The experiences of undergraduate nursing students working in mental health care settings in the Western Cape, South Africa

The mental health care environment is perceived to be a stressful clinical learning environment for nursing students to work in due to a myriad of factors. These factors include amongst other, the physical environment, the patient population, perceived student unpreparedness and the emotional demands placed on the students which are inherent in the nature of the work. The use of the self as a therapeutic tool in caring for mentally ill patients may also present a challenge for students. The aim of this study was to explore and describe the experiences of student nurses working in this challenging environment. A qualitative approach using an exploratory, descriptive design was used. Purposive sampling was employed to select sample of 36 student participants who met the eligibility criteria. Data collection was by means of focus group interviews. Data were analysed by means of Tesch’s method of content analysis. Lazarus’s cognitive transactional model of stress-appraisal-coping was used to structure the themes. The main themes were organisational, sociological, physiological and psychological emotional responses. Each main theme had sub-themes namely: effect of the organisational climate and organisational culture; socio-cultural background and youthful age a detriment; bodily responses and lastly, the compromised self and the self in growth. In conclusion, students’ mental health experience was perceived as mostly negative and coping was problem-focused. A quantitative study to measure student stress, anxiety and depression among student nurses working in mental health care settings and also from other diverse student populations should be conducted.Department of HE and Training approved lis

The perceptions and factors influencing the competency in newly qualified professional nurses working in private hospitals in the Western Cape, South Africa

In our constantly changing healthcare system and with large numbers of staff shortages in hospitals, newly qualified professional nurses (PNs) are expected to be competent and work unsupervised in leadership capacities soon after they have completed their nursing programmes. This study was aimed at determining the perceptions of newly qualified PNs competency as well as factors that influence competence. A quantitative approach using a descriptive survey design was employed, using 34 experienced PNs working in selected private hospitals in the Western Cape. Data were collected by means of a peer evaluation questionnaire, namely the Competency Inventory for Registered Nurses (CIRN). Data were analysed, using SPSS 19. The results of the 55-item CIRN indicate that newly qualified nurses were perceived as highly competent in clinical care, leadership, interpersonal relation, legal/ethical and professional development. Newly qualified nurses were perceived as low in competency in teaching/coaching and critical thinking/research aptitude. All of the factors identified using literature was perceived as having an influence on competence. Recommendations were made to the institutions to assist newly qualified nurses in competence development.Department of HE and Training approved lis

Professional nurses' knowledge and skills in the management of aggressive patients in a psychiatric hospital in the Western Cape

Aggression and violence by patients towards psychiatric nurses are a global issue. Professional nurses working in psychiatric hospitals are required to look after psychiatric patients who may become aggressive. They may not be equipped to deal with aggression as the focus of nursing is on patient care, thus they may not have the necessary skills and knowledge to intervene in aggressive episodes. A quantitative approach, descriptive design was used to determine the knowledge and skills of professional nurses in managing aggression of psychiatric patients. The study was conducted in a psychiatric hospital in the Western Cape. The target population consisted of 119 professional nurses working in the psychiatric hospital. An all-inclusive sample of professional nurses was selected to complete a self-developed structured questionnaire. The overall Cronbach's Alpha for the instrument was 0.721. A total of 70 questionnaires were handed out, yielding a return of 52 completed questionnaires. The response rate was74%. Data analysis was done using SPSS version 22 from which descriptive data was obtained. Findings suggest that nurses are likely to be exposed to verbal aggression as opposed to sexual aggression. Nurses with less years of experience had more knowledge than experienced nurses who have been in practice longer. Nurses who had training in aggression management reported that it did not meet their needs. Overall, the findings revealed that nurses have good (above 80) knowledge about management of aggressive psychiatric patients. There is a need for on-going in-service training and refresher courses in the management of aggression. There should be a needs analysis prior to the commencement of the training.Department of HE and Training approved lis

Challenges of nurse tutors’ classroom and clinical performance when teaching

INTRODUCTION: Nursing is a dual profession that involves teaching both in class and at the clinical area. Nurse tutors meet a lot of challenges in their profession through their cognitive, affective and psychomotor nursing performance. The aim of this paper is to determine the challenges of nurse tutor clinical affective, cognitive and psychomotor performance in Malawi. METHODS: Mixed methods design was employed. Quantitatively, 129 students and 82 nurse tutors randomly selected were involved for the five ranked Likert Scale questionnaire, and 42 nurse tutors were involved in in-depth. While 8 focus group discussions were conducted in 8 nursing colleges. Descriptive and inferential statistics were used quantitatively for predictive variable of nurse tutor work experience and student study experience to compare with the dependent variables from the 39 cognitive, affective and psychomotor attributes. RESULTS: Both nurse tutors and students are not impressed with nurse tutors cognitive, affective and psychomotor performance during teaching. There is inadequate clinical orientation to students [OR ≤ 0.302; 95%CI (0.096 ± 2.955); p ≥ 0.042] and inadequate funding from college administration [OR ≤ 1.013; 95%CI (0.271 ± 3.793); p ≥ 0.985] as a result it creates much pressure on teaching. CONCLUSION: There is a need to develop an effective teaching strategy that would be conducive and easy to use for the limited resource environments in Malawi

Clinical learning experiences of male nursing students in a Bachelor of Nursing programme" Strategies to overcome challenges

BACKGROUND: Male nursing students are faced with more challenges in the clinical setting than their female counterparts. The ways in which male nurses are viewed and received by nursing staff and patients have an impact on how they perceive themselves and their role in the profession. These perceptions of self have a significant impact on their self-esteem. This study was conducted to explore the clinical learning experiences of male nursing students at a university during their placement in clinical settings in the Western Cape Province, and how these experiences impacted on their self-esteem. OBJECTIVES: To describe the learning experiences of male nursing students during placement in clinical settings, and how these impact on their self-esteem. METHOD: A qualitative, exploratory study was conducted. Purposive sampling was used to select participants. Three focus group (FG) discussions, consisting of six participants per group, were used to collect data. Data analysis was conducted by means of Coliazzi’s (1978) seven steps method of qualitative analysis. STUDY FINDINGS: The following three major themes were identified: experiences that related to the constraints in the learning environment, the impact on the self-esteem, and the social support of students working in a female-dominated profession. CONCLUSION: Male nurses should be supported in nursing training, as the rate at which males enter the profession is increasing.Department of HE and Training approved lis

A model of emotional support for student nurses working in mental health settings in the Western Cape, South Africa : a methodological perspective

The mental health care environment is a stressful environment, especially among student nurses. The purpose of the study was to develop a model of emotional support for student nurses working in the mental health care environment. The objectives were set in two phases: Phase one - identification of concepts; Phase two - development of a model of emotional support for student nurses. A theory-generating design, based on a qualitative, explorative and descriptive research approach, was used to meet the aim of the study. Data was purposively collected from 40 nursing students using (n=6) focus group discussions and eight educators and nine clinical staff by way of semi-structured interviews. Data was analysed by means of Tesch's method of data analysis. The model was developed by means of the four steps of which the first two are discussed in this paper as step three and four will be discussed elsewhere. Step one is the concept development consisting of concept identification and concept definition. A total of 22 concepts were identified, which were synthesised into six main concepts, namely, positive self-concept, positive work environment, academic and professional development, effective communication, formal and informal supportive interventions, and collaboration between the higher education institution and the mental health care setting. Step two is the model development during which the main concepts were placed in relation to one another, which formed an emotional support model for students working in mental health care settings. This paper gives an account of the methodological processes that were utilised to meet the aim and objectives of the study.DHE

Professional quality of life amongst nurses in psychiatric observation units

Professional quality of life amongst nurses in psychiatric observations units may be affected by working conditions such as an overflow of mental health care users (MHCUs), a shortage of nurses, lack of specialised staff and inadequate infrastructure to accommodate MHCUs amongst others. Aim: The aim of the study was to investigate the professional quality of life amongst nurses in psychiatric observation units. Setting: The study was conducted in psychiatric observation units in eight hospitals in the Metropole District Health Services in the Western Cape. Method: A quantitative descriptive survey design using the Professional Quality of Life (ProQoL version 5) questionnaire was conducted with an all-inclusive sample of 175 nurses. The ProQoL has two scales, namely, the compassion satisfaction and the compassion fatigue. Compassion fatigue includes two subscales, burnout and secondary traumatic stress. Ethics to conduct the study was obtained from the Research Ethics Committee at the university and the Department of Health in the Western Cape

Vitamin D receptor gene polymorphisms have negligible effect on human height.

Human height is a highly heritable trait, with genetic factors explaining up to 90% of phenotypic variation. Vitamin D levels are known to influence several physiological processes, including skeletal growth. The vitamin D receptor (VDR) gene has been reported as contributing to variation in height. A meta-analysis of 13607 adult individuals found a small but significant association with the rs1544410 (Bsml) polymorphism. In contrast, the meta-analysis found no effect in a sample of 550 children. Two recent studies reported variants with large effect on height elsewhere in VDR (rs10735810 [Fokl] and rs7139166 [-1521] polymorphisms). We genotyped large Caucasian samples from Australia (N = 3906) and the Netherlands (N = 1689) for polymorphisms in VDR. The Australian samples were twin families with height measures from 3 time points throughout adolescence. The Dutch samples were adult twins. We use the available family data to perform both within and between family tests of association. We found no significant associations for any of the genotyped variants after multiple testing correction. The (non-significant) effect of rs1544410 in the Australian adolescent cohort was in the same direction and of similar magnitude (additive effect 0.3cm) to the effect observed in the published adult meta-analysis. An effect of this size explains similar to 0.1% of the phenotypic variance in height - this implies that many, probably hundreds, of such variants are responsible for the observed genetic variation. Our results did not support any role for two other regions (rs10735810, rs7139166) of VDR in explaining variation in height

Hematopoietic Cell Types: Prototype for a Revised Cell Ontology

The Cell Ontology (CL) is an OBO Foundry candidate ontology intended for the representation of cell types from all of biology. A recent workshop sponsored by NIAID on hematopoietic cell types in the CL addressed issues of both the content and structure of the CL. The section of the ontology dealing with hematopoietic cells was extensively revised, and plans were made for restructuring these cell type terms as cross-products with logical definitions based on relationships to external ontologies, such as the Protein Ontology and the Gene Ontology. The improvements to the CL in this area represent a paradigm for the future revision of the whole of the CL

Oncological outcomes in an Australian cohort according to the new prostate cancer grading groupings

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: A new 5-tiered grading grouping system has recently been endorsed for reporting of prostate cancer (PCa) grade to better reflect escalating risk of progression and cancer death. While several validations of the new grade groupings have been undertaken, most have involved centralised pathological review by specialist urological pathologists. Methods: Participants included 4268 men with non-metastatic PCa diagnosed between 2006 and 2013 from the multi-institutional South Australia Prostate Cancer Clinical Outcomes Collaborative registry. PCa-specific survival and biochemical recurrence-free survival were compared across the five grade groups using multivariable competing risk regression. Results: For the entire cohort, risk of PCa death increased with increasing grade groups (at biopsy) Adjusted subdistribution-hazard ratios [sHR] and 95% confidence intervals [95%CI] were: 2.2 (1.5–3.6); 2.5 (1.6–4.2); 4.1 (2.6–6.7) and 8.7 (4.5–14.0) for grade groups II (pattern 3 + 4), III (pattern 4 + 3), IV (total score 8) and V (total score 9–10) respectively, relative to grade group I (total score < =6). Clear gradients in risk of PCa death were observed for radical prostatectomy (RP), but were less clear for those who had radiotherapy (RT) with curative intent and those who were managed conservatively. Likewise, risk of biochemical recurrence increased across grade groups, with a strong and clear gradient for men undergoing RP [sHR (95%CI): 2.0 (1.4–2.8); 3.8 (2.9–5.9); 5.3 (3.5–8.0); 11.2 (6.5–19.2) for grade groups II, III, IV and V respectively, relative to grade group I], and a less clear gradient for men undergoing RT. Conclusion: In general, the new five-tiered grade groupings distinguished PCa survival and recurrence outcomes for men with PCa. The absence of a clear gradient for RT may be due to heterogeneity in this patient group