacked practical skills, with only 13%
considering SBE as a current teaching method. Educators emphasised lack of infrastructure, skills laboratories, teaching hospitals, equipment, and a deficit in formal training as critical barriers to SBE implementation.

Conclusion: The study concluded that skilled educators, appropriate infrastructure and resources could facilitate SBE implementation in Malawi.

Contribution: Recommendations included regulatory body support, formal training for educators, utilisation of low-fidelity simulators, and establishment of SBE centres and corners in health facilities.

Pregnancy outcomes following non-screening of tuberculosis at primary healthcare facilities

Violet M. Chewe — Wed, 15 Jan 2025 00:00:00 +0000

Background: In South Africa, tuberculosis (TB) screening should be offered to all pregnant women at each antenatal care (ANC) visit. Therefore, access to TB screening for women and their families is crucial through maternity and child health services.

Aim: The study aimed to explore the repercussions of the non-screening of TB among pregnant women in the Capricorn District of Limpopo province.

Setting: The study was conducted in the selected primary healthcare facilities in the Capricorn District, Limpopo province, at selected primary healthcare facilities. Midwives employed within the primary healthcare facilities of Limpopo, offering ANC to pregnant women comprised the population.

Methods: The study was carried out using a qualitative exploratory research methodology. Ten participants were selected using purposive sampling method. As a result of limitations on coronavirus disease, data were gathered through in-depth, semi-structured virtual interviews with individual participants. Data analysis was employed manually using Tesch’s method.

Results: Two themes emerged from the data analysis: obstetric outcomes because of non-screening of TB and suggestions to enhance TB screening during ANC.

Conclusion: The study’s findings revealed that non-screening of TB among pregnant women may lead to severe pregnancy outcomes for both the mother and the unborn child should the woman be suffering from TB.

Contribution: The Department of Health may employ the results of this study to develop strategies that might be implemented to enhance TB screening among pregnant women and improve pregnancy outcomes for women diagnosed with TB.

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa

Wed, 15 Jan 2025 00:00:00 +0000

Background: This qualitative study aimed to investigate the barriers that hinder men’s utilisation of healthcare services in the Sedibeng district of South Africa.

Methods: The study was conducted using flyers with questions posted on the Best Health Solutions’ Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents. The authors analysed the
participants’ self-reported data thematically on demographics, geographic area, and reasons for men not using healthcare services.

Results: The findings revealed that sociocultural norms played a significant role in men’s reluctance to seek medical help, as it was perceived as a sign of weakness. The scarcity of male healthcare professionals hinders open discussions. Stigma and discrimination were identified as substantial barriers. Convenience, trust, and confidentiality concerns, along with the influence of intimate partners, also influence men’s decision-making.

Conclusion: This study highlights the complex interplay between various barriers that impact men’s utilisation of healthcare services in the district. By addressing these factors, healthcare providers and policymakers can enhance healthcare access and promote better health outcomes for men in Sedibeng district.

Contribution: The manuscript’s primary contribution lies in uncovering multifaceted barriers to men’s healthcare utilisation in Sedibeng district. It explores socio-cultural norms, healthcare worker demographics, stigma, discrimination, convenience factors, trust, confidentiality concerns, and the influence of intimate partners on men’s healthcare choices. These insights illuminate the complex factors affecting men’s healthcare access, providing valuable knowledge for healthcare providers and policymakers.

Nurses’ experiences of the family’s role in end-of-life care

Lesley A. Paterson, Jeanette E. Maritz — Wed, 15 Jan 2025 00:00:00 +0000

Background: Family units can be deeply affected and require nurses’ attention and care when their loved ones reach the end-of-life stage. However, the role of the family in end-of-life nursing is under-researched in a tertiary hospital setting.

Aim: This study aims to explore and describe nurses’ lived experiences of the family’s role in end-of-life care at a tertiary hospital in the Western Cape.

Setting: The study took place in a tertiary hospital in the Western Cape.

Methods: A qualitative hermeneutic design with a phenomenological approach was used. Ten professional nurses were interviewed in person, and two focus groups comprised enrolled and auxiliary nurses (11) with a minimum of 6 months of experience in end-of-life care. Data analysis was conducted by categorising qualitative information into codes and themes, following Creswell’s outlined methodology.

Results: Three themes emerged: emotional challenges associated with families of end-of-life patients, strategies that assist families and impediments to providing care. Participants experienced challenges managing strong emotions expressed by families and their own, but provided care regardless. Strategies that have been found to be helpful to families include
communication, access, and involving them in patient care. Participants experienced the need for emotional support and specialised end-of-life training.

Conclusion: Participants strive to provide understanding and support to families despite challenges, but emotional and end-of-life training resources are required to equip nurses to address patients’ and families’ needs competently.

Contribution: This study adds the nurses’ experience and understanding of the family’s role in providing end-of-life care in a tertiary hospital.

Knowledge of autism among students at a South African Institute of Higher Education

Marguerite De Jongh, Heidi A.M. Mapisa — Wed, 15 Jan 2025 00:00:00 +0000

Background: Autism is a significant concern because of the increase in the prevalence of the disorder. University healthcare students might not all be adequately prepared to serve autistic individuals. Hence, there is a need in the South African context for information on healthcare practitioners’ knowledge of general aspects, diagnosis and management of autism.

Aim: To determine current knowledge on autism among speech-language pathology and audiology (SLP & A) students at a South African Higher Education Institution.
Setting: The study was conducted among 65 second, third and fourth year students at the SLP & A Department of a South African Higher Education Institution.

Methods: A descriptive quantitative design utilising an online questionnaire was used to gather the quantitative and, to a lesser extent, qualitative data. Descriptive measures were used to analyse and summarise the data.

Results: Participants mainly understood autism’s fundamental symptoms and comorbidities, early intervention, team management and speech-language therapist (SLT) duties. Students were found to have little awareness of autism’s prevalence, causes, diagnosing experts, intervention methods and treatment. Participants felt uncomfortable treating autistic people
owing to a lack of clinical exposure. Participants want further training.

Conclusion: Students reported the need for additional training on autism, including its identification, diagnosis, assessment and treatment. It is recommended that the study be replicated at other institutions to impact other curricula.

Contribution: This research article provides input for enhancing the curriculum for Health Science Departments in Higher Education Institutions.

Fear of COVID-19 among oral health professionals in South Africa

Siphokazi M. Matomane, David P. Motloba — Wed, 15 Jan 2025 00:00:00 +0000

Background: The coronavirus disease 2019 (COVID-19) pandemic caused widespread psychological morbidity, especially among frontline workers. Oral health professionals (OHPs) are at increased risk of contracting and dying from COVID-19 because pf their proximity to infected patients. The objective of this study was to measure the level of COVID-19 fear and its predictors among South African OHPs.

Aim: To evaluate the severity of fear of COVID-19 among OHPs in South Africa.

Setting: Online platforms.

Methods: In this cross-sectional study, a Google Forms-based online survey was conducted. The fear scale of COVID-19 (FCV-19S) was used to assess the level of fear among OHPs. Statistical data analysis was performed using SPSS 28.0. The multivariate logistic regression
model was developed to assess the predictors of COVID-19 fear.

Results: A total of 462 OHPs participated in this study. Approximately half of the participants, 212 (45.6%), indicated having severe fear of COVID-19. The regression model showed a significant association between COVID-19 fear and increased age, clinical experience, employment sector, professional group, positive COVID-19 test and COVID-19 vaccination.

Conclusion: The results indicate that South African OHPs had low levels of corona phobia. Females, older and vaccinated OHPs had the greatest odds of COVID-19 fear.

Contribution: This study provides insights into the severity of fear and anxiety experienced by OHPs in the time of the pandemic. The findings will aid in the development of appropriate interventions and programmes to deal with similar outbreaks in the future.

Nurses experiences regarding ideal clinic project implementation in eThekwini district

Thembelihle S.P. Ngxongo, Mthokozisi Zulu — Wed, 15 Jan 2025 00:00:00 +0000

Background: The South African National Department of Health introduced the ideal clinic realisation and maintenance (ICRM) programme in response to primary health care (PHC) services and to lay a strong foundation for the National Health Insurance implementation. The progress report 2015–2016 on the implementation of this programme indicated that achieving the 50% target in selected vital areas such as staffing, resource allocation, and utilisation was not achieved.

Aim: The study aimed to explore and describe nurses’ experiences regarding the ideal clinic project (ICP) implementation.

Setting: The study was conducted in 18 PHC clinics in eThekwini district, KwaZulu-Natal.

Methods: An exploratory descriptive, contextual qualitative design was employed guided by Donabedian’s structure, process, and outcomes model. Data were collected using semistructured interviews with 24 nurses between 15 September and 25 October 2020 following receipt of ethics and analysed using Tesch’s open coding approach.

Results: The three themes that emerged included structural limitations, processes involved in running the clinic, and support offered to the PHC clinics. These were highlighted as challenges experienced by nurses during the implementation of an ICP.

Conclusion: Nurses’ negative experiences and perceptions made it difficult for them to accomplish the ICP standards.

Contribution: The findings from the study highlighted critical actions by the health care institution management which if instituted, could facilitate improved implementation of the ICP and achievement of the 50% target in selected vital areas.

Experiences of families living with tuberculosis patients in the North West province, South Africa

Keni J. Sebothoma, Mampheko D. Peu, Mmamphamo M. Moagi, Nombeko Mshunqane — Wed, 15 Jan 2025 00:00:00 +0000

Background: The families living with tuberculosis (TB) patients play a vital role in the care of these patients. Little is known about the experiences of families living with family members who are infected with TB.

Aim: The aim of the study was to explore and describe the experiences of families having a member or members diagnosed with TB.

Setting: The study was conducted in the Ngaka Modiri Molema district in the North West province of South Africa.

Methods: This was a qualitative study using a descriptive phenomenological approach. Ten families with member(s) who had TB were purposively selected. Data were collected through face-to-face, semi-structured individual interviews that were recorded. Data were analysed using Colaizzi’s seven steps.

Results: The following essential meanings emerged: family members’ caregiving experiences, family members’ challenging experiences, and family members’ health literacy experiences.

Conclusion: Families had a lack of TB knowledge, which was associated with their poverty and with community health nurses not being committed to patient education. In poor, rural settings, nurses need to support families with adequate TB knowledge to limit the spread of TB and achieve the best treatment outcomes.

Contribution: Family involvement is vitally important in TB health promotion. Health promotion is a crucial tool for achieving comprehensive health and social growth. Wider interventions concentrating on families are beneficial for promoting health and preventing TB.

Factors that influence locum practice in public and faith-based hospitals in Malawi

Mabel B.N. Chinkhata, Masauko Msiska, Rodwell Gundo — Wed, 15 Jan 2025 00:00:00 +0000

Background: Locum practice is a non-standard form of employment used to address the shortage of healthcare workers in hospitals. In Malawi, the locum practice is used to improve the availability of healthcare workers and promote continuity of care. Despite this, little attention has been paid to the effective and efficient use of locum practice.

Aim: To explore the factors influencing locum practices in public and faith-based hospitals in Malawi.

Setting: Six public and faith-based hospitals in Malawi.

Methods: An exploratory descriptive design was used in the qualitative strand of this larger mixed-methods study. Data were collected through in-depth interviews with hospital managers (n = 15) and focus group discussions (FGD) with nurses, medical officers, and
clinical officers (n = 29). All the interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data.

Results: Locum practice was characterised by challenges related to healthcare workers working beyond the prescribed hours, a lack of orientation for locu staff, inconsistent locum rates, and delayed payments. The consequences of these challenges are compromised quality and safety of patient care.

Conclusion: Locum practice is associated with numerous challenges in both public and faithbased
hospitals in resource-limited settings. This could be attributed to the lack of regulation, supervision and monitoring of locum practice.

Contribution: The findings suggest the need for the development and adherence to guidelines and policies for managing locum practice. Further studies could explore measures to retain permanent staff as a way of reducing the demand for locum staff.

Interaction of social support and depressive symptoms on antiretroviral therapy adherence among people living with HIV in South Africa

Muziwandile Q. Luthuli, Johannes John-Langba — Wed, 15 Jan 2025 00:00:00 +0000

Background: Depression consistently emerges as a significant predictor of poor antiretroviral therapy (ART) adherence among adult people living with human immunodeficiency virus (PLHIV). However, a gap exists regarding how social support and depressive symptoms can interact to influence ART adherence among adult PLHIV in South Africa (SA).

Aim: To investigate the interaction between social support and depressive symptoms on ART adherence among adult PLHIV.

Setting: A tertiary hospital in Durban, KwaZulu-Natal province of SA.

Methods: Utilising a quantitative cross-sectional research design along with time location sampling technique (TLS); the study recruited 201 adult patients enrolled in an ART programme.

Results: The results indicated that depressive symptoms were significantly associated with ART adherence with and without the interaction (B = -0.105; odds ratios [OR] 0.901; 95% confidence intervals [CI] = 0.827, 0.981; p = 0.016), while social support was not significantly associated with ART adherence (B = 0.007; OR 1.007; 95%CI = 0.989, 1.025; p = 0.475). However, a statistically significant interaction was found between social support
and depressive symptoms (B = -0.006; OR 0.994; 95%CI = 0.989, 1.000; p = 0.037) on ART adherence.

Conclusion: Based on the results, depressive symptoms significantly influenced ART adherence. However, social support did not buffer the adverse effects of clinical depression associated with poor ART adherence.

Contribution: This study provides an evidence-based approach to address gaps in the mental health and social well-being of PLHIV in the context of ART adherence.

Government policies on job satisfaction of radiographers in tertiary hospitals, Gauteng

Thandokuhle E. Khoza — Wed, 15 Jan 2025 00:00:00 +0000

Background: The National Department of Health has different operational policies to monitor the performance of its employees and to reward them accordingly. These policies could have a direct bearing on job satisfaction and career advancement for radiographers employed by the public sector, as there are previous reports that show that these policies affect the job satisfaction of other healthcare professionals negatively.

Aim: The aim of the study was to explore the influence of government policies on the job satisfaction of radiographers employed by public tertiary hospitals in the Gauteng province.

Setting: The study was conducted in two public tertiary hospitals in the Gauteng province.

Methods: The study used a primary exploratory qualitative research design, with a purposive sampling technique. Data were collected through individual and focus group interviews. The researcher recorded and transcribed the interviews. Thematic analysis was used to analyse the data.

Results: Three government policies had a negative impact on job satisfaction for radiographers. These were the Occupational Specific Dispensation (OSD), the Performance Management and Development System (PMDS) and the Employment Equity Act (EEA). The failure to effectively implement these policies also had a negative bearing on career pathing.

Conclusion: The implementation and structure of these three government policies have resulted in job dissatisfaction amongst radiographers employed by public tertiary hospitals and reduced the structure of career pathing.

Contribution: The study highlighted three government policies that negatively affect job satisfaction in Gauteng.

Effects of metformin on arterial elasticity and pro-inflammatory markers in black diabetes patients

Tsakani L. Rasakanya, Elzbieta Osuch — Wed, 15 Jan 2025 00:00:00 +0000

Background: Pro-inflammatory markers are linked with the development and progression of type 2 diabetes mellitus and arterial stiffening. Pulse Wave Velocity (PWV) and Augmentation Index (Aix) are non-invasive standard markers of arterial elasticity and predictors of
cardiovascular mortality and morbidity.

Aim: To investigate the effects of metformin alone and in combination with glimepiride on arterial elasticity, pro-inflammatory cytokines in black type 2 diabetes mellitus patients.

Settings: Participants were enrolled from Sefako Makgatho Health Sciences University community, Gauteng, South Africa.

Methods: PWV and Aix were measured using the AtCor SphygmoCor® system (AtCor Medical, Inc., Sydney, Australia). Cytokines levels were measured using Multiplexing with Bio-Plex Pro™ human inflammation panel I assay. Treatment naïve type 2 diabetes participants were divided into two groups: metformin (M) (n = 10) and metformin glimepiride (MS) (n = 14). The study participants were followed up at 4 and 8 months after treatment initiation.

Results: In the M and MS, IL-1β increased significantly at four months (58.19 ± 0.03 pg/ml, 58.35 ± 0.30 pg/ml) when compared to baseline (33.05 ± 18.56 pg/ml, 34.79 ± 18.77 pg/ml) then decreased significantly at eight months (29.25 ± 11.64 pg/ml, 32.54 ± 14.26 pg/ml) when
compared to four months (58.19 ± 0.03 pg/ml, 58.35 ± 0.3 pg/ml) (p < 0.05). There were no significant changes in PWV, Aix, IL-1ra, IL-2, IL-6, IL-8, TNF-α and hs-CRP levels at both treatment intervals.

Conclusion: Metformin alone or in combination with glimepiride did not improve arterial elasticity and did not reduce pro-inflammatory cytokines levels in T2DM black South African patients.

Contribution: The context-based knowledge generated by the current study is expected to enhance the continuum of care for T2DM patients.

Patient perceptions of nurses’ cultural competence in public sector hospitals in Gauteng

Disebo R. Maboko, Sue Armstrong, Daleen Casteleijn — Wed, 15 Jan 2025 00:00:00 +0000

Background: Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses’ cultural competence are largely unexplored in South Africa.

Aim: This study explored how the concept of cultural competence is perceived by patients.

Setting: Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals – district (level one), regional (level two), and academic (tertiary, level three).

Methods: This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis
followed Tesch’s eight steps of data analysis.

Results: Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses’ level of cultural competence.

Conclusion: Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients.

Contribution: Patients’ perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

Anaemia at mid-pregnancy is associated with prehypertension in late pregnancy among urban women

Wed, 15 Jan 2025 00:00:00 +0000

Background: Antenatal iron deficiency and anaemia are associated with gestational hypertension and diabetes mellitus, but so are elevated iron stores and haemoglobin. In South Africa, pregnant women receive routine iron supplementation regardless of iron status.

Aim: This study aimed to assess associations of antenatal iron status and anaemia with blood pressure in pregnant women in urban South Africa. Secondary to this, associations with heart rate, fasting glucose and glucose tolerance were also investigated.

Methods: A total of 250 pregnant women, aged 27 (24–32) years, were recruited using consecutive sampling. The authors measured biomarkers of iron status and anaemia at < 18 and ± 22 weeks’, blood pressure and heart rate at ± 36 weeks’, and fasting glucose and glucose tolerance between 24 and 28 weeks’ gestation. Associations were determined using multivariable regression models adjusted for confounders.

Results: The odds of prehypertension in late pregnancy among women with anaemia at ± 22 weeks’ gestation were three times higher than among women without anaemia (odds ratio [OR]: 3.01, 95% confidence interval [CI]: 1.22, 7.42). Participants with anaemia at ± 22 weeks’
gestation had 2.15 times higher odds of having elevated mean arterial pressure than women without anaemia (OR: 2.15, 95% CI: 1.01, 4.60).

Conclusion: Anaemia at mid-pregnancy could be a predictor of hypertensive disorders in pregnancy. The cause of antenatal anaemia may need further investigation apart from iron deficiency. The effective management of anaemia in pregnant women living in urban South Africa remains a challenge.

Contribution: This study provides evidence about the health impact of pregnant women regarding antenatal supplementation practices in South Africa.

Feeding practices of caregivers with children attending early childhood development centres in Xhariep, South Africa

Angelique C. Carson-Porter, Violet L. van den Berg, Ntsoaki L. Meko — Wed, 15 Jan 2025 00:00:00 +0000

Background: In low- to middle-income countries, malnutrition is a major contributing factor in children failing to achieve their developmental potential. The prevention of malnutrition requires, among others, nutritious, diverse and safe foods in early childhood.

Aim: The study aimed to determine primary caregivers’ choices and motivation for the foods they fed their children.

Setting: The study was conducted among early childhood development centres in the Xhariep District, Free State.

Methods: A qualitative study was undertaken. Twelve participants who met the inclusion criteria were conveniently sampled. Semi-structured interviews were conducted to find out the primary caregivers’ choices and motivation for foods they fed their children until data saturation was reached.

Results: The mean age of the participants was 31 years. Nine of the participants relied on social grants as a source of income. The participants reported feeding their children mainly maize porridge, milk, juice, and water. Vegetables and meat were fed to the children once a week. Fruits were fed to the children at the beginning of the month.

Conclusion: The level of education, employment status, and community support influenced the primary caregivers’ feeding practices. The content of the diets of their children was insufficient in vegetables and fruit, not only placing the children at risk of undernutrition but also at risk of obesity and micronutrient deficiencies. Primary caregivers ensured their children were fed, although limited foods were offered.

Contribution: This research creates awareness of the level of social progress and access to resources within rural communities in the Xhariep district, and gives the opportunity to extend this research to confirm these findings in other poverty-stricken areas.

Conceptualising the experiences of continuing professional development of young private sector audiologists as an attribute of andragogy

Suvishka Barath, Andrew J. Ross — Wed, 15 Jan 2025 00:00:00 +0000

Background: Continuing professional development (CPD) is an ongoing learning process that builds on initial training and education to improve competency. Low compliance rates of audiologists adhering to CPD have been reported by the Health Professions Council of
South Africa. However, there is an absence of research on the uptake of CPD from the perspective of young audiologists working in the private sector.

Aim: This study aimed to explore the experiences and views of young audiologists working in the private sector on continuing professional development.

Setting: The study was conducted in KwaZulu-Natal province, South Africa.

Methods: The descriptive, qualitative approach entailed conducting 11 online, semi-structured interviews with audiologists working in the private sector. Semi-structured interviews consisted of open-ended questions, and the qualitative data were thematically analysed. The adult learning theory, andragogy, was used as both the conceptual and analytical framework.

Results: Five andragogy concepts were used to analyse the data, with eight sub-themes emerging related to: self-concept, adult learning experiences, readiness to learn, orientation to learning and internal motivation.

Conclusion: The experiences of audiologists in the private sector on CPD aligned with the concepts of andragogy. Audiologists’ experiences need to be taken into consideration during the planning and implementation of CPD for it to be relevant, effective and purposeful.

Contribution: This study highlighted the experiences of audiologists on CPD working in the private sector with continuing professional development.

The influence of infant sleep problems and sleep training on maternal subjective well-being

Jacomien Muller, Tharina Guse — Wed, 15 Jan 2025 00:00:00 +0000

Background: Disturbed sleep during infancy and early childhood can have a detrimental effect on parental sleep and consequently parental well-being. However, there is a paucity of research on how perceived child sleep problems and behavioural sleep interventions as
treatment influence maternal subjective well-being.

Aim: This study aimed to explore the incidence of subjective well-being in mothers of children with sleep problems and whether implementing two behavioural sleep interventions changed their well-being.

Setting: The research was conducted in a community setting, with parents voluntarily approaching a sleep consultancy based in South Africa.

Method: Using data from 119 mothers voluntarily approaching a sleep consultancy in South Africa, a pre-test-post-test design was employed to investigate changes in life satisfaction, affect, couple satisfaction, perceived stress and depression approximately 3 weeks after implementation of a sleep intervention.

Results: Results indicate that mothers of children with sleep problems experienced moderate to high life satisfaction and positive affect although the presence of moderate negative affect, couple satisfaction and stress and mild depression suggest possible decreased subjective well-being.

Conclusion: Findings suggest implementation of graduated extinction and extinction with parental presence sleep interventions may improve life satisfaction, affect, stress and depression but not couple satisfaction in the short-term.

Contribution: This study contributes towards understanding the effect of sleep loss on the subjective well-being of mothers and provides preliminary evidence regarding the benefits of two sleep interventions for improving maternal subjective well-being.

Facility managers’ experiences of mentorship in a district of Gauteng province, South Africa

Itumeleng G. Msiza, Thanyani G. Lumadi — Wed, 15 Jan 2025 00:00:00 +0000

Background: Mentoring is recommended as a method to assist nurses in developing their leadership roles. Support and mentorship of nursing managers can yield positive results for their organisations because of the leadership quality. The lack of mentorship programmes for newly appointed facility managers has an impact on the management of the facilities.

Aim: This study aims to explore and describe how facility managers experience mentorship at primary health care (PHC) facilities.

Setting: Participants were drawn from 11 different PHC facilities falling under the three sub-districts: Emfuleni, mid-Vaal and Lesedi.

Methods: A qualitative exploratory and descriptive research design was employed to achieve the study objectives. A non-probability purposive sampling method was used to select the facility managers from three sub-districts; a signed informed consent to participate in the study was obtained from each participant. A semi-structured interview guide was used to interview purposively selected facility managers. The interviews were audio recorded and subsequently transcribed verbatim. Data were analysed using the content analysis method. Rigour was ensured, and ethical principles measures were applied.

Results: Four themes emerged from the results: the experiences on mentorship, views on mentorship, barriers to mentorship and mentorship improvement strategies.

Conclusion: The study found that there was a lack of formal mentoring in the district, and there is a need for benchmarking and the development of a formal mentorship programme.

Contribution: The results could be useful in identifying gaps, making recommendations to nursing management and future research. They could further broaden insight into the mentoring needs of facility managers.

Lived experiences of radiology caregivers during a health crisis: A COVID-19 case analysis

Shillah N. Hundah, Maureen N. Sibiya, Thandokuhle E. Khoza — Wed, 15 Jan 2025 00:00:00 +0000

Background: Health crises have been linked with the exacerbation of pre-existing difficulties and the emergence of unique challenges, as evidenced by the impact of coronavirus disease 2019 (COVID-19) on health caregivers worldwide. Baseline data allow for reflection and preparation for any future health emergencies therefore giving impetus to phenomenological enquiries among the experiencers.

Aim: This study aimed to explore the lived experiences of the eThekwini district frontline radiology caregivers during the COVID-19 pandemic.

Methods: A qualitative, interpretative phenomenological analysis methodology was adopted
in a multi-method data-collection context comprising semi-structured interviews and focus group discussions (FGDs) among 24 radiologists, radiographers, and radiology nurses obtained by non-probability sampling. Data were transcribed verbatim and analysed using an
interpretative phenomenological approach.

Results: Three superordinate themes emerged, namely: (1) duties and roles during the COVID-19 pandemic, (2) work-related challenges, (3) personal challenges.

Conclusion: Frontline radiology caregivers experienced increased workload, staff shortages, salary cuts, personal protective equipment (PPE) shortages, non-recognition, poor managerial support, disrupted social relations, and poor work–life balance. This necessitates the need for the radiology departments to address staffing, infection prevention and control deficits, and
invest in support interventions to assist frontline radiology caregivers during health crises.

Contribution: The findings comprise baseline information that can be used for reflection and guiding radiology departments in preparing for any future health crises.

Strategy actions to include students in a private hospital’s nursing teams: A qualitative study

Adele Neethling, Madeleen Rheeder-Jooste, Won-Li Richardson, Lizeth Roets — Wed, 15 Jan 2025 00:00:00 +0000

Background: Student nurse education focusses on preparing competent professionals integral to nursing teams.

Aim: To develop strategic actions to include student nurses within the nursing team.

Setting: A private healthcare group in South Africa.

Methods: A qualitative approach in three phases was used. Thirty purposively sampled participants recorded reflective journals in phase one. Tesch’s eight steps were utilised for analysis. Phase two involved non-probability volunteer sampling of 11 participants for the nominal group technique analysis. In phase three, total population sampling recruited nine panellists for an e-Delphi technique that provided data that were open coded.

Results: Phase one identified themes, including perceptions of responsibilities, support needs, recognition, conflict and communication issues. Phase two revealed five strategic actions: fair treatment, aligned work allocation, active participation, respect and acknowledgement of contributions. Phase three validated 19 strategic statements underpinning the strategic actions.

Conclusion: Unit managers play a key role in fostering inclusivity, impacting student nurse retention.

Contribution: Enhancing team cohesion can improve workplace wellness and patient outcomes while aiding in retention and recruitment efforts.

Communication of health messages using theatre: Appreciative inquiry from Ubuntu theatre group

Wed, 15 Jan 2025 00:00:00 +0000

Background: Theatre involves expressing meaning in a collaborative art using words, movements, and visual elements. However, theatre remains poorly used as a viable teaching strategy or a method for communicating health messages. Instead, it is relegated to solemnly
transmitting indigenous knowledge.

Aim: To explore and describe communication of educational health messages through theatre using an appreciative inquiry approach.

Setting: The study was conducted among the Ubuntu theatre group from a rural province in South Africa. The group is famous for using theatre to communicate educational health messages through the lens of Ubuntu philosophy.

Methods: A qualitative exploratory descriptive design was followed. A non-probability purposive sampling was used to select thirteen members of the Ubuntu theatre group. Data were collected by two moderators from the two focus group discussions through conference calls.
Deductive thematic content data analysis was used to describe the 4-Ds of appreciative inquiry.

Results: Theatre is a playful pedagogy that can cut through language and cultural barriers when used to communicate educational health messages. There is a need to formalise it as an alternative pedagogy within the health care sciences curriculum. Furthermore, the
sustainability of theatre as an educational tool is dependent on expanding educational practices, documenting its success stories and periodical in-service training.

Conclusion: Using Ubuntu innovation to communicate complex educational health messages through theatre can maximise learning. This study recommends that Ubuntu-infused health messages be conveyed using theatre.

Contribution: The study adds to the body of knowledge by presenting Ubuntu innovation in communicating health messages through theatre.

Capturing growth indices on the road to health booklets in clinics in Free State, South Africa

Patience O. Legoale, Mashudu Manafe — Wed, 15 Jan 2025 00:00:00 +0000

Background: Growth monitoring plays an essential role in the development of young children. Anthropometric indices are of utmost importance for healthcare professionals to identify children at risk of inadequate growth and malnutrition.

Aim: This study aimed to assess the capturing of the growth indices in the Road to Health Booklets (RTHB) in clinics.

Setting: The study was carried out in Mangaung Metropolitan municipal clinics in the Free State province, South Africa.

Methods: A descriptive quantitative study was conducted using a checklist to audit 264 RTHBs. Descriptive statistics were used to analyse data.

Results: The findings showed that birth weight was recorded in most 99% (n = 262) of the RTHBs. The mid-upper arm circumference (MUAC) was not recorded in 58% (n = 153) of the cases during the last visit. Weight-for-Age (WfA) was routinely plotted in 91% (n = 241) of the RTHB. The length or Height-for-Age (LHfA) was plotted in 38% (n = 99) of the RTHB and Weight-for-Length or height (WfLH) was plotted in 31% (n = 81) of the RTHB.

Conclusion: The results demonstrated that certain anthropometric measures including MUAC, length, or height were absent from the records of the RTHB. Consequently, RTHB may not be effectively used as a means of evaluating nutritional status, affecting early detection of malnutrition in children.

Contribution: The research makes a valuable addition to the existing body of knowledge for monitoring growth and measurement of anthropometric indices in the RTHB, as well as the appropriate execution of these practices.

Adolescent girls’ perceptions regarding the use of contraceptives in Ekurhuleni District, Gauteng

Pretty T. Moloi, Rakgadi G. Malapela — Wed, 15 Jan 2025 00:00:00 +0000

Background: Unintended pregnancies pose various challenges for adolescent girls and can be prevented through contraceptive use. However, contraceptive use among adolescents is lower compared to among older women.

Aim: To describe adolescent girls’ perceptions of the use of contraceptives.

Setting: Two high schools in Tembisa were selected as the study setting.

Methods: Purposive sampling was used to select adolescent girls who had reached menarche and were willing to participate. Data collection involved narrative writing for girls under 16 and interviews for older adolescents. Braun and Clark’s six-step method was used for data analysis.

Results: A total of 35 adolescent girls were identified, and the final sample size was N = 33 adolescent girls whose ages ranged from 13 to 18 years. Two main themes emerged. Theme 1 was positive perceptions of contraceptives. Theme 1 was supported by two subthemes: the first was the influence of the male partner; the second was financial constraints in families.
The second theme was negative perceptions of contraceptives. Four subthemes supported the second main theme, which were: myths and misconceptions, influence of parents, healthcare worker attitudes and negative attitudes of community members.

Conclusion: Addressing the low contraceptive uptake among adolescent girls requires understanding their perceptions to tailor interventions accordingly.

Contribution: The study contributes by highlighting the negative perceptions of contraceptive use, including family financial constraints and the influence of male partners. These findings can inform reproductive health initiatives aimed at increasing contraceptive use among
adolescents.

The use and ethics of dental photography and social media at an oral healthcare training centre in South Africa

Wed, 15 Jan 2025 00:00:00 +0000

Background: The ethics surrounding the use and sharing of photographs on social media has come under the spotlight as the Protection of Personal Information Act (POPI Act) has come into play.

Aim: The aim is to determine the use, ethical practice and sharing of dental photography on social media among qualified and undergraduate oral health practitioners at a dental school in South Africa.

Methods: A cross-sectional study design was used on staff and students at the University of the Western Cape’s Dental Faculty in 2022. Chi-squared and Fisher’s exact tests were used to determine associations between the different graduation statuses and various demographic factors.

Results: From the 80 undergraduate students and 46 qualified oral healthcare practitioners, the majority were aware that photography could be used in dentistry, and 87.3% (n = 110) took photographs of the dental treatments performed on their patients. Only 60.3% of the participants attended an ethical course that addressed issues with social media and digital photography. Almost 80% (n = 100) of the participants did not feel that they needed to mention all the social media platforms that they would use with their patients’ photographs before sharing.

Conclusion: Dental photography is being used and sometimes shared on social media platforms by some students and staff at university level. Not all participants have attended an ethical course on clinical photography. Dental training needs to include an ethical course on
dental photography and the use of sharing photographs on social media.

Contribution: Good ethical practice regarding clinical photographs in all undergraduate and postgraduate curriculums, to eliminate any uncertainty.

Beyond the curriculum: A gay medical student’s perceptions of health sciences education and healthcare access in KwaZulu-Natal

Sthembiso P. Mkhize, Sanele Buthelezi, Attah M. Mkhize, Lwandile Tokwe — Wed, 15 Jan 2025 00:00:00 +0000

Background: The prevailing social constructs of cis-heteronormativity and endosexism have structurally marginalised sexual and gender minorities, leading to their limited representation and inclusion in mainstream health systems and health sciences education.

Aim: The study aimed to explore a gay medical student’s perceptions of the health sciences curriculum and their experiences in accessing and utilising healthcare services offered both by the university and externally.

Setting: At a university in KwaZulu-Natal, South Africa.

Methods: This study originates from a larger qualitative study conducted in 2018, involving 12 Lesbian, Gay, Bisexual, Transgender (LGBT)-identifying participants who were selected using purposive and snowball sampling techniques. The larger study used a case study
approach to explore how healthcare services meet the sexual health needs of LGBT youth. Among the 12 sampled participants, one participant self-identified as ‘gay’ and was pursuing a Bachelor of Medicine and Bachelor of Surgery. This participant was specifically selected for analysis in this study because of their knowledge of health sciences education and pursuit of a
career in healthcare.

Results: Three themes were identified in the participant’s interview, including: (1) navigating healthcare services as a young gay man, (2) silenced voices: the impact of the limited Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual and + (LGBTIQA+) health education, and (3) challenging the silenced voices.

Conclusion: There is a need for a well-planned curriculum that includes LGBTIQA+ issues to equip healthcare professionals with the knowledge to provide high-quality care to all patients, regardless of their sex, gender, or sexuality.

Contribution: The study provides solid proposals for developing an inclusive healthcare curriculum that considers identities beyond binary going forward.

Infant feeding knowledge, attitudes and practices of HIV-positive breastfeeding mothers

Kgabo M. Mabotja, Annette van Onselen, Reno E. Gordon — Wed, 15 Jan 2025 00:00:00 +0000

Background: Assessment of infant feeding knowledge, attitudes and practices of human immunodeficiency virus (HIV)-positive breastfeeding mothers may determine compliance with the chosen feeding method.

Aim: The study assessed knowledge, attitudes and practices on infant feeding among HIV-positive breastfeeding mothers.

Setting: The study was conducted at five clinics in the Chief Albert Luthuli sub-district of Mpumalanga, South Africa.

Methods: A descriptive cross-sectional study with a convenient sample of 155 HIV-positive breastfeeding mothers.

Results: More than half of the participants (54.8%) were knowledgeable of exclusive breastfeeding in general. However, less than half were knowledgeable of exclusive
breastfeeding in the context of HIV (46.5%), mixed feeding (28.4%) and replacement feeding (49.0%). Most participants (85.8%) reported that they were advised to exclusively breastfeed for 6 months, 61.3% intended to exclusively breastfeed for 6 months, and 29% intended to stop breastfeeding at 6 months. Most participants (64.5%) intended to introduce solids at 6 months,
and for participants who intended to introduce solids before 6 months, 37.7% did not believe that exclusive breastfeeding was sufficient for the baby.

Conclusion: Although most participants were knowledgeable about exclusive breastfeeding, there were misconceptions that required attention such as the lack of knowledge on exclusive breastfeeding in the context of HIV, mixed feeding and replacement feeding. Exclusive breastfeeding for 6 months was the most emphasised infant feeding practice.

Contribution: This study builds on existing literature on infant feeding knowledge, attitudes and practices and provides a basis for interventions for improved exclusive breastfeeding rates.

Blended learning: Exploring nurse educators’ perspectives

Daniel O. Ashipala, Emmanuel M. Sapalo, Peneyambeko I. Shikulo — Wed, 15 Jan 2025 00:00:00 +0000

Background: In a rapidly evolving educational landscape, blended learning is becoming an increasingly popular transition from traditional forms of learning and teaching to e-learning. It is therefore important that lecturers adapt their practice and transform their teaching in line with the online platform in use, as this has the potential to benefit students, lecturers and the institution alike. However, little research exists regarding the perspectives of nurse educators on the use of blended learning as a teaching method.

Aim: The study aimed to explore and describe the perspectives of nurse educators on the use of blended learning as a teaching method at the Faculty of Health Sciences at a university in Namibia.

Setting: The study was conducted at a public nurse education institution in Namibia.

Methods: A qualitative exploratory, descriptive design that was contextual was applied to collect data from a convenient sample of 15 lecturers using semi-structured interviews.

Results: Four themes emerged in this study, namely, understanding of blended learning, benefits of utilising blended learning, challenges of utilising blended learning, and recommendations to ensure effective use of blended learning.

Conclusion: The study findings identified potential areas of both strengths and shortcomings in nurse educators’ use of blended learning as a teaching and learning strategy.

Contribution: These findings may be used to develop ongoing strategies and targeted interventions that can strengthen nurse educators’ abilities to design learning environments that are conducive to blended learning.

Strengthening the planning and design of Objective Structured Clinical Examinations

Thandolwakhe Nyangeni, Wilma ten Ham-Baloyi, Dalena R.M. van Rooyen — Wed, 15 Jan 2025 00:00:00 +0000

Background: Although Objective Structured Clinical Examinations (OSCEs) offer innovative, objective, and fair methods of clinical assessment, their quality is compromised by poor planning and design.

Aim: This study aimed to describe the development and present evidence-based recommendations on strengthening the planning and design of OSCEs for a South African public College of Nursing.

Setting: A South African public College of Nursing.

Methods: Recommendations were developed based on synthesising two sets of qualitative data. Set 1 included two main themes with each of the four sub-themes related to barriers and facilitators towards quality in OSCE designs from 14 nurse educator interviews and 15 external moderator reports. Set 2 included 12 quality measures to be adopted in the quality design of OSCEs derived from an integrative literature review. The draft recommendations were reviewed by eight experts to be finalised.

Results: Seven recommendations were developed for strengthening OSCEs’ planning and design, related to: (1) policy framework, standard operating procedures and stakeholder code of conduct; (2) blueprinting and mapping of the OSCE content; (3) developing a bank of OSCE stations; (4) scoring rubric and standard-setting method selection; (5) examiners and standardised patients’ recruitment and training; (6) venue selection; and (7) station piloting.

Conclusion: The seven developed recommendations can strengthen the quality of OSCEs in the South African public College of Nursing context.

Contribution: The developed recommendations can assist nurse educators in planning and designing to conduct quality OSCEs following piloting and implementation.

Facilitation of constructive intra- and inter-personal relationships: A concept analysis

Andile G. Mokoena-De Beer — Wed, 15 Jan 2025 00:00:00 +0000

Background: The researcher’s previous study indicated that couples in a relationship where one partner is diagnosed with borderline personality disorder (BPD) experience intra- and inter-personal difficulties affecting interaction with self and others. Therefore, constructive
intra- and inter-personal relationships are essential to facilitate the mental health of couples in a relationship where one partner is diagnosed with BPD. However, the concept has not been defined and applied in caring for such couples.

Aim: The study aims to clarify its meaning by identifying and defining the central concept of ‘facilitation of constructive intra- and inter-personal relationships’.
Setting: The researcher used results from a previous study that explored the experiences of couples in a relationship where one partner is diagnosed with a mental illness to identify and define the central concept.

Methods: The concept was examined using analysis, synthesis, and inductive reasoning strategies, which were applied in two phases.

Results: The central concept of ‘facilitation of constructive intra- and inter-personal relationships’ for couples where one partner is diagnosed with BPD was identified and defined using a dictionary and subject definitions.

Conclusion: Identifying and defining the central concept is essential to developing a model to facilitate constructive intra- and inter-personal relationships.

Contribution: The concept ‘facilitation of constructive intra- and inter-personal relationships’ is unique in its form and valuable for developing a model that can be used as a guiding tool for psychiatric nurses to facilitate the mental health of such couples. Furthermore, the model could benefit other relationships experiencing intra- and inter-personal challenges.

Guardians’ involvement in the management of childhood illnesses in Vhembe district, Limpopo

Livhuwani Tshivhase, Tshifhiwa A. Magavha, Sophy M. Moloko — Wed, 15 Jan 2025 00:00:00 +0000

Background: Guardians’ involvement in the management of childhood illnesses plays a pivotal role in reducing mortality and morbidity among children under 5 years old. It is through the guardian’s eyes that the child can be afforded timely healthcare, prevented
from contracting an illness and effectively taken prescribed medication.

Aim: The study aimed to explore the guardians’ lived experiences in their involvement in managing childhood illnesses in Vhembe district, Limpopo province, South Africa.

Setting: A qualitative, exploratory and descriptive study was conducted with 16 purposively sampled participants.

Methods: One-on-one individual interviews were conducted with participants. Data were analysed following Braun and Clarke’s thematic analysis.

Results: Guardians reported their involvement by seeking child healthcare in healthcare facilities when ill and due for immunisations. Involvement in childhood care is performed through assessment of child illness at home, follow-up, referral of children to healthcare
facilities, promotion of child health and prevention of childhood illnesses.

Conclusion: Children remain dependent on guardians for their well-being. Seeking care, preventing illnesses and promoting childhood health are vital in reducing child mortality and childhood morbidity.

Contribution: Involving and empowering guardians regarding the care of children under 5 years old are vital in achieving Sustainable Development Goal number 3 in 2030.

Nursing students’ perceptions and attitudes towards dementia care in Namibia

Nestor Tomas, Andrias M. Mangundu — Wed, 15 Jan 2025 00:00:00 +0000

Background: Dementia is a significant public health concern and a leading cause of disability and dependency among elderly individuals globally. However, there is currently limited research examining the perceptions and attitudes of healthcare providers, including nursing students, in Namibia.

Aim: This study aimed to examine nursing students’ perceptions and attitudes of caring for patients with dementia.

Setting: The study was conducted at two university campuses in Namibia.

Methods: A quantitative correlational design was employed to conveniently recruit 196 third-and
fourth-year nursing students between April and August 2023, utilising the Geriatric In-Hospital Nursing Care Questionnaire (GerINCQ) online survey. Data were analysed using SPSSv28 for descriptive and inferential statistics.

Results: The perception score ranged from 2.26 to 2.43, indicating negative attitudes and perceptions towards dementia care. The highest mean perception of 2.43 (95% CI = 2.3–2.55) was on reacting to challenging behaviour and the lowest was on professional
responsibility 2.26 (95% CI = 2.12–2.4). Correlations were observed between age and performed interventions (r = 0.66; p = 0.01) and gender and dementia-sensitive care
(r = 0.52; p = 0.01).

Conclusion: The study revealed unfavourable attitudes and perceptions towards dementia care among nursing students, contrary to the optimistic anticipation. The results highlight the urgent need to develop and integrate dementia care strategies and practices into nursing education curricula.

Contribution: This study provides valuable data for informing quality assurance initiatives aimed at improving nursing training in dementia care.

Physical fitness profile of primary school learners in the Eastern Cape province of South Africa

Howard Gomwe, Lesego Phiri, Chioneso S. Marange — Wed, 15 Jan 2025 00:00:00 +0000

Background: Low levels of physical activity in high- to low-income countries, including South Africa, pose a great risk of cardiovascular-related diseases.

Aim: This study aimed to assess and compare the physical fitness profile among children.

Setting: The study setting comprised rural and urban primary school learners in the Eastern Cape province, South Africa.

Methods: A cross-sectional study was adopted utilising a randomly selected sample of boys and girls aged 9–14 years. Physical fitness measures were assessed using the Euro-fit test battery. Some parametric tests were used for mean comparisons of the various anthropometric measurements and physical fitness characteristics across demographics.

Results: The sample consisted of 870 primary school learners. The average weight and height of the sample were 39.29 ± 10.34 kg and 144.06 ± 10.81 cm, respectively, with a mean body mass index (BMI) of 18.80 ± 4.11 kg/m². The results showed that boys reported significantly high levels of physical fitness. Sit-ups (p ≤ 0.001) and VO2 max (p ≤ 0.001) significantly increase with age, while all the physical fitness measures were significantly higher among rural-based learners.

Conclusion: Rural-based learners and boys generally had better physical fitness performance than their peers. The effect of gender and place of residence should be considered when designing physical fitness interventions.

Contribution: This study adds to the existing body of knowledge about the effect of demographic factors on the physical fitness profile of children, where boys and rural-based learners are reported to be more physically fit than their counterparts.

Micronutrient and antinutrient content of semiprocessed fruit peels: Towards boosting immunity

Eridiong O. Onyenweaku, Hema Kesa — Wed, 15 Jan 2025 00:00:00 +0000

Background: Fruits are excellent sources of micronutrients; hence, their consumption is highly recommended. However, fruit peels, often discarded, despite some being edible have been reported to contain essential nutrients and antioxidants, which contribute to disease prevention and well-being.

Aim: This study sought to evaluate the micronutrient and antinutrient content of 10 edible fruit peels namely, orange, mango, pineapple, banana, lemon, mandarin, red apple, cucumber, guava and pawpaw peels.

Setting: Laboratory analyses of the fruit peels were conducted at the University of Calabar, in a well-ventilated and temperature controlled environment to ensure accurate results.

Methods: The research design was quantitative and experimental; laboratory analyses were carried out to determine the minerals, vitamins and antinutrients in fruit peels using AOAC standard methods. Data were analysed using ANOVA on SPSS version 20.0.

Results: Calcium was the most predominant of the minerals analysed, with values ranging from 33.12 ± 0.05 mg/100 g (cucumber peels) to 72.04 ± 0.08 mg/100 g (mango peels); calcium was followed by magnesium. Mandarin, banana and pineapple peels had statistically similar (p > 0.05) content of zinc (about 1.2 mg/100g), which was significantly (p < 0.05) higher than others. Mandarin peels had significantly higher content (100.48 ± 2.03 mg/100 g) of vitamin C, while cucumber peels recorded the lowest (27.50 ± 0.01 mg/100 g). The results show significant concentrations of micronutrients such as iron, selenium and vitamin K; among the antinutrients, hydrogen cyanide had the highest concentrations, followed by phytate. The values were
within safe limits.

Conclusion: Therefore, the processing of fruit peels, for use as dietary additives to enrich foods and boost immunity, should be promoted.

Contribution: The study shows the potential of fruit peels as food additives.

Nutrition knowledge and practice of midwives in Botswana

Anastacia Masesane, Thembekile Dhlamini, Maria Nnyepi, Xikombiso Mbhenyane — Wed, 15 Jan 2025 00:00:00 +0000

Background: The roles and responsibilities of midwives include providing adequate nutrition assessment, nutrition and health education, counselling, and support to pregnant women.

Aim: This study aims to assess midwives’ nutrition knowledge and to what extent they integrate maternal nutrition in services provided at health facilities.

Setting: This study included hospitals and clinics within the three selected districts in Botswana.

Methods: A cross-sectional study design with an analytical component was employed. Direct observation through a checklist and a structured interviewer-administered questionnaire were used. Data were analysed using SPSS IBM version 26.

Results: A sample of 102 midwives participated, resulting in a response rate of 82%. Most of the participants were females (89.2%). Maternal nutrition knowledge was found to be variable but decreased with midwives’ age. A statistically significant correlation coefficient of p < 0.005 at r = –0.278 was observed between maternal nutrition knowledge and age.
Similarly, there was a statistically significant negative correlation between maternal nutrition knowledge, practices and maternal nutrition course attended using Pearson correlation (r = –0.217 p < 0.028).

Conclusion: Midwives had adequate to variable but declining maternal nutrition knowledge and practices with age. There is a need to provide midwives with refresher courses, as their nutrition knowledge and practices were related with courses attended.

Contribution: The study contributes to provide the literature concerning nutrition knowledge and practices of midwives. The results will assist in addressing the gaps encountered and lead to the improvement of maternal nutrition and pregnancy outcomes.

HIV and sexual risk behaviours by 18-25-yearold youth at Nyandeni Municipality in the Eastern Cape

Lorraine N. Mntonintshi- Mketo, Robert T. Netangaheni, Moganki H. Lefoka — Wed, 15 Jan 2025 00:00:00 +0000

Background: The human immunodeficiency virus (HIV) epidemic in South Africa is among the worst in the world; in 2017, 38% of new infections were among young people aged 15–24 years. Estimates for HIV infection in 2020 worldwide indicate that there will be 1.5 million new cases, 10.2 million untreated cases (out of 37.7 million), and 680 000 deaths from acquired immunodeficiency syndrome (AIDS). Despite a 46% decline in new HIV infections among adolescents and youth over the previous 10 years, two of the seven new HIV infections in 2019 occurred in people between the ages of 15 and 24. HIV prevalence among young people has remained unchanged since 2008. This consistent pattern among people under 30 years of age indicates a failure in HIV prevention.

Aim: The study aimed to explore HIV and sexual risk behaviours by 18–25-year-old youth at Nyandeni Municipality in the Eastern Cape province.

Setting: The investigation was conducted Nyandeni Municipality in the Eastern Cape province.

Methods: Qualitative approach was used to explore, describe and investigate the knowledge and attitudes about HIV among the 18–25 years old youth

Results: The findings are based on three themes namely, knowledge and attitudes about HIV and AIDS in youth, sexual risk behaviour among youth, and HIV prevention strategies.

Conclusion: This exploratory investigation confirms that the participants’ knowledge is limited by showing that most of them knew very little about HIV and AIDS infection and prevention. Ongoing educational initiatives are required.

Contribution: Youth experience high HIV incidence because of their knowledge gaps.

Radiography managers’ perceptions on skills required in public health institutes in Gauteng

Joseph L. Mopeli, Portia N. Ramashia, Lynne J. Hazell — Wed, 15 Jan 2025 00:00:00 +0000

Background: Management of radiography departments requires skilled and competent managers. This task becomes complex if there is no management development and collaborative performance monitoring.

Aim: The study aimed to explore and describe the radiography managers’ perceptions regarding management training and skills required.

Setting: The research was conducted in public health institutions of Gauteng, South Africa.

Methods: Qualitative, exploratory and descriptive approach was adopted, and a purposive sampling method was used to select twenty-three (23) managers from the radiography departments; however, data saturation guided the sample size. Data were collected through online focus group discussions (FGDs). Ethical approval was obtained through Departmental Research Committee (DRC) of Medical Imaging and Radiation Sciences (MIRS) department, Higher Degrees Committee (HDC), Research Ethics Committee and Gauteng Department of Health Research Committees. Data trustworthiness was obtained through member checking, data verification and an independent coder to verify the accuracy of the data. Thematic data analysis method was used to analyse the data.

Results: Five themes emerged from the thematic analysis and centred on: difficulties in transitioning into management, lack of management support, the need for post-graduate management qualification, coaching and mentoring and required skills for radiography
managers.

Conclusion: Public health institutions continuously face transitions in service delivery frameworks. This requires competent and skilled radiography managers to survive in this environment. The study revealed that new managers experience difficulties and require management support to succeed in their roles.

Contribution: Awareness of managers developmental needs relative to the real-life dynamics of radiography management in Gauteng public health environment.

Physiotherapy students’ and officers’ knowledge, attitudes, and perceptions of mental health

Marilyn Hooblaul, Oladapo M. Olagbegi, Thayananthee Nadasan — Wed, 15 Jan 2025 00:00:00 +0000

Background: Physiotherapy in mental health is not very popular among physiotherapists, students, healthcare professionals, and people living with mental illness (PLWMI), although many PLWMI are managed by physiotherapy students and physiotherapists.

Aim: This study aimed to determine the knowledge, attitudes, and perceptions of physiotherapy students and physiotherapy community service officers (PCSOs) towards mental health.

Setting: The study was conducted in KwaZulu-Natal (KZN).

Methods: A concurrent mixed-method was employed using the Attitudes Toward Psychiatry (ATP-30) questionnaire and focus group discussions. The questionnaire was distributed to 100 PCSOs and 191 physiotherapy students. Focus groups were conducted to assess the knowledge gained through the undergraduate programme, comprising three groups of students from second to fourth year and two groups of PCSOs. An interview was also conducted with one
PCSO.

Results: A total of 146 students and 72 community service officers completed the questionnaire. Participants had an overall positive attitude, with a mean ATP-30 score of 108.02 (standard deviation [s.d.] = 10.86). Those with a family member or friend with a mental illness scored higher. Focus groups revealed limited knowledge about mental health and reluctance to work in the field.

Conclusion: Physiotherapy students and PCSOs in KZN had positive attitudes towards mental health despite limited knowledge. They expressed a desire for more information about mental health.

Contribution: The curriculum needs to include adequate mental health content to prepare students to manage PLWMI after graduation, reducing stigma, and negative perceptions, and ensuring confidence.

Experiences of primary eye care use among adults in Southern Ethiopia: A qualitative study

Temesgen W. Kentayiso, Naomi L. Nkoane, Kholofelo L. Matlhaba — Wed, 15 Jan 2025 00:00:00 +0000

Background: Primary eye care (PEC) is an important component of comprehensive eye care services that allows communities to enjoy basic high-quality services. However, because of various determinants, communities do not use this service.

Aim: This study aimed to explore and describe the experience of adults who used PEC services in the last 6 months.

Setting: This study was carried out in four districts in southern Ethiopia from June to September 2023.

Methods: An exploratory descriptive qualitative study design was used to understand the experiences of adults 40 years and older who had used PEC services. Six focus group discussions were conducted with a total of 48 participants. A nonprobability purposive sampling technique was used to draw participants. Data were analysed thematically using ATLAS.ti software version 23.2.2.

Results: Primary eye care service use experiences of adults 40 years and above were discussed in terms of three emerging themes: the experience of community service use, barriers to service and suggestions to improve service. The study identified poor access to services, service provider-related factors and quality and awareness gaps as barriers to the use of PEC services.

Conclusion: Attention to PEC services, integration of eye care with other primary health care services, deployment of service providers, awareness creation and expansion of PEC units are needed to improve PEC service use.

Contribution: The findings will guide community-based intervention plans to reduce avoidable blindness and low vision, thus improving quality of life.

Experiences of occupational nurses regarding non-adherent mineworkers with chronic illnesses

Lorato G. Manyeneng, Mogale L. Pilusa — Wed, 15 Jan 2025 00:00:00 +0000

Background: Occupational nurses continue to provide service to mineworkers diagnosed with chronic illnesses, however, non-adherence to medication is prevalent, cause overcrowding, long queues and admission at hospitals as they become sick.

Aim: This study aimed to describe the experience of occupational nurses (ONs) regarding non-adherence to medication among mineworkers diagnosed with chronic illnesses.

Setting: The study was conducted at a selected mine in Gauteng province, South Africa.

Methods: A qualitative, exploratory, descriptive design that is contextual in nature, was used with a phenomenological approach. Thirteen ONs were purposively sampled and individual face-to-face interviews were conducted until data saturation was reached. Thematic analysis using ATLAS.ti 24 software was applied to analyse the data collected. The researcher and the independent coder held a consensus discussion and agreed on the themes and the sub-themes.

Results: Two themes and various sub-themes emerged along with Care-related challenges linked to the mineworkers and challenges related to the provision of service to mineworkers. Data analysed indicated that the ONs had varying but often similar perspectives regarding non-adherence to medication among mineworkers diagnosed with chronic illnesses.

Conclusion: Non-adherence to medication is prevalent among mineworkers diagnosed with chronic illnesses and improving the mineworkers’ outcomes requires addressing the issue of non-adherence to primary medication.

Contribution: This study highlights the importance of adhering to prescribed medication among mineworkers diagnosed with chronic illnesses to ensure quality of life.

Challenges experienced by nurses in implementing Adolescent and Youth Friendly Services in clinics of the Limpopo province

Wed, 15 Jan 2025 00:00:00 +0000

Background: Effective implementation of Adolescent and Youth Friendly Services (AYFS) that are accessible, acceptable and effective for diverse youth population groups is significant to enhancing youth health. Because of various factors, improving youth health is a challenge
in clinics in rural areas.

Aim: This study aims to explore and understand the challenges nurses experience while implementing AYFS programmes in Kganya local area clinics of the Capricorn district, Limpopo province, South Africa.

Setting: The study was conducted in the clinics of Kganya local area of Capricorn district, Limpopo province, South Africa.

Method: A qualitative, phenomenological, exploratory, descriptive design is employed in this study. Twelve nurses were selected using purposive sampling. Data were collected through semi-structured interviews with an interview guide. Notably, data were analysed using
Tesch’s open coding method.

Results: Two themes emerge from this study: ‘Challenges experienced related to the implementation of Adolescent and Youth Friendly Services’ and ‘Suggestions to improve Adolescent and Youth Friendly Services’.

Conclusion: The results of this study confirm that nurses experience diverse challenges while implementing AYFS. Challenges include a lack of trained staff and material resources and the negative attitudes of adolescents, parents and community members.

Contributions: This study’s findings might help identify the gaps in implementing the AYFS programmes. The findings may assist policymakers and the National Department of Health (NDoH) to monitor and review the effectiveness of the AYFS programme standards.

Effectiveness of group work among the final radiography students of the National Diploma

Kealeboga P. Menwe, Lynne Hazell, Heather A. Lawrence — Wed, 15 Jan 2025 00:00:00 +0000

Background: Group work is employed in higher education institutions to foster communication, collaborative learning, leadership qualities and teamwork skills. The rationale behind group work as a learning strategy is to ensure that graduates are equipped with teamwork skills.

Aim: The aim of this study was to establish whether the final-year radiography students of the National Diploma curriculum in three universities in South Africa were exposed to effective group work.

Setting: The study was conducted in three universities in South Africa, all of which offer diagnostic radiography programmes.

Methods: This study used a non-experimental descriptive design to collect data. A purposive sampling technique was used to select participants. This was an attempt to conduct a census on 167 students, out of which 124 students responded to the questionnaire, giving a response rate of 74.25%.

Results: The findings show that the majority (n = 81; 66.9%) of students did not enjoy group work, as 101 (81.5%) of them preferred less group projects. The results further demonstrated that participants rated factors such as co-operation, leadership, choice, diversity and effectiveness of group work neutral on the Likert scale.

Conclusion: The study results imply that factors that contribute towards the effectiveness of group work should be incorporated into group activities in order for student radiographers to be exposed to effective group work. The gaps identified in this study indicate the need for a follow-up study within the current 4-year bachelor’s degree in radiography.

Contribution: Identification of a gap in radiography education, which group work needs to be facilitated effectively.

Theory of optimising radiation protection among diagnostic radiographers depicted as a model

Shantel Lewis, Charlene Downing, Christopher M. Hayre — Wed, 15 Jan 2025 00:00:00 +0000

Background: When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices.

Aim: Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers.

Setting: The study was conducted in South Africa.

Methods: A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated.

Results: The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model’s purpose, assumptions, context, structure and process are described.

Conclusion: A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection.

Contribution: In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

The family and substance abuser in the mental health institution environment

Ruwayda Jacobs, Johanita Strumpher — Wed, 15 Jan 2025 00:00:00 +0000

Background: South African drug usage demographics are rare. Substance abuse disorder patients and their families have complex interactions. This study examines family members living with drug addict.

Aim: The study seeks to investigate the experiences of family members living with a substance use disorder (SUD) individual.

Setting: The research took place in a Gqeberha psychiatric facility. Low-income households were interviewed.

Methods: This research is qualitative, exploratory, and descriptive study. Recorded and transcribed in-depth patient family interviews were collected. Qualitative thematic analysis was used to analyse data. The data themes were interpreted using family systems theory.

Results: Each of the three main themes has subthemes. The first theme concerns family members’ inadequate comprehension of addiction. The subtheme explores family members’ denial and failure to recognize substance use disease symptoms. The second theme concerns variations in behaviour that challenge cultural norms. This subtheme addresses hallucinations, delusions, and fury in SUD patients. The third theme addresses the negative effects of drug use on families, potentially leading to divorce. This subtheme focuses on the family’s lack of awareness of resources that may have supported them and the SUD individual.

Conclusion: Immediate family members are crucial to patient recovery. The family seemed to be struggling living with an SUD relative. Experts should help the family to manage the addict’s treatment. Healthcare education can help families cope with substance abusers.

Contribution: This study will assist the nursing administration in discovering ways to help families manage a loved one with an SUD.

Utilisation of maternal healthcare services and influencing factors in public health facilities in Addis Ababa, Ethiopia

Sintayehu A. Temesgen, Thinavhuyo R. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: Ethiopian maternal mortality remains high, despite the implementation of extensive health programmes. This indicates that the full potential of maternal health services is not being effectively utilised.

Aim: This study aimed to evaluate the utilisation and factors influencing maternal healthcare services in public health facilities in Addis Ababa.

Setting: This study was conducted in five public hospitals and 10 public health centres of Addis Ababa city administration from 31st August 2023 to 13th October 2023.

Methods: The study’s design utilised a cross-sectional quantitative technique, which involved interviewing 354 women from each group who received visits throughout their pregnancy, delivery and postpartum period. The data were analysed using SPSS version 26.

Results: This study analysed maternal health service utilisation indicators, revealing a 70.8% overall utilisation of services, with antenatal care (ANC) at 85.5%, delivery at 71.58% and family planning services (PNC) at 55.4%. The study found that the length of time spent travelling to public health facilities significantly impacts the use of maternal health services. Pregnant women who travelled less than 30 min used services 2.29 times more than those over 2 h. The average client wait time also influenced service usage. Pregnant women with four or more prenatal care visits were more likely to use services.

Conclusion: The study conducted in Addis Ababa’s capital city revealed that the utilisation of maternity health care services is not optimal, despite the concentrated resources.

Contribution: The findings of the study could be beneficial for the Addis Ababa Health Bureau, Ministry of Health, legislators, and other stakeholders. It can help in the development of affordable intervention programmes, filling knowledge gaps and updating scientific understanding.

Factors influencing nursing students’ learning in a clinical skills laboratory

Catherine M. Hoffman, Juliana Willemse — Wed, 15 Jan 2025 00:00:00 +0000

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.

Experiences of nurses studying towards post-basic qualifications during COVID-19 in KwaZulu-Natal

Dudu G. Sokhela, Kathleen Nokes, Penelope M. Orton — Wed, 15 Jan 2025 00:00:00 +0000

Background: The COVID-19 pandemic caused abrupt closure of schools including higher education institutions. The transition from in-person to virtual teaching platforms caused challenges for frontline nurses in post-basic programmes. Nurses were forced to divide their efforts between responding to the pandemic and their studies.

Aim: The study aims to describe the experiences of nurses studying post-basic qualifications during COVID-19 in KwaZulu-Natal.

Setting: The setting comprised virtual platforms such as closed social media groups (nursing colleagues and South African Society of Occupational Health Nurses Facebook) and Microsoft Teams or WhatsApp calls.

Methods: A qualitative descriptive design using individual virtual interviews with eight nurses working in healthcare settings while studying post-basic qualifications. The framework was Fullan’s Change Theory in educational settings. Data were analysed using applied thematic analysis.

Results: Four themes were identified; transitioning from in-person to online teaching and learning, challenges in clinical placements, support to achieve educational goals, and unique aspects of studying and caring for infected patients and 10 sub-themes emerged.

Conclusion: Participants found benefits of online learning despite challenges with the Internet network. There was a shortage of mentors, and personal protective equipment in clinical settings; however, participants were cognisant of the duty to care for infected patients notwithstanding personal risk of infection.

Contribution: Nurses were at the frontline of the pandemic yet facing challenges in clinical facilities and their studies. The study could contribute to understanding participants’ experiences, which might help with response planning in future pandemics.

Adolescent girls’ sexual and reproductive health information needs and barriers in Cape Town

Natheerah Holtman, Million Bimerew, Katlego Mthimunye — Wed, 15 Jan 2025 00:00:00 +0000

Background: The sexual and reproductive health (SRH) information needs of adolescent girls in developing countries are not being met.

Aim: The study explored the sexual and reproductive health information needs, information-seeking behaviour and barriers among adolescent girls in the Western Cape, South Africa.

Setting: The study was conducted in the South eastern sub district of Cape Town metropole.

Methods: The study was conducted at one of the high schools in a highly populated area in the Cape Town metropole. Semi-structured interviews were conducted with 17 adolescent girls aged 16–17 years, who were recruited using purposive sampling techniques. The interviews were audio recorded and transcribed verbatim. Data were analysed using an inductive
thematic analysis framework.

Results: Three themes emerged from the data: (1) adolescent girls exhibit limited awareness and comprehension of sexual and reproductive health; (2) the information-seeking behaviours of adolescent girls regarding sexual and reproductive health and (3) barriers to seeking information.

Conclusion: The establishment of primary healthcare facilities that are friendly to adolescents, combined with impactful reproductive health education and improved parent–adolescent girl relations, is crucial for promoting sexual and reproductive health among adolescent girls.

Contribution: The study offered valuable insights into the SRH information needs, information-seeking behaviour and barriers faced by adolescent girls in accessing SRH information sources and services. These barriers include lack of knowledge about SRH and contraception, challenges within family dynamics, difficulties accessing friendly healthcare services and encountering negative attitudes from healthcare
professionals.

Professional nurses’ perspectives of an ideal performance management process

Sibonelo Ndlovu, Neltjie C. van Wyk, Ronell Leech — Wed, 15 Jan 2025 00:00:00 +0000

Background: A well-managed performance management process can significantly influence professional nurses’ job satisfaction and improve patient outcomes. Conversely, ineffective management of the process can lead to demotivation of the nursing staff.

Aim: This study aimed to understand professional nurses’ perspectives on an ideal performance management process.

Setting: The study was conducted in a designated hospital in South Africa owned by a private healthcare group. The study population consisted of professional nurses involved in a performance management cycle.

Methods: A descriptive qualitative research design with an appreciative inquiry approach was employed. Participants were selected through purposive sampling. Five focus groups of five professional nurses each were used to conduct interviews. The interviews lasted between 60 min and 80 min. The number of interviews conducted provided sufficient data for data saturation.
The data were analysed using thematic analysis and the 5-D model of appreciative inquiry.

Results: Trusting relationships between management and professional nurses play an essential role in ensuring a tailored performance management process. Training of both professional nurses and managers, a sound reward system for high-performing employees, and a fair and transparent process that addresses challenges and promotes opportunities can promote a
positive work environment.

Conclusion: Professional nurses require support from their managers and top management. Involving professional nurses in the planning and implementation can ensure proper relationships exist and that constraints are appropriately addressed.

Contribution: Implementing the findings can improve the competencies of both managers and professional nurses to maintain a positive performance management process.

Perceptions of the MDT towards the health needs and support for grandparents caring for AIDS orphans

Furaha Akimanimpaye, Million S. Bimerew, Isaiah D. Owoeye, Deliwe R. Phetlhu — Wed, 15 Jan 2025 00:00:00 +0000

Background: The acquired immunodeficiency syndrome (AIDS) crisis has orphaned many children, shifting care giving duties to grandparents. This has challenged the health of the grandparents, underscoring the need for support in caring for both the grandparents and the
children orphaned due to AIDS.

Aim: This study investigated the multidisciplinary team’s (MDT) perceptions of health needs and support for grandparents caring for children orphaned due to AIDS.

Setting: The study took place within Metropolitan area in the Western Cape Province, South Africa.

Methods: A cross-sectional descriptive survey was used to assess health needs and support for grandparents caring for children orphaned due of AIDS. A sample of 65 MDT members comprising professional nurses, psychologists and social workers participated in the study.

Results: The assessment revealed moderate awareness (mean 2.79) among MDT regarding the health needs of grandparents caring for the orphans. Key concerns were a lack of income (mean = 4.9) and no access to health services (mean = 4.8), with low awareness and involvement in organisational support (mean = 1.8).

Conclusion: Despite an awareness of the health needs and support perceptions among grandparents, there remains a significant gap in the availability of support structures to address these needs. The study highlights the critical necessity for developing robust support systems to enhance the well-being of grandparents, especially those caring for AIDS orphans, ensuring they receive the comprehensive care and assistance required.

Contribution: The study’s findings provide key insights for supporting grandparents who are caring for AIDS orphans via a MDT approach.

Implementation facilitators and barriers of person and family-centred emergency

Mari-Louise Joubert, Neltjie C. van Wyk, Ronell Leech — Wed, 15 Jan 2025 00:00:00 +0000

Background: At the time of the research, the nurses in the designated hospital’s emergency department did not implement person- and family-centred care to the detriment of patients and families. They were, however, eager to embark on the implementation of the recommendations of the Registered Nurses Association of Ontario for person- and family-centred care.

Aim: This study therefore aimed to explore and describe the possible implementation facilitators and barriers prior to the use of the association’s recommendations.
Setting: The study included eight nurses with different specialisation fields and more than 5 years of experience in an emergency department.

Methods: During focus group interviews with nurse participants, the domains of the Consolidated Framework for Implementation Research were used to explore whether the recommendations of the Registered Nurses Association of Ontario could be used to structure person- and family-centred care in the emergency department of the designated hospital in the Mpumalanga province in South Africa. The framework guided the deductive data analysis.

Results: The identified facilitators referred to a positive match between the recommendations and existing practice in the department. The barriers referred to the department’s fast-paced work environment in which a combination of emergency and primary care is delivered.

Conclusion: One of the facilitators referred to the participants being used to ongoing training by and communication from management to support their adjustment to improvements. One of the barriers referred to the department’s fast-paced work environment.

Contributions: The article contributes to practice improvement with a description of the use of frameworks to explore possible facilitators and barriers prior to endeavours to implement recommendations.

Sense of coherence in students while studying abroad

Claude-Hélène Mayer, Jeff Larsen — Wed, 15 Jan 2025 00:00:00 +0000

Background: In the 1970s, medical sociologist Aaron Antonovsky developed the concept of salutogenesis, which is the study of health and development focusing on sense of coherence (SOC). Although salutogenesis has been well researched in higher education contexts, the concept has not been studied in depth in intercultural and cross-cultural settings, such as the
one provided by semester at sea (SAS), which is a United States (US) study-abroad programme.

Aim: The aim was to investigate and compare levels of SOC in students in the SAS study-abroad programme.

Setting: The research was conducted during a selected voyage at sea over a period of 106 days.

Methods: The authors used a quantitative cross-sectional correlational design and investigated mean score differences in three SOC sub-scale scores measuring meaningfulness, comprehensibility, and manageability. The authors compared US students’ SOC scores to those of students from other countries and compared the scores of women to men. Measurement
invariance was firstly established before investigating mean score differences. Data were collected in the form of a survey, using Antonovsky’s 29-item Life Orientation Questionnaire.

Results: The study shows that overall scores in meaningfulness were the highest, followed by manageability and comprehensibility, which potentially supports the idea that the motivational component in life of these students is the most important. Finally, women scored higher in meaningfulness than men.

Conclusion: The study can provide insights in SOC in students and might provide implications for interventions regarding SOC results across diverse student populations in SAS.

Contribution: This article contributes to SOC research in study-abroad programmes.

Dietary habits among primary school learners in the Tshwane West District of Gauteng, South Africa

Morentho C. Phetla, Linda Skaal, Kiprano P. Chelule — Wed, 15 Jan 2025 00:00:00 +0000

Background: Poor dietary habits are major contributors to malnutrition globally, particularly in children living in African countries. The widespread transition from African diet of healthy indigenous foods to a nutrient-poor Western-style diet is well-documented in global societal culture.

Aim: This study aimed to assess the dietary habits and their nutritional implications among learners in public primary schools.

Setting: City of Tshwane, located in the Gauteng province of South Africa.

Methods: This was a quantitative cross-sectional study where researcher-administered questionnaire was used to collect data from 814 primary school learners in grades 4–7. Anthropometric data were also collected. The study was conducted in 10 primary schools in
the City of Tshwane.

Results: Unhealthy dietary practices were observed where consumption of refined carbohydrates, sugar-filled beverages and limited protein was prevalent. The prevalence rates for overweight and obesity were 15.1% and 11.3%, respectively. Most learners (77.4%) purchased foods from street vendors and tuckshops. Also, learners who knew about healthy eating were less likely to be underweight than those who did not (OR: 0.35; 95% CI: 0.14–0.85; p = 0.020).

Conclusion: Poor dietary habits are demonstrated in this study and may be associated with the rising levels of overweight and obesity among the learners. The findings also showed that the school environment is the main source of exposure to unhealthy diet.

Contribution: Intervention strategies, such as amendment of the national school nutrition policy, need to be implemented.

Describing Zoom exhaustion and fatigue in nursing students at a university in South Africa

Waheedha Emmamally, Dorien Wentzel, Petra Brysiewicz — Wed, 15 Jan 2025 00:00:00 +0000

Background: Online platforms have gained considerable support from students and lecturers post COVID-19, however they are associated with student exhaustion and fatigue.

Aim: To determine Zoom exhaustion and fatigue in nursing students at a selected university in South Africa.

Methods: A quantitative cross - sectional study was conducted in KwaZulu-Natal to collect data from 146 nursing students registered at the selected university for the 4-year Bachelor of Nursing programme. The Zoom Exhaustion and Fatigue Scale collected data on responses to domains of general fatigue, visual fatigue, social fatigue, motivational fatigue, and emotional fatigue. The data were analysed using the International Business Machines, Statistical Package for Social Sciences, version 26.0. Descriptive statistics were calculated for demographics, a total score was calculated and mean scores and 95% confidence
intervals for the different domains were calculated. Mann Whitney U and Kruskal Wallis Independent Tests were calculated to determine associations between demographics and Zoom usage.

Results: The overall Zoom exhaustion and fatigue score was 46.71 (s.d. = 10.50). The motivational fatigue construct had the highest mean score of 3.29 (s.d. = 0.83), followed by general (3.18 s.d. = 0.81), social (3.11, s.d. = 0.88), emotional (3.06, s.d. = 0.99) and visual
fatigue (2.92, s.d. = 0.94).

Conclusion: The study concluded that while the overall mean score indicated moderate levels of Zoom exhaustion and fatigue among respondents, majority of the respondents scored high levels (> 48) of Zoom fatigue. Students reported higher levels of motivational fatigue compared to the other 4 constructs.

Identifying legitimate websites selling medicines in South Africa

Wed, 15 Jan 2025 00:00:00 +0000

Background: The online sale of medicines has skyrocketed globally, where medicines are purchased in the comfort and privacy of one’s own home. However, there are an increasing number of illegal websites selling counterfeit and falsified medicines.

Aim: The aim of this study was to review the information and medicines sold online through pharmacy websites in South Africa (SA) and their compliance with local legislation.

Setting: The study setting comprised online pharmacy websites in SA.

Methods: This quantitative descriptive study used a purposeful questionnaire based on the South African Pharmacy Council inspection questionnaire for pharmacies operating websites. Websites claiming to be an online pharmacy in SA were included.

Results: There were 25 websites reviewed, which claimed to be online pharmacies. Majority (n = 22) were found to be legal websites, operated by a registered community pharmacy and required a prescription for the purchase of prescription only medicines. Few websites complied with legislation such as displaying the Y number (n = 5) and name of the responsible pharmacist (n = 10). The remaining three websites were not linked to physical pharmacies, none complied with legislation and supplied medicines without a prescription.

Conclusion: Although the online sale of medicines is regulated in SA, not all websites complied with legislation. The study highlighted the importance of monitoring websites claiming to be online pharmacies and their compliance with legislation.

Contribution: Four stakeholders, consumers; pharmacy websites; regulators and healthcare providers, were identified and their role outlined in promoting the safe online purchasing of medicines.

Considering patient-centred care and patient empowerment as essential to quality health care delivery in Ghana

Ruby V. Kodom, Robert T. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: Rising cases of non-communicable diseases (NCDs), poor health choices, mistrust of the health system, self-medication, resistance of diseases to medication and dissatisfaction with the service experience serve as red flags on the path to Universal
Health Coverage (UHC).

Aim: This study explored the importance of patient-centred care (PCC) and patient empowerment (PE) within the context of healthcare service delivery in Ghana.

Setting: The study considered PCC and PE from the perspective of three public healthcare facilities within the Greater Accra region.

Methods: The researcher adopted a qualitative exploratory research approach. The study employed purposive sampling for the selection of healthcare facilities and healthcare providers. Convenience sampling was applied to select patient participants. A total of 33 in-depth interviews and 4 focus group discussions (FGDs) were conducted across the three sampled facilities as part of the data collection process.

Results: Healthcare providers and patients unanimously view quality as essential for effective healthcare delivery. The application of the capacitating role of PE and PCC is inexact and largely left to subjective interpretation.

Conclusion: The Ministry of Health (MOH) has recognised that patient experiences, a key indicator of care quality, have often been suboptimal and is actively working to address these weaknesses.

Contribution: This study supports the call for health systems to remain committed to efforts to achieve UHC, with a focus on PCC and PE.

The experiences of women diagnosed with uterine fibroids in the Kingdom of Eswatini

Wed, 15 Jan 2025 00:00:00 +0000

Background: Uterine fibroids (UFs) are benign uterine growths that significantly impact women’s daily activities, quality of life, fertility and expenditure.

Aim: This study aimed to provide in-depth insights into the lived experiences of women diagnosed with UFs.

Setting: The study was conducted in Eswatini health facilities across the four geographic regions.

Methods: An explorative qualitative design was used; participants with confirmed UFs diagnoses or surgery related to UFs were purposively recruited for focus group discussions. Data collection was guided by the revised Wilson and Cleary model of health-related quality of life (HRQOL), which was iteratively analysed using Braun and Clark’s thematic analysis framework.
Results: Sixty participants with confirmed UFs diagnoses or surgery related to UFs were included in this study. Five themes emerged: awareness of the disease, symptoms experienced, treatment and care, perceptions and beliefs and health-seeking behaviour. Most participants experienced physical symptoms, abdominal pain and vaginal bleeding. Among the emotional and psychological consequences experienced by the majority of participants were fear, worry, tension and (perceived) disrupted body image. The majority of the participants lacked knowledge of UFs, and their perceptions and health-seeking behaviour differed.

Conclusion: Findings showed that most participants experienced physical, psychological, emotional and social challenges.

Contribution: These experiences were influenced by lack of knowledge, symptoms experienced, poor treatment and care and perceptions and beliefs about UFs. Health education, client involvement, early diagnosis and effective treatment are recommended to improve the experiences of UFs.

Stakeholders’ perspectives on competencybased education program in Africa: A qualitative study

Barbara M. Dube, Ntombifikile G. Mtshali — Wed, 15 Jan 2025 00:00:00 +0000

Background: Competency-based education (CBE) is adopted to reform health professionals’ education. The goal is to produce graduates who are not only competent in their fields but also equipped with the necessary social accountability skills for safe practice.

Aim: The study aimed to explore nursing education stakeholders’ perspectives on competency-based
primary healthcare (PHC)-oriented nursing education programmes in the South African context.

Setting: The setting for this study was a higher education institution in South Africa.

Methods: A descriptive qualitative method was used in this study. After taking ethical clearance from the university ethics committee, data were purposively collected and theoretically sampled from 40 participants through focus group discussion, individual interviews and document analysis.

Results: The data findings reported categories that emerged from this study, which include the attributes of a competency-based PHC-oriented programme and the outcomes of a competency-based PHC-oriented programme.

Conclusion: In the context of this study, the concept of CBE was portrayed as a programme with strong social accountability that aims at addressing priority health needs surrounding communities and ensuring that the health needs of the community are met while providing
health delivery service to communities in their natural environment.

Contribution: These findings add to the growing evidence base around CBE as an approach to strengthen PHC-oriented health services in low- and middle-income countries, a key aspect of which is providing service within communities. This enables the accessibility of quality healthcare closer to where people live and work to achieve Sustainable Development Goal number three.

Challenges in accessing patient-centered care and patient empowerment in selected Ghanaian hospitals

Ruby V. Kodom, Robert T. Netangaheni — Wed, 15 Jan 2025 00:00:00 +0000

Background: Patient-centred care (PCC) and patient empowerment (PE) are crucial for better healthcare outcomes, in lower-middle-income countries like Ghana, which continues to encounter many challenges.

Aim: The study sought to determine the factors affecting the implementation of PCC and PE in Ghana through the voices of patients and healthcare providers.
Setting: The study is based in Ghana, West Africa, and includes three healthcare facilities representing primary, secondary and tertiary care.

Methods: A qualitative exploratory descriptive research design was employed to investigate the study’s objective by engaging healthcare workers and patients in selected facilities through purposive sampling. While 33 healthcare service providers participated in in-depth interviews, focus group discussions were held with four patient groups. The collected data were analysed thematically to identify key themes and insights.

Results: The analysis revealed three overarching themes: organisational-, individual-, and environmental-level factors influencing PCC and PE. Findings presented under 10 sub-themes show that resource constraints and staff shortages hinder PCC, while patient agency and communication impact PE. In addition, the ability to pay and geographical barriers further hinder access to patient-centred services, affecting overall healthcare
delivery.

Conclusion: The findings from this study emphasise that without system-wide interventions to address these issues – including improving resource allocation, enhancing communication, and reducing geographical and financial barriers – achieving Universal Health Coverage (UHC) by 2030 remains highly aspirational.

Contribution: The contribution of the study is inherent in the relevance of contextual findings towards improving health service delivery.

Experiences of men undergoing prostate cancer screening at a hospital in Gauteng, South Africa

Boitumelo M. Komane, Anna Mosalo — Wed, 15 Jan 2025 00:00:00 +0000

Background: Prostate cancer is a global concern and a leading cause of death among men. Screening for prostate cancer is crucial for early detection and to mitigate advanced disease and high-cost treatments. However, men are not well informed about the disease and tend not to be supported during prostate cancer screening.

Aim: The aim of the study was to explore the experiences of men undergoing prostate cancer screening at a hospital in Gauteng province, South Africa.

Setting: The study was conducted at a tertiary care hospital in Gauteng province.

Methods: A qualitative exploratory research design was followed. A convenient sampling method was used and the data were collected through in-depth interviews conducted with 19 participants. The data were analysed using thematic analyses.

Results: Three themes were generated, namely: (1) prostate cancer knowledge, (2) screening influencers and (3) support needs.

Conclusion: The insights from the study underscore the need for improved management of discomfort and pain during screening (including education) and emotional support, as well as considering poor uptake and the high prevalence of prostate cancer among black men.

Contribution: The study highlights the importance of informing men about the prostate cancer screening process to gain their cooperation, including the management of discomfort and pain, and to provide a support person during the process while addressing the high prevalence of the disease among black men.

Development of strategies to enhance recordkeeping during intrapartum care in Limpopo province: A Delphi technique

Phogole C. Maesela, Johanna M. Mathibe-Neke — Wed, 15 Jan 2025 00:00:00 +0000

Background: South Africa is experiencing increased medico-legal litigations in maternity services arising from poor recordkeeping. To enhance the quality of recordkeeping and reduce the lawsuits, the strategies were developed and validated by maternal healthcare experts.

Aim: The study is aimed to develop and validate strategies for recordkeeping during intrapartum care in Limpopo province.

Setting: The study was conducted in seven hospitals located in Sekhukhune District, Limpopo province.

Methods: The hospitals were purposefully selected to participate in this study. A sequential explanatory mixed-method design was applied. For the quantitative phase, the maternity case records were reviewed for completeness. Statistician assisted in translation of the checklist into statistical package for social science (SPSS) program. The data analysis included descriptive and inferential statistics. The qualitative phase, focus group discussions and in-depth interviews were conducted with midwives and doctors to describe and determine their perceptions and experiences of recordkeeping during intrapartum. A co-coder was engaged in
qualitative data analysis. The findings of quantitative and qualitative phases were integrated to develop the strategies for recordkeeping. A two-rounds Delphi technique was employed to validate the strategies by engaging maternal healthcare experts.

Results: Ten (10) strategies to enhance recordkeeping were developed and validated by the experts.

Conclusion: The proposed strategies were operationalised into interventions with the aim to
improve recordkeeping.

Contribution: The strategies aim to improve the quality-of-service provision during intrapartum care and reduce or culminate legal claims in Limpopo province.

Pulmonary embolism diagnosis with D-dimer levels and computed tomography

Rochelle A. Kruger, Jeanetta du Plessis, Henra Muller — Wed, 15 Jan 2025 00:00:00 +0000

Background: Pulmonary embolism (PE), a common heart and blood vessel disease, causes complications such as haemodynamic instability and cardiovascular mortality. Timely diagnosis and treatment are imperative for managing this potentially life-threatening
condition.

Aim: The aim of this study was to establish the relationship between an elevated D-dimer level and a positive computed tomography pulmonary angiogram (CTPA), which could confirm PE in patients with chest pain and suspected PE.

Setting: Data were collected at a private diagnostic radiology practice located in Bloemfontein, South Africa.

Methods: Data were retrospectively collected from the Picture Archiving and Communications System (PACS).

Results: Of the sampled patients (n = 1219), only 16.7% were diagnosed with PE after CTPA. Approximately 14% of the D-dimer-positive patient group were diagnosed with PE and, in the D-dimer-negative patient group, approximately 20% of the patients were diagnosed
with PE. Of the patients sampled, 86% were not diagnosed with PE despite having increased D-dimer values. No specific trends in the relation between elevated D-dimer levels and a positive PE diagnosis could be identified at the significance level of 0.05; a Chi-square test of independence indicated (χ2 [1, N = 995] = 1.84, p = 0.175).

Conclusion: No strong relationship between elevated D-dimer levels in the blood and a positive yield of PE after CTPA; was found hence, clinical decision rules for PE workups need refining, especially to limit unnecessary CTPA referrals in this setting.

Contribution: The findings suggest that PE workup at the private practice should be revised to improve the quality of service.

Compliance with radiation protection among radiographers in Eswatini public health facilities

Amelia Shungube, Thandokuhle E. Khoza — Wed, 15 Jan 2025 00:00:00 +0000

Background: The consequence of non-compliance with patient radiation safety standards increases unnecessary radiation exposure with high chances of harmful biological effects. Radiographers are trained to prevent these harmful effects by enforcing radiation
protection, which is achieved through proper techniques, equipment, shielding materials and beam collimation.

Aim: The study aimed to explore compliance with radiation protection by radiographers in Eswatini public health facilities (PHFs).

Setting: Eswatini PHFs with radiography departments (RDs) representing all four regions in the country.

Methods: The study applied a qualitative exploratory design. Purposive sampling was used to select participants. In-depth face-to-face interviews were conducted with radiographers (who have at least 2 years of work experience) until data saturation was achieved with the 13th participant. Data were analysed thematically.

Results: A total of three themes were identified from the data analysis, namely participants’ attitudes towards compliance with radiation safety standards; participants’ subjective norms; and perceived behavioural control factors.

Conclusion: The study demonstrated radiographers’ awareness and knowledge of patient radiation safety standards. However, compliance with the standards remained a personal decision as radiographers are not obliged to comply. Moreover, defective lead protective
devices, the unavailability of the full scope of lead protective designs, the inappropriate design of the RD building and unauthorised staff making unjustified X-ray requests contributed to non-compliance.

Contribution: The study highlighted a gap in compliance with patient radiation safety standards that requires attention from Eswatini’s Ministry of Health (MOH).

Conceptual framework to provide culturally congruent care to epilepsy patients in selected rural communities in South Africa

Muofheni Nemathaga, Maria S. Maputle, Lufuno Makhado, Ntsieni S. Mashau — Wed, 15 Jan 2025 00:00:00 +0000

Background: Epilepsy is a neurological disorder affecting millions of people in Africa. Among other reported findings, many people living with epilepsy (PLWE) believe that the condition is caused by spiritual factors. Previous studies have revealed that majority of
PLWE are not receiving adequate care and treatment because of diverse cultural beliefs associated with epilepsy. Consequently, they consult either faith-based healers or traditional healers. Others, however, acknowledge the medical causes of epilepsy and seek developed medical treatment.

Aim: To develop a culturally congruent care conceptual framework to provide comprehensive and holistic epilepsy care.

Setting: This study was conducted in the selected rural communities of Limpopo and Mpumalanga provinces.

Methods: A qualitative multi-method research approach was employed and sub-divided into three phases. Phase 1: All 15 articles were reviewed and appraised using the Critical Appraisal Skills Programme (CASP) rating tool. Phase 2 involved two stages of empirical study in which
an exploratory-descriptive study design was used. The study population comprised of 20 traditional healers, 15 faith-based healers, 20 professional nurses and 22 PLWE. Data were collected using in-depth individual interviews and analysed through eight Tesch’s steps of data analysis. Following data analysis, Phase 3 entailed synthesising the systematic and empirical findings into a conceptual framework.

Results: Three themes that emerged from the findings were cultural epilepsy interventions, faith-based epilepsy intervention and medically developed epilepsy interventions.

Conclusion: Incorporation of cultural beliefs, values and practices into the medically developed management of epilepsy is crucial for providing culturally congruent care that is preferred by majority of PLWE.

Contribution: Healthcare providers may tailor care interventions that are culturally appropriate and acceptable hence promoting early diagnosis and treatment adherence leading to improved quality of life

Lived experiences of patients with epidermolysis bullosa: A rare genetic skin disease

Wed, 15 Jan 2025 00:00:00 +0000

Background: Epidermolysis bullosa (EB) is a rare genodermatosis that results in extreme skin fragility, for which there is no cure and may be fatal. The quality of life of patients affected may be greatly impacted.

Aim: This study aims to understand the lived experiences of patients with EB.

Setting: Intensive semi-structured interviews were conducted with three participants via Zoom, and a follow-up member checking session was held in person at the RARE-X conference.

Methods: This qualitative research used interpretative phenomenological analysis with the aim of understanding the lived experiences of patients with EB. Semi-structured interviews were conducted with three participants using Lincoln and Guba’s framework of trustworthiness was used to ensure rigour.

Results: Three adult participants shared in-depth experiences of living with EB. Four themes with subthemes were identified: (1) medical damages, (2) development trajectory, (3) subjective well-being and life satisfaction and (4) sources of resilience and support.

Conclusion: Epidermolysis bullosa affected all developmental stages of life, impacting them physically, emotionally, socially and financially. They shared their concerns relating to a lack of knowledge of healthcare practitioners (HCPs) in managing their illness and society for judging their condition. There is a need for comprehensive biopsychosocial care of patients and their families, as well as continued medical education for HCPs and awareness of society regarding this debilitating condition.

Contribution: To our knowledge, this is the first study in Africa focused on the lived experiences of patients with EB. This highlights the physical, psychosocial and financial challenges that patients with rare diseases encounter in our local setting.

Accessibility of ART in the farming community of OR Tambo District Municipality in the Eastern Cape province

Lorraine N. Mntonintshi- Mketo, Phillip Nhlanhla — Wed, 15 Jan 2025 00:00:00 +0000

Background: South Africa accounts for 14% of all new HIV infections representing the highest annual rate of new HIV infections globally. In addition, South Africa is home to 21% of the worldwide HIV burden, with 7.97 million people living with HIV. HIV not only affects the
health of those living with the virus but also impacts their economic well-being.

Aim: The study aimed to develop an in-depth understanding of the accessibility of anti-retroviral
treatment in the farming communities of the OR Tambo District Municipality in the Eastern Cape province.

Setting: The study was conducted in two local municipalities of OR Tambo District Municipality in the Eastern Cape province.

Methods: A qualitative approach was used to explore and describe the accessibility of anti-retroviral treatment (ART) in the farming communities.

Results: The study revealed that travelling long distances, transport costs, lack of transportation and traditional beliefs were the major barriers for farming communities to access ART.

Conclusion: The findings of the study propose that poor access to ART in farming communities is linked to socio-cultural status, weak social support and limiting socioeconomic status.

Contribution: The Eastern Cape Provincial Department of Health’s management can use the study’s findings for recommendations to the National Department of Health management on how to improve HIV roll-out initiatives.

Self-reported meal planning practices among households in the Tshwane North area, Gauteng

Lindiwe J. Ncube, Mashudu Manafe, Reno E. Gordon — Wed, 15 Jan 2025 00:00:00 +0000

Background: Meal planning is crucial for households to improve food choices and promote healthier eating habits.
Aim: The study aims to assess meal planning practices in households in Tshwane area, Gauteng province.

Setting: The study was conducted in households, north of Tshwane, Gauteng province.

Methods: A survey questionnaire was administered to 368 households. Descriptive statistics were analysed, and Pearson’s chi-square test was used to assess the relationship between categorical variables. The Spearman-Rho correlation coefficient was used to determine the relationship between variables. A p ≤ 0.05 was considered statistically significant and a Spearman Rho correlation coefficient (r) ≥ 0.25 signified a positive relationship.

Results: Sixty-one per cent of the participants regarded meal planning as important. A total of 137 participants (37%) reported that they planned their meals before cooking and 64% (n = 235) never used recipes. There was statistical significance (p <0.05) between the options considered when buying food and the age of the participants. A positive association (p < 0.05) between the options considered when planning meals and employment status were obtained. The Spearman’s Rho correlation coefficient showed a positive relationship between the options considered when planning meals and buying groceries (r = 0.377, p < 0.001).

Conclusion: Meal planning was considered important by participants but was not fully practised in households. Therefore, interventions through practical sessions are recommended to improve household’s meal planning and meal preparation practices, including household’s
cooking skills.

Contribution: Community-based nutrition education intervention strategies will empower households to opt for healthier meals through meal planning.

Corrigendum: The mental health and well-being of healthcare workers during COVID-19 in South Africa

Jennifer Watermeyer, Sonto Madonsela, Johanna Beukes — Wed, 15 Jan 2025 00:00:00 +0000

No abstract

Corrigendum: Knowledge, attitudes and practices of oral health workers regarding COVID-19 and its vaccine

Zara Chothia, Ntombizodwa R. Nkambule, Ahmed Bhayat, Mpho Morule — Wed, 15 Jan 2025 00:00:00 +0000

No abstract

Corrigendum: The moderating effect of gender on physical activity participation and physical fitness in children

Howard Gomwe, Lesego Phiri, Chioneso Show Marange — Wed, 15 Jan 2025 00:00:00 +0000

No abstract