A conceptual framework to facilitate the mental health of student nurses working with persons with intellectual disabilities

BACKGROUND : Student nurses (SNs) experience emotional discomfort during placement in the clinical psychiatric learning environment. This may negatively influence their mental health. Limited support is available to assist both SNs working with persons with intellectual disabilities and nurse educators during clinical accompaniment. OBJECTIVES : This article aims to discuss the generation of this framework to enhance student support. METHOD : A theory-generative, qualitative, exploratory, descriptive, contextual design was utilised to develop the framework by applying four steps. In step 1 concept analysis identified the central concept through field work. Data were collected from 13 SNs purposively selected from a specific higher educational institution in Gauteng through two focus group interviews,reflective journals, a reflective letter, naïve sketches, drawings and field notes and analysed with thematic coding. The central concept was identified from the results, supported by a literature review and defined by essential attributes. The central concept was classified through a survey list and demonstrated in a model case. In step 2 the central concepts were placed into relationships with each other. The conceptual framework was described and evaluated in step 3 and guidelines for implementation were described in step 4. The focus of this article will be on generating the conceptual framework. RESULTS : The central concept was ‘the facilitation of engagement on a deeper emotional level of SNs’. The conceptual framework was described and evaluated. CONCLUSION : The conceptual framework can enhance the educational practices of nurse educators and can SN’s practices of care for persons with intellectual disabilities.http://www.curationis.org.zahb201

A conceptual framework to facilitate the mental health of student nurses working with persons with intellectual disabilities

BACKGROUND : Student nurses (SNs) experience emotional discomfort during placement in the clinical psychiatric learning environment. This may negatively influence their mental health. Limited support is available to assist both SNs working with persons with intellectual disabilities and nurse educators during clinical accompaniment. OBJECTIVES : This article aims to discuss the generation of this framework to enhance student support. METHOD : A theory-generative, qualitative, exploratory, descriptive, contextual design was utilised to develop the framework by applying four steps. In step 1 concept analysis identified the central concept through field work. Data were collected from 13 SNs purposively selected from a specific higher educational institution in Gauteng through two focus group interviews,reflective journals, a reflective letter, naïve sketches, drawings and field notes and analysed with thematic coding. The central concept was identified from the results, supported by a literature review and defined by essential attributes. The central concept was classified through a survey list and demonstrated in a model case. In step 2 the central concepts were placed into relationships with each other. The conceptual framework was described and evaluated in step 3 and guidelines for implementation were described in step 4. The focus of this article will be on generating the conceptual framework. RESULTS : The central concept was ‘the facilitation of engagement on a deeper emotional level of SNs’. The conceptual framework was described and evaluated. CONCLUSION : The conceptual framework can enhance the educational practices of nurse educators and can SN’s practices of care for persons with intellectual disabilities.http://www.curationis.org.zahb201

Student nurses' experiences of the clinical psychiatric learning environment in an education institution

This study investigated lived experiences of student nurses working in a clinical psychiatric learning environment in South Africa. Participants were 29 fourth-year student nurses in the clinical psychiatric learning environment at a nursing education institution (females = 27; males =2). They engaged in focus group discussion on their experiences of the clinical psychiatric learning environment. The data were thematically analyzed using Tesch’s method of open coding. The student nurses experienced the environment as growth enhancing on a professional and personal level.http://www.elliottfitzpatrick.com/jpa.htmlam2014ay201

Factors contributing to relapse of mental health care users treated for substance-induced psychotic disorder in a psychiatric hospital in Gauteng, South Africa

This study explored the factors contributing to relapse of mental health care users (MHCUs) treated for substance-induced psychotic disorder in a public psychiatric hospital in Gauteng, South Africa. A qualitative, explorative, descriptive and contextual research design was followed. The study was conducted at the outpatient department of the hospital. Participants were selected purposefully from MHCUs visiting the outpatient department for follow-up. Ten semi-structured interviews were used to collect data until data saturation occurred. The transcribed interviews and field notes were analysed using Tesch's method of qualitative data analysis. The researcher and an independent coder reached consensus on the categories, sub-categories and themes. Trustworthiness was ensured through application of the strategies of dependability, transferability, conformability, credibility and authenticity. The findings explicated the factors contributing to relapse of MHCUs treated for substance-induced psychotic disorder in a psychiatric hospital. These factors included psychological, physical and social factors. Recommendations were provided for psychiatric nurses in terms of therapeutic programme planning and involvement of the community and family in the management of MHCUs treated for substance-induced psychotic disorder.http://www.unisa.ac.za/Default.asp?Cmd=ViewContent&ContentID=24782http://reference.sabinet.co.za/sa_epublication/ajnmam201

Strategies to sustain a quality improvement initiative in neonatal resuscitation

BACKGROUND : Many neonatal deaths can be prevented globally through effective resuscitation. South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4) set by the World Health Organization (WHO). However, SA’s district hospitals have the highest early neonatal mortality rates. Modifiable and avoidable causes associated with patient-related, administrative and health care provider factors contribute to neonatal mortality. A quality improvement initiative in neonatal resuscitation could contribute towards decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4. AIM : The aim of this study was, (1) to explore and describe the existing situation regarding neonatal resuscitation in a district hospital, (2) to develop strategies to sustain a neonatal resuscitation quality improvement initiative and (3) to decrease neonatal mortality. Changes that occurred and the sustainability of strategies were evaluated. SETTING : A maternity section of a district hospital in South Africa. METHODS : The National Health Service (NHS) Sustainability Model formed the theoretical framework for the study. The Problem Resolving Action Research model was applied and the study was conducted in three cycles. Purposive sampling was used for the quantitative and qualitative aspects of data collection. Data was analysed accordingly. RESULTS : The findings indicated that the strategies formulated and implemented to address factors related to neonatal resuscitation (training, equipment and stock, staff shortages, staff attitude, neonatal transport and protocols) had probable sustainability and contributed towards a reduction in neonatal mortality in the setting. CONCLUSION : These strategies had the probability of sustainability and could potentially improve neonatal outcomes and reduce neonatal mortality to contribute toward South Africa’s’ drive to attain the MDG4.C.v.H. was the main researcher as doctoral candidate at the time of the study and main author of this study. C.M. was the supervisor and E.v.R. was the co-supervisor for the study.http://www.phcfm.orgam2016Nursing Scienc

Emergency nurses' experiences of caring for survivors of intimate partner violence

AIM : To report a study of emergency nurses’ experiences of caring for survivors of intimate partner violence. BACKGROUND : Emergency nurses have the opportunity to intervene during the period following exposure to intimate partner violence when survivors are most receptive for interventions. The confrontation with the trauma of intimate partner violence can, however, affect emergency nurses’ ability to engage empathetically with survivors, which is fundamental to all interventions. DESIGN : The research was guided by the philosophical foundations of phenomenology as founded by Husserl. METHOD : A descriptive phenomenological inquiry grounded in Husserlian philosophy was used. The phenomenological reductions were applied throughout data collection and analysis. During 2010, concrete descriptions were obtained from interviewing 11 nurses working in emergency units of two public hospitals in an urban setting in South Africa. To arrive at a description of the essence, the data were analysed by searching for the meaning given to the experience of caring for survivors of intimate partner violence. FINDINGS : Emergency nurses in South Africa are often witnesses of the emotional and physical effects of intimate partner violence. Exposure to the vulnerability and suffering of survivors elicits sympathy and emotional distress. Emergency nurses are left with the emotional impact and disruptive and recurrent memories. CONCLUSION : Exploring the tacit internal experiences related to caring for survivors of intimate partner violence revealed emergency nurses’ vulnerability to the effects of secondary traumatic stress. The findings generated an opportunity to develop guidelines through which to support and empower emergency nurses.A UNEDSA project grant through the Community-Oriented Nursing Education for Women and Child Health Programme: A joint collaborative initiative of the University of Pretoria and the University of Limpopo (Medunsa Campus).http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2648hb2016Nursing Scienc

Emergency nurses’ ways of coping influence their ability to empower women to move beyond the oppression of intimate partner violence

BACKGROUND : Millennium Developmental Goal 3 (MDG 3) aims at enhancing gender equity and empowerment of women. Emergency nurses who often encounter women injured by their intimate partners are at risk of developing vicarious traumatisation, which may influence their ability to empower women to move beyond the oppression of intimate partner violence. AIM : This article aims to, (1) describe emergency nurses’ ways of coping with the exposure to survivors of intimate partner violence, and (2) recommend a way towards effective coping that will enhance emergency nurses’ abilities to empower women to move beyond the oppression of intimate partner violence to contribute to the achievement of MDG 3. SETTING : The study was conducted in emergency units of two public hospitals in an urban setting in South Africa. METHOD : A qualitative design and descriptive phenomenological method was used. Emergency nurses working in the setting were purposively sampled and interviewed. The data were analysed by searching for the essence and meaning attached to the exposure of emergency nurses to survivors of intimate partner violence. RESULTS : Emergency nurses’ coping responses were either aimed at avoiding or dealing with their exposure to survivors of intimate partner violence. Coping aimed at dealing with the exposure included seeking support, emotion regulation and accommodative coping. CONCLUSION : Emergency nurses employ either effective or ineffective ways of coping. Less effective ways of coping may increase their risk of vicarious and secondary traumatisation, which in turn may influence their ability to empower women to move beyond the oppression of intimate partner violence.The authors wished to thank the UNEDSA project grant through the Community-Oriented Nursing Education for Women and Child Health Programme: A joint collaborative initiative of the University of Pretoria and the University of Limpopo (Medunsa Campus) for the scholarship and support.http://www.phcfm.orgam2016Nursing Scienc

Emergency nurses’ ways of coping influence their ability to empower women to move beyond the oppression of intimate partner violence

BACKGROUND : Millennium Developmental Goal 3 (MDG 3) aims at enhancing gender equity and empowerment of women. Emergency nurses who often encounter women injured by their intimate partners are at risk of developing vicarious traumatisation, which may influence their ability to empower women to move beyond the oppression of intimate partner violence. AIM : This article aims to, (1) describe emergency nurses’ ways of coping with the exposure to survivors of intimate partner violence, and (2) recommend a way towards effective coping that will enhance emergency nurses’ abilities to empower women to move beyond the oppression of intimate partner violence to contribute to the achievement of MDG 3. SETTING : The study was conducted in emergency units of two public hospitals in an urban setting in South Africa. METHOD : A qualitative design and descriptive phenomenological method was used. Emergency nurses working in the setting were purposively sampled and interviewed. The data were analysed by searching for the essence and meaning attached to the exposure of emergency nurses to survivors of intimate partner violence. RESULTS : Emergency nurses’ coping responses were either aimed at avoiding or dealing with their exposure to survivors of intimate partner violence. Coping aimed at dealing with the exposure included seeking support, emotion regulation and accommodative coping. CONCLUSION : Emergency nurses employ either effective or ineffective ways of coping. Less effective ways of coping may increase their risk of vicarious and secondary traumatisation, which in turn may influence their ability to empower women to move beyond the oppression of intimate partner violence.The authors wished to thank the UNEDSA project grant through the Community-Oriented Nursing Education for Women and Child Health Programme: A joint collaborative initiative of the University of Pretoria and the University of Limpopo (Medunsa Campus) for the scholarship and support.http://www.phcfm.orgam2016Nursing Scienc

Competencies for structured professional development of neonatal nurses in South Africa

Background. The unpredictability of any illness at birth, and recovery from such an illness after birth, create challenges for nurses involved in neonatal care, and require competent nurses in the period following birth in both resource-limited and technologically advanced contexts. Neonatal nursing emerged worldwide as a nursing specialty over the last five decades to meet these challenges through in-depth knowledge of healthy, preterm and ill neonates. There is a high demand for neonatal nurses to lower neonatal mortality and morbidity, negative media exposure and litigation.Objectives. To reflect on a competency framework for nurses in neonatal practice to enhance professional development that is context specific.Methods. A competency framework for nurses involved in neonatal practice was developed and validated through nominal group techniques, literature control and Delphi techniques.Results. Although nurse training is done at tertiary education institutions, there is a gap in ensuring consistencies in clinical performance and professional development from novice to expert, especially in a field such as neonatal care. Professional development can enhance the standard of neonatal care, especially if linked to competencies that are specific to the neonatal context.Conclusion. A competency framework has an important role to play in equipping nurses in neonatal practice with the knowledge and skills required to reduce the persistent neonatal mortality and morbidity rates in South Africa

FACTORS CONTRIBUTING TO RELAPSE OF MENTAL HEALTH CARE USERS TREATED FOR SUBSTANCEINDUCED PSYCHOTIC DISORDER IN A PSYCHIATRIC HOSPITAL IN GAUTENG, SOUTH AFRICA

This study explored the factors contributing to relapse of mental health care users (MHCUs) treated for substance-induced psychotic disorder in a public psychiatric hospital in Gauteng, South Africa. A qualitative, explorative, descriptive and contextual research design was followed. The study was conducted at the outpatient department of the hospital. Participants were selected purposefully from MHCUs visiting the outpatient department for follow-up. Ten semistructured interviews were used to collect data until data saturation occurred. The transcribed interviews and field notes were analysed using Tesch’s method of qualitative data analysis. The researcher and an independent coder reached consensus on the categories, sub-categories and themes. Trustworthiness was ensured through application of the strategies of dependability, transferability, conformability, credibility and authenticity. The findings explicated the factors contributing to relapse of MHCUs treated for substanceinduced psychotic disorder in a psychiatric hospital. These factors included psychological, physical and social factors. Recommendations were provided for psychiatric nurses in terms of therapeutic programme planning and involvement of the community and family in the management of MHCUs treated for substance-induced psychotic disorder.Â