Quality of life domains relevant to people living with HIV and AIDS who are on antiretroviral therapy in Swaziland

Quality of life (QOL) domains that are context specific to people living with HIV and AIDS (PLWHA) who are on antiretroviral therapy (ART) in Swaziland are unknown. This presents a problem when research has to be conducted on QOL of PLWHA who are on ART. As a result, this study was conducted to identify, validate and describe domains necessary to assess QOL of PLWHA, who are on ART in Swaziland. A qualitative, explorative, descriptive, and contextual design was used for this study. The first phase dealt with a review of fifty existing QOL definitions and the identification of the common domains amongst them. Findings from this review revealed that the most common domains of QOL are the physiological, psychological, spiritual and socio-economic domains. The second phase was the validation of the above common domains identified from the examined QOL definitions to make them context specific to PLWHA who are on ART in Swaziland. A workshop was used to validate the domains with expert nurses involved in the care of PLWHA in Swaziland. The experts in ART care were trained on ART and had more than a year’s experience of working with PLWHA who are on ART. The validation process revealed that the essential context specific domains to consider when assessing QOL of PLWHA who are on ART are, (1) physiological domain, (2) psychological domain, (3) spiritual domain, (4) socio-economic domain, (5) cognitive domain, and (6) environmental domain. The process of validation of the domains was important as two extra domain

Outcomes of self-induced late pregnancy termination in women presenting to a tertiary hospital in the Eastern Cape Province, South Africa

Background. Little is known about the outcomes of self-induced pregnancy termination after 24 weeks’ gestation, as previous studies have concentrated on outcomes before 24 weeks.Objectives. To investigate the gestational age, misoprostol dosage, source of information on misoprostol, reasons for termination and outcomes of self-induced pregnancy termination after 24 weeks’ gestation.Methods. A quantitative, retrospective case series observational research design was utilised. Paediatric case summaries and the Perinatal Problem Identification Programme were used to collect data. Cases of self-induced pregnancy termination using misoprostol after 24 weeks’ gestation treated at a tertiary hospital in the Eastern Cape Province, South Africa, during the period 1 July 2011 - 1 January 2012 were identified and included in the study. Frequencies and proportions were used to analyse data.Results. Eighteen known cases of self-induced pregnancy termination using misoprostol after 24 weeks’ gestation were treated at the hospital during the 6-month study period. Misoprostol doses ranged from 400 to 1 200 µg. Birth weight was <500 g in 1 case (6%), 500 - 1499 g in 12 (67%), 1 500 - 1 999 g in 2 (11%), >2 500 g in 1 (6%) and unknown in 1 (6%). Eleven of the babies (67%) were born alive and 5 (28%) were stillborn (1 further stillbirth (6%) was classified as an abortion, <500 g). One baby (6%) survived, and in 1 case (6%) the pregnancy continued. Eight of the 10 neonatal deaths were early and 2 were late. The major cause of neonatal death was hyaline membrane disease (n=8, 44%). Other causes were hypoxia (n=2), septicaemia (n=2), necrotising enterocolitis (n=2), pulmonary haemorrhage (n=2) and intraventricular haemorrhage (n=2). More than one cause applied in some cases. The maternal complications were manual removal of the placenta (n=2, 11%), ruptured uterus (n=1, 6%), and anaemia with blood transfusion (n=1, 6%).Conclusions. Self-administration of misoprostol to induce pregnancy termination after 24 weeks’ gestation contributes to preterm births and perinatal morbidity and mortality. The findings of this study show that there is a need to educate women on the perinatal and maternal risks associated with self-induced pregnancy termination at a late stage of gestation, availability of safe options for pregnancy termination, and contraceptive use and adherence. Healthcare workers need to be sensitive to the possibility that cases of apparent spontaneous preterm labour or birth may have been self-induced.

The attitudes of nurses towards mentally ill people in a general hospital setting in Durban

A quantitative survey was undertaken to determine the attitudes of nurses towards mentally ill people at King Edward VIII Hospital, large academic hospital in Durban. Data were collected by a questionnaire intended to measure attitudes according to cognitive, affective and behavioral components in a sample of 100 black nurses. The results of this study were analyzed through a statistical software package, the statgraphic version 5

Employee Retention Factors For South African Higher Education Institutions: A Case Study

The success of the most competitive companies throughout the world, including higher education institutions, lies in their highly skilled employees on which these institutions spend millions to retain. Literature reveals the cost of losing best employees to be enormous – beyond monetary quantification. Also worth noting is that the loss of one competent employee to a competitor institution strengthens the competitor’s advantage. This case study analysed human resources turnover data, and interviewed academic managers and employees in order to examine the possible employee retention factors for a higher education institution in South Africa. The findings reveal different institutional interests between institutional managers and employees. The former are concerned more about profits, business sustenance and justification for spending, while the latter are driven by introverted interests such as development, monetary rewards and personal fulfilment