T​​he effectiveness of in-hospital psychosocial intervention programmes for families of critically ill patients - a systematic review.

Background. A review of in-hospital psychosocial intervention studies for families with a relative in a critical care unit was conducted. Purpose of review. To review the literature on studies addressing the topic, discuss research methods critically, describe clinical outcomes and make recommendations for future research efforts. In doing so, empirically tested interventions producing positive outcomes may be applied to support families who have a relative in a critical care unit. Data sources. Research citations from 1991 to 2006 from CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane and SCOPUS databases, Internet search engines and unpublished abstracts through NEXUS were searched. Review methods. Citations were reviewed and evaluated for sample, design, intervention, threats to validity and outcomes. Review studies were limited to those that evaluated in-hospital interventions in family members of patients in a critical care unit. Results. Six studies were reviewed. Positive outcomes were reported for all of the intervention strategies. All but one of the studies reviewed studied small samples and single critical care units, and were poor in design. Conclusions. The paucity of interventional studies and the lack of systemic empirical precision to evaluate effectiveness of these interventions necessitate that future studies be methodologically rigorous.Department of HE and Training approved lis

Orientation among multiple truths: An introduction to qualitative research

AbstractIn order to provide some guidance for the researcher unfamiliar with qualitative research, this article compares quantitative and qualitative research, and introduces a number of qualitative methods. Aspects of methodological rigor are also presented as well as an example of qualitative data analysis using content analysis. Qualitative research methods explore, in a holistic fashion, the complex reality constructed by individuals in the context of their everyday worlds. Qualitative research is based on the subjective, looking at human realities instead of concrete realities of objects. When conducting a qualitative study the researcher is part of the study and is, in fact, the research instrument. The qualitative researcher embraces the ontological assumption of multiple truths, multiple realities, i.e., persons understand reality in different ways that reflect individual perspectives

The development of an intervention model for managing abrupt death trajectories in KwaZulu-Natal level 1 emergency departments.

Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.AIM: The aim of this research was to describe how the health professionals manage sudden/abrupt deaths in the ED and to foster change in current practice by involving the clients (dead or dying clients and their families) and the health professionals. METHOD: Action research was the approach used in this four year research project, and co-researchers (nurses) from three Level I ED's in KwaZulu-Natal were actively involved in shaping and guiding the project. The participants involved in the research were health professionals, bereaved families and mortuary staff members. FINDINGS: An intervention model, the Dealing with Sudden Death Model, was developed in order to guide the therapeutic management of sudden/abrupt deaths in ED's. Along with this was the development of the family pamphlet, the Preparation Checklist and the Incident Evaluation Checklist. Following the implementation of this model the health professionals emphasized the fact that this model provided guidance and meaning to the care rendered to the dead or dying client, the bereaved families and fellow colleagues. The Dealing with Sudden Death Model had resulted in a production of knowledge and planned changes in the management of sudden/abrupt deaths in the ED's

A systematic review of the effectiveness of videoconference-based tele-education for medical and nursing education.

BACKGROUND: Rural nurses and doctors typically have little opportunity to further their education and training. Studies have shown high participant satisfaction with the use of educational technology, such as videoconferencing, for education. A review of effectiveness of videoconference-based tele-education for medical and nursing education was conducted. AIMS The aims of this study were to: (1) systematically review the literature and critique the research methods on studies addressing the review question: “How effective is videoconference-based education for the education of doctors and nurses?” (2) summarize the existing evidence on the effectiveness of videoconference education for medical and nursing staff; and (3) apply the findings to South Africa and other countries across the globe. Methods: Research citations from 1990 to 2011 from cumulative index of nursing and allied health literature, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews, the Cochrane Controlled Trial Registry, Database of Abstracts of Reviews of Effectiveness, unpublished abstracts through NEXUS and Internet search engines (Google/Google scholar) were searched. Review methods included searching, sifting, abstraction, and quality assessment of relevant studies by two reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. No meta-analysis was conducted as the studies provided heterogeneous outcome data. RESULTS: Five studies were reviewed. Videoconference and face-to-face education is at least equivalent and one study reported an increase in knowledge and knowledge integration. Recommendations: Despite the methodological limitations and heterogeneity of the reviewed studies, there appears to be sufficient evidence of effectiveness to provide a rigorous Grade B evidence-based recommendation of moderate support. Conclusions: The use of videoconferencing for nursing and medical education should be encouraged along with guidelines for the use of videoconferencing. The paucity of studies and the lack of empirical precision in evaluating effectiveness of these interventions necessitate future rigorously designed experimental studies.Department of HE and Training approved lis

A survey of University Students' Perceptions of Learning Management Systems in a Low-Resource Setting using a Technology Acceptance Model

Learning management systems have been widelyadvocated for the support of distance learning. Inlow-resource settings, the uptake of these systemsby students has been mixed. This study aimed to dentify, through the use of the Technology AcceptanceModel, the individual, organizational, and technological factors that could be influencing the use of learning management systems. A simple quantitative descriptive surveywas conducted of nursing and health science students at a university in South Africa as part of their first exposure to a learning management system. A total of 274 respondents (56.7%) completed the survey questionnaire,made up of 213 nursing respondents (87.7%) and 61 health sciences respondents (25%).Overall, the respondents found the learning management system easy to use and useful for learning. Therewere significant differences between the two groups of respondents, with the respondents from health sciences being both younger andmore computer literate. The nursing respondents, who received more support and orientations, reported finding the learning management system more useful. Recommendations are made for training and support to ensure uptake.Department of HE and Training approved lis

Out of chaos leaders emerged

There has always been a recognition for the need of a strong nursing workforce in his- tory. After the end of World War II, President Truman in the Associated Press, 1946, February 28, stated that nurses are “one of the most important groups of health workers in the country.”1 More than 70 years later, in 2020, the Year of the Nurse, with more than 5 million cases of COVID-19 recorded around the world, “nurses were standing firm against the onslaught of the virus and have saved many thousands of lives” (ICN President, 2020).2 Toward the end of 2019, our world changed due to the COVID-19 pandemic, and our lives, both personally and professionally, were irrevocably altered. Although hailed as heroes,3 nurses were faced with finding new ways of living and new ways of work- ing while navigating this changed landscape. For nurses across the globe, numerous new challenges emerged but so too has there been the emergence of a resilient work- force with new learning and ways of doing

Parents perceptions of stress in a neonatal intensive care unit in Rwanda

BACKGROUND: Having a newborn infant hospitalised in the neonatal intensive care unit (NICU) is an unexpected and stressful event for a family. A number of potential stressors to which family members of patients in these units may be exposed have been identified, although no studies about this issue have been conducted in Rwanda. AIM: The aim of this study was to describe and analyse parental perception of stress that resulted from having their infant admitted to a NICU in Kigali, Rwanda. METHOD: A quantitative survey was used to describe and analyse parents’ perceptions of stress when they had an infant admitted to a NICU. The Parental Stress Scale: Neonatal Intensive Care Unit was used to measure the level of stress that those parents experienced. RESULTS: The results indicated that parents experienced stress from having their infants cared for in a NICU. The most stressful events were the appearance and behaviour of the baby with a mean score of 4.02, whilst the subscale items related to sights and sounds were found to be the least significant source of stress for parents with a mean score of 2.51. In addition, the current study found that parents’ age, educational level, occupation, and infant birth weight were associated with parental stress. CONCLUSION: The study established that a range of factors was responsible for parental stress when a baby was cared for in a NICU. Identification of these factors could enable health professionals from a hospital in Kigali, Rwanda, to facilitate parents’ adjusting and coping.Web of Scienc

Informal mobile learning in nurse education and practice in remote areas-a case study from rural South Africa

BACKGROUND: With the proliferation of portable digital technology, mobile learning is becoming increasingly popular in nursing education and practice. Most of the research in this field has been concentrated on small-scale projects in high income countries. Very little is known about the ways in which nurses and midwives use mobile technology in remote and resource poor areas in informal learning contexts in low and middle income countries. OBJECTIVES: To address this gap, this study investigates whether nurses use mobile phones as effective educational tools in marginalized and remote areas, and if so, how and why. SETTING AND METHODS: In rural South Africa, 16 nurses who attended an advanced midwifery education program, facilitators and clinical managers were interviewed about their use of digital mobile technology for learning. Techniques of qualitative content analysis were used to examine the data. RESULTS: Several rich “organically-grown”, learning practices were identified: mobile phone usage facilitated (1) authentic problem solving; (2) reflective practice; (3) emotional support and belongingness; (4) the realization of unpredictable teaching situations; and (5) life-long learning. CONCLUSIONS: It is concluded that mobile phones, and the convergence of mobile phones and social media, in particular, change learning environments. In addition, these tools are suitable to connect learners and learning distributed in marginalized areas. Finally, a few suggestions are made about how these insights from informal settings can inform the development of more systematic mobile learning formats.Web of Scienc

African emergency nursing curriculum: : Development of a curriculum model

© 2016 The Authors. Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/The African Emergency Nursing Curriculum (AENC) provides a consensus document to guide the development of harmonised standards of emergency nursing theory and practice across Africa for the benefit of the emergency patient population. The need to strengthen emergency care systems to address the global burden of disease is increasingly recognised (Wolf et al., 2012). Most low-income countries lack organised emergency care systems and therefore suffer the highest rates of injury, from primary health burdens such as maternal death due to complications of pregnancy, and acute medical complications of communicable diseases involving tuberculosis, malaria and human immunodeficiency virus (HIV) (Reynolds et al., 2014). Conditions requiring surgical intervention inevitably add to this growing challenge to emergency care systems. Annually, worldwide injuries contribute to a leading public health concern. One hundred million people sustain injuries; 5 million people die from violence and injury; and 90% of the global burden of violence and injury mortality occurs in low-middle income countries (World Health Organization, 2007). It is predicted that by 2030 road accidents will be the fifth leading cause of death in the developing world, with violent crime and conflict contributing significantly to this public health emergency (Institute for Health Metrics and Evaluation, 2010). This critically important prediction requires pre-hospital, emergency/trauma and rehabilitation services to be implemented and/or strengthened as soon as possible. This paper outlines the development of the AENC as part of a strategic action plan of the African Federation of Emergency Medicine (AFEM) Consensus Meeting held in Cape Town in November 2013 (Reynolds et al., 2014) to address the increasing African emergency care burden and other disease burdens addressed in the World Health Organization Millennium Development Goals (World Health Organization, 2015).Peer reviewedFinal Published versio

Factors influencing critical care nurses' family engagement practices: An international perspective

Background: Family engagement positively impacts patient and family members' experiences of care and health outcomes. While partnering with families denotes best practice in intensive care units (ICUs), its full adoption requires improvement. A better understanding of the factors that influence the implementation of family engagement practices is necessary. Aim: To investigate the factors that enable or hinder adult ICU nurse-family engagement and to explore potential international variations. Study design: Descriptive, cross-sectional survey. Nurses from 10 countries completed the 'Questionnaire on Factors that Influence Family Engagement' (QFIFE), including five open-ended questions. We performed descriptive statistics on quantitative data and content analysis for open-ended questions, and then integrated the findings according to influencing factors and geographical patterns. This was part of a larger qualitative study where 65 nurses participated from adult intensive care units. Results: Sixty-one nurses completed the questionnaire, making a response rate of 94%. Overall, patient acuity (Md = 5.0) and nurses' attitudes (Md = 4.6) seemed to be the most influential facilitator, followed by nurse workflow (Md = 4.0) and ICU environment (Md = 3.1) (score 1-6 most influential). The open-ended question data showed a more nuanced picture of the complexity of family engagement in care around these four determinants. Adding a fifth determinant, namely Families are complex structures that respond uniquely to the ICU and patient, revealed that difficult family dynamics, miscommunication and family having difficulty in understanding the situation or health literacy, hindered family engagement. Exploring geographical variations, Africa/Middle East consistently differed from others on three of the four QFIFE subscales, showing lower median levels. Conclusions: Some determinants are perceived to be more influential than others, becoming barriers or enablers to nurse-family engagement in adult ICU. Research that investigates contextual determinants and which compares implementation and improvement initiatives tailored to address family engagement practices barriers and enablers are needed. Relevance to clinical practice: Knowledge of this international study expands our understanding of enablers and barriers in family engagement that may inform family engagement practice improvement efforts around the world. Keywords: communication; critical care nursing; family nursing; intensive care unit; social factor