The use of synchronous videoconferencing teaching to increase access to specialist nurse education in rural Kwazulu-Natal, South Africa

ABSTRACT: In KwaZulu-Natal more than 50% of the population lives in the rural area but most of the health workers are based in urban centres where teaching hospitals and high incomes are common. Nursing provides the backbone of health care in the public sector. Specialist nurses such as advanced midwives or specialist HIV nurses are in short supply. Teaching via live synchronous videoconference (VC) provides an opportunity to extend specialist education to nurses at rural hospitals. AIM: The aim of the study was to review and evaluate the current use of videoconference education for nurses in KwaZulu-Natal.METHODOLOGY: A review the literature on VC education in nursing using bibliometric review strategies was conducted and two nurses’ education courses conducted via videoconferencing was evaluated against a set of criteria developed and validated by the Department of TeleHealth at the University. RESULTS: 81 publications addressing videoconference nurse education were found, most being published after 2000. Over half were descriptive studies, but were still valuable for informing this study. Based on the evaluation of the two courses against the set of criteria, the two courses were aligned sufficiently well with the measurement criteria. Additionally, the delivery of the courses via videoconferencing allowed for the identification of potential cost savings.DISCUSSION: This evaluation indicates that these two courses have been successfully implemented using VC. In the light of the potential savings of time and money, VC can be used to teach specialist nursing courses to rural nurses. Recommendations to improve the VC courses included orientation training for presenters and encouraging more research regarding the effectiveness of VC as a teaching modality for clinical nurses in rural areas. CONCLUSION: More attention should be given to developing the infrastructure and skills to make this technology available and commonly used in health services in under-resourced public health services and hospitals. Additional research is also suggested.Web of Scienc

A survey of cultural competence of critical care nurses in KwaZulu-Natal.

BACKGROUND. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA). Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities. OBJECTIVE. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA. METHODS. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R) cultural competence questionnaire. RESULTS. Nearly three quarters of the critical care nurses scored highest in the cultural awareness range of the cultural competence scale, with nurses from non-English-speaking backgrounds scoring significantly higher in cultural competence than English-speaking nurses. CONCLUSION. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.Department of HE and Training approved lis

Technology enhanced learning for remote nurses in KwaZulu-Natal.

The paper describes a project at the School of Nursing at the University of KwaZulu-Natal in Durban South Africa to increase access to university based education through the use of videoconference specialist education for nurses in rural areas of KwaZulu-Natal. Objectives: To evaluate the perceptions of lecturers and participants on the use of video-conferencing for nurse education. METHODOLOGY: Two surveys were conducted: a perceptions survey with lecturers of the School of Nursing and an initial and second survey with participants of a pilot advanced midwifery education programme conducted by video-conferencing. RESULTS: Both participants and lecturers had very little prior experience of video-conferencing, but felt that it would increase access for rural nurses to high quality specialist education. Concerns were mainly about technical issues in running and conducting the sessions and the application of progressive education strategies using this technology CONCLUSION: Videoconferenced academic specialist nursing programs would provide technology enhanced learning for remote nurses in KwaZulu-Natal, but for optimal use, the presenters need to be trained in the use of VC

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

OBJECTIVE: A review of systematic reviews of the effectiveness and feasibility of videoconference-based telepsychiatry services for resource constrained environments was conducted. Specifically with the aim of producing an evidence-based review of the effectiveness and feasibility of videoconference-based telepsychiatry services in resource constrained countries like South Africa. METHODS: Eight key questions on telepsychiatry effectiveness and feasibility were identified and inclusion and exclusion criteria were developed. Review of citations from 2000-2011 from CINAHL, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews (CCTR), Cochrane Controlled Trial Registry (CCTR), Database of Abstracts of Reviews of Effectiveness (DARE), unpublished abstracts through NEXUS and internet search engines (Google/Google scholar) was conducted. RESULTS: Ten systematic reviews were included for review. Despite the methodological limitations and heterogeneity of the systematic reviews, there appears to be good evidence of effectiveness (reliability and improved outcomes) and feasibility (use, satisfaction, acceptability and cost) for videoconference-based telepsychiatry internationally. The application of this evidence in lower middle income countries is dependent on the integration of telepsychiatry into local health system contexts. CONCLUSION: Based on the evidence, resource constrained countries such as South Africa should be encouraged to develop telepsychiatry programs along with rigorous evaluation methods.Web of Scienc

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

The Use of Mobile Phones to Deliver Acceptance and Commitment Therapy in the Prevention of Mother Child HIV Transmission in Nigeria

The objective of this study was to determine if introducing acceptance and commitment therapy in the prevention of mother to child HIV transmission (PMTCT) programme using weekly mobile phone messages would result in improved mental health status of HIV-positive, pregnant women in Nigeria. We used a Solomon four-group (two intervention and two control groups) randomised design. The study population was 144 randomly selected, HIV-positive pregnant women attending four randomly selected PMTCT centres in Nigeria. The intervention groups were exposed to one session of acceptance and commitment therapy with weekly value-based health messages sent by mobile phone for three months during pregnancy. The control groups received only post-HIV test counselling. A total of 132 participants (33 per site) were enrolled in the study from the two intervention and two control sites. In the pre-tests, the intervention and control groups did not differ significantly with regard to demographics. Evaluation of the pre- and post-tests of the intervention group indicated significantly higher Action and Acceptance Questionnaire (AAQ-II) scores. The introduction of a mobile phone acceptance and commitment therapy programme may result in greater psychological flexibility in women diagnosed with HIV.Department of HE and Training approved lis

Mental health legislation: does it protect the rights of people with mental health problems?

The International Federation of Social Work places a concern with human rights and social justice at the core of its definition of social work. Social work values are based on “respect for the equality, dignity and worth of all people” (IFSW, 2000), and social work practice has a special concern for vulnerable and oppressed people. People with mental health problems are amongst the most vulnerable members of society and in South Africa they comprise a considerable proportion of our society. According to the South African Stress and Health Survey (Herman, Steyn, Seedat, Heeringa, Moonal & Williams, 2009), the lifetime prevalence for any mental health problems in South Africa is 30.3% and neuropsychiatric disorders rank third in their contribution to the burden of disease in South Africa (Bradshaw, Norman & Schneider, 2007).Department of HE and Training approved lis

MENTAL HEALTH LEGISLATION: DOES IT PROTECT THE RIGHTS OF PEOPLE WITH MENTAL HEALTH PROBLEMS?

The International Federation of Social Work places a concern with human rights and social justice at the core of its definition of social work. Social work values are based on “respect for the equality, dignity and worth of all people” (IFSW, 2000), and social work practice has a special concern for vulnerable and oppressed people. People with mental health problems are amongst the most vulnerable members of society and in South Africa they comprise a considerable proportion of our society. According to the South African Stress and Health Survey (Herman, Steyn, Seedat, Heeringa, Moonal & Williams, 2009), the lifetime prevalence for any mental health problems in South Africa is 30.3% and neuropsychiatric disorders rank third in their contribution to the burden of disease in South Africa (Bradshaw, Norman & Schneider, 2007)

Technology-assisted communication in older persons in a residential care facility in South Africa

Relocation to residential care facilities by older persons (60þ) can decrease their social connectedness with their primary networks. The purpose of the study was to identify the use and acceptance of technology-assisted communication to increase social connectedness in older persons (N = 103) in an urban residential care facility in South Africa. The research design was a non-experimental quantitative descriptive survey using self-administered questionnaires based on the Technology Acceptance Model. All residents were included in the study. Perceived Ease of Use, Perceived Usefulness and Attitude scales were calculated and the Behavioural Intention for technology use was measured. Participants with the highest Behavioural Intention were residents in their first year of relocation, younger participants (60–74 years), divorced participants and participants with higher educational qualifications. Perceived Ease of Use and Perceived Usefulness were low and were directly correlated. Perceived Ease of Use contributed significantly towards Attitudes concerning technology use. The overall Behavioural Intention for technology use was good (60/75) and the Technology Acceptance Model pathway was confirmed using Structural Equation Modelling. Video chat offered greatest appeal for future use.IS

Suicide in New South Wales: the NSW suicide data report.

The NSW Suicide Prevention Strategy has identified suicide prevention as a high priority for government and the community. Death by suicide is a relatively uncommon event; however, more people in NSW now die from suicide than road injury. Nationally, two per cent of all deaths were attributed to suicide in 1998. This article describes the Suicide in New South Wales—The NSW Suicide Data Report, which has been developed and produced by the Centre for Mental Health, and presents improved information on suicide, hospitalisation following attempted suicide, and risk of suicide, both at a state and an area health service level.Web of Scienc