Relationships between anti-retroviral adherence, self-efficacy, and resilience among women living with HIV in Niger State, Nigeria

The objectives of the study were to describe the level of self-efficacy and its relationship with resilience among women living with HIV in Niger State, Nigeria. Self-efficacy is an important predictor of treatment outcomes among people living with HIV. Using a systematic random sampling technique, 676 participants completed adherence self-efficacy and resilience measures from three selected hospitals in Niger State. The result showed high levels of self-efficacy among the participants, linear relationships between perceived stress and resilience (-.601), perceived stress and self-efficacy integration (-.504), perceived stress and selfefficacy perseverance (-.220), resilience and self-efficacy integration (.667) and resilience and self-efficacy perseverance (.377). Hierarchical multiple linear regression indicated that 48.3% of the variance in resilience was explained by the two sub-scales of self-efficacy (p = < .001). Also, 26% (p = < .001) of the variance in perceived stress was explained by the two subscales of the self-efficacy. It is concluded that self-efficacy is a significant predictor of resilience and perceived stress among women living with HIV in Niger State, Nigeria. Keywords: HIV, Nigeria, Perceived stress, Resilience, Self-efficacy, Women Les objectifs de l'étude étaient de décrire le niveau d'auto-efficacité et sa relation avec la résilience chez les femmes vivant avec le VIH dans l'État du Niger, au Nigéria. L'auto-efficacité est un prédicteur important des résultats du traitement chez les personnes vivant avec le VIH. À l'aide d'une technique d'échantillonnage aléatoire systématique, 676 participants ont complété des mesures d'auto-efficacité et de résilience de l'observance dans trois hôpitaux sélectionnés dans l'État du Niger. Le résultat a montré des niveaux élevés d'auto-efficacité chez les participants, des relations linéaires entre le stress perçu et la résilience (- .601), le stress perçu et l'intégration de l'auto-efficacité (-.504), le stress perçu et la persévérance de l'auto-efficacité (-.220) ), l'intégration de la résilience et de l'auto-efficacité (.667) et la persévérance de la résilience et de l'auto-efficacité (.377). Larégression linéaire multiple hiérarchique a indiqué que 48,3% de la variance de la résilience était expliquée par les deux souséchelles d'auto-efficacité (p = <.001). De plus, 26% (p = <.001) de la variance du stress perçu était expliquée par les deux souséchelles de l'auto-efficacité. Il est conclu que l'auto-efficacité est un prédicteur significatif de la résilience et du stress perçu chez les femmes vivant avec le VIH dans l'État du Niger, au Nigéria. Mots-clés: VIH, Nigéria, Stress perçu, Résilience, Auto-efficacité, Femme

Collaborative clinical facilitation in selected nursing and midwifery colleges in Northern Ghana

Background: Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana. Aim: To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana. Setting: The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana. Methods: A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically. Results: Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication. Conclusion: This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students’ clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment. Contribution: This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students’ clinical learning

Social support and health behaviour in women living with HIV in KwaZulu-Natal

The article explores the relationship between social support and health behaviour of rural and urban women who are living with HIV in South Africa. Our study was a descriptive survey of a group of pregnant and non-pregnant women living with HIV.The sample size was 262 women, 165 from urban area and 97 from rural area. Data were collected using 3 instruments, namely a demographic questionnaire, the health behaviour schedule and the Medical Outcomes Study (MOS) Social Support Survey. Significant findings indicate that in the urban area 71% of women had disclosed their HIV status to someone, while in the rural area 49% had done so.A total of 77% of the women indicated that they were sexually active – 21% had 2 partners and 20% indicated that they had at least one episode of a sexually transmitted disease since finding out their HIV status. A total of 16% said that they currently received counselling, which was significantly more frequent in the rural sample (27%) than the urban (11%).The membership of support groups is at 12% among the participating women, and social support as well as membership of a support group was higher in the rural group than the urban group. Good social support showed an association with condom use, support group attendance and taking vitamins. However, receiving counselling as well as membership of a support group showed stronger association with positive health behaviour than social support on its own.The higher social support was not associated with increased disclosure. Keywords: HIV, health behaviour, social support, rural/urban, women. Résumé Cet article va à la découverte de la relation entre le soutien social et le comportement sanitaire des femmes rurales et urbaines qui vivent avec le VIH en Afrique du Sud. Notre étude était une enquête descriptive d'un groupe de femmes enceintes et non enceintes vivant avec le VIH. L'échantillon était de 262 femmes, 165 originaires d'un milieu urbain et 97 d'un milieu rural. Les données ont été recueillies par le biais de trois utiles, notamment un questionnaire démographique, un barème du comportement sanitaire et l'Enquête du Soutien Social de l'Étude Médicale de Résultats. Les résultats significatifs de recherche démontrent que dans le milieu urbain 71% de femmes avaient révélé leur statut séropositif à quelqu'un alors que seulement 49% du milieu rural l'ont fait. 77% de femmes ont signalé qu'elles avaient des rapports sexuels – 21% avaient deux partenaires et 20% ont signalé qu'elles ont eu au moins une épisode de maladies sexuellement transmises depuis qu'elles ont découvert leur statut séropositif. 16% de ces femmes ont dit qu'elles sont actuellement en consultation psychologique. Les consultations se sont passées plus fréquemment auprès de l'échantillon rural (27%) par rapport à l'échantillon urbain (11%). 12% de femmes participantes fait partie des groupes de soutien. Le soutien social ainsi qu'appartenir à un groupe de soutien étaient plus importants dans le groupe rural que dans le groupe urbain. Un bon soutien social a démontré un lien avec l'utilisation de préservatifs, l'assister au groupe de soutien et la prise des vitamines. Cependant, être en consultation psychologique et appartenir à un groupe de soutien ont démontré une association forte à un comportement sanitaire positif beaucoup plus que le soutien social en tant que tel. Le soutien social plus élevé n'a pas été associé aux révélations augmentées. Mots clés:VIH, comportement sanitaire, soutien social, rural/urbain, femmes

Condom use: a less travelled route among minibus taxi drivers and their taxi queens in KwaZulu-Natal, South Africa

Background: Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease. Population subgroups, through ignorance, disbelief or recklessness, continue to engage in risky sexual behaviour. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. These taxi drivers have been linked with so-called taxi queens, with whom they engage in transactional and intergenerational relationships. Objectives: The study explored condom use and condom negotiation strategies among taxi drivers and taxi queens in KwaZulu-Natal, South Africa. Methods: Applying explorative qualitative design, we conducted focus group discussion and individual interviews among participants who were purposively recruited in KwaZulu-Natal. Results: Qualitative data analysis revealed that condom use and negotiation are sources of conflict for the participants. In addition, the strategies employed by participants to ensure condom usage are not always sustainable and are likely to be problematic due to a variety of complex factors. Conclusion: Our study concludes by recommending a nested public health response that takes cognizance of factors that promote sustainable condom use strategies among this population subgroup

Stakeholders’ experiences in implementation of rapid changes to the South African prevention of mother-to-child transmission programme

Background: South Africa’s prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) programme has undergone rapid changes in the last two decades. Initially, the provision of single antiretroviral therapy was based on eligibility criteria in the year 2001, which later changed to combination therapy. This was aimed at preventing mother-to-child transmission of HIV. Since 2015, all pregnant women were eligible for antiretroviral treatment regardless of their CD4 count. Although significant strides were made to reduce mother-to-child transmission of HIV, increased efforts are required to meet UNAIDS targets, World Health Organization (WHO) elimination framework goals and sustainable development goals to eliminate new HIV infections in children and ending the HIV epidemic by 2030. Aim: The aim of the study was to explore healthcare workers’ experiences and patient perceptions of the implementation of rapid changes to the PMTCT programme in four public healthcare facilities. Setting: The study was conducted in the four public healthcare facilities within the two highly HIV-burdened districts of iLembe and eThekwini in KwaZulu-Natal province, South Africa. Methods: This study used a qualitative, exploratory, descriptive study design using interviews and focus group discussions. Participants were selected using purposive sampling. Following verbatim transcription of the data, thematic data analysis was used through data reduction and data display and the emergence of four themes. Results: A total of 61 stakeholders were interviewed. Four major themes emerged: (1) impact of poor health system design, (2) impact of poor communication of changes, (3) contextual factors affecting innovation in healthcare and (4) skill deficit in change management and forward planning. Conclusion: A healthcare system more responsive to the experiences of healthcare workers and pregnant women is required to effectively implement changes in priority programmes

Simulation debriefing as part of simulation for clinical teaching and learning in nursing education: A scoping review

Aim: To map the evidence of the simulation debriefing phase in simulation activities of nursing education, to address and inform clinical teaching and learning in nursing.Design: A scoping review.Methods: A systematic review of literature published between 2008–2021 was conducted using CINAHL & ERIC, MEDLINE, EMBASE, APA PsycInfo, the Cochrane Library and JBI Evidence synthesis. Inclusion criteria were primary studies published in English on simulation debriefing at all levels in nursing education.Results: Of 140 included references, only 80% (N= 112) framed simulation debriefing theoretically either by specific theories/models or as a literature review of the topic. A variety of simulation debriefing methods were identified; however, debriefing methods were only described in 79% (N= 110) of the references. There appears to be a gap in consensus concerning the theoretical or methodological frameworks characterizing simulation debriefing in nursing education. The majority of studies (86%) were conducted at a bachelor's degree level (N= 121).publishedVersio

A Survey of the quality of nursing care in several health districts in South Africa.

BACKGROUND: South Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses. METHODS: From March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires. RESULTS: The average scores on the different aspects varied from 11% (for nursing records) to 73% (for management of chronic diseases). Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%). While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts. CONCLUSION: The quality of care measurements identified specific training needs, but other management strategies are probably also indicated

Aboveground biomass density models for NASA's Global Ecosystem Dynamics Investigation (GEDI) lidar mission

NASA's Global Ecosystem Dynamics Investigation (GEDI) is collecting spaceborne full waveform lidar data with a primary science goal of producing accurate estimates of forest aboveground biomass density (AGBD). This paper presents the development of the models used to create GEDI's footprint-level (similar to 25 m) AGBD (GEDI04_A) product, including a description of the datasets used and the procedure for final model selection. The data used to fit our models are from a compilation of globally distributed spatially and temporally coincident field and airborne lidar datasets, whereby we simulated GEDI-like waveforms from airborne lidar to build a calibration database. We used this database to expand the geographic extent of past waveform lidar studies, and divided the globe into four broad strata by Plant Functional Type (PFT) and six geographic regions. GEDI's waveform-to-biomass models take the form of parametric Ordinary Least Squares (OLS) models with simulated Relative Height (RH) metrics as predictor variables. From an exhaustive set of candidate models, we selected the best input predictor variables, and data transformations for each geographic stratum in the GEDI domain to produce a set of comprehensive predictive footprint-level models. We found that model selection frequently favored combinations of RH metrics at the 98th, 90th, 50th, and 10th height above ground-level percentiles (RH98, RH90, RH50, and RH10, respectively), but that inclusion of lower RH metrics (e.g. RH10) did not markedly improve model performance. Second, forced inclusion of RH98 in all models was important and did not degrade model performance, and the best performing models were parsimonious, typically having only 1-3 predictors. Third, stratification by geographic domain (PFT, geographic region) improved model performance in comparison to global models without stratification. Fourth, for the vast majority of strata, the best performing models were fit using square root transformation of field AGBD and/or height metrics. There was considerable variability in model performance across geographic strata, and areas with sparse training data and/or high AGBD values had the poorest performance. These models are used to produce global predictions of AGBD, but will be improved in the future as more and better training data become available