Theses and Dissertations (Nursing Science)

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Strategies for induction of novice midwives in labour wards in an academic hospital cluster in Gauteng province, South Africa
(University of Pretoria, 2022) Yazbek, Mariatha; Moagi, Mmamphamo Miriam; Ngunyulu, Roinah Nkhensani; fezmafisa@gmail.com; Mafisa, Florence Fezeka
Introduction: Globally, emphasis is placed on effective induction in the workplace to direct human capital in an appropriate manner. Induction of novice midwives might help forestalling unfavourable health effects that impact negatively on the health of mothers and babies. South African studies support that an effective induction programme for novice midwives can improve patient care outcomes in a labour ward. Aim: To develop induction strategies to guide novice midwives in a labour ward with the intention to empower them from novice to competent midwives. Objectives: Phase 1: (a) Explore and describe the experiences of novice midwives regarding their induction in a labour ward during the first six months of practice. (b) Explore and describe the views of the labour ward operational managers. (c) Explore and describe the support provided by maternity area managers regarding the induction of novice midwives in a labour ward. Phase 2: Develop the induction strategies with labour ward operational managers and maternity area managers through consensus method using Nominal Group Technique. Phase 3: Refine and validate the induction strategies with midwifery experts through consensus method using Delphi Technique. Research design: - A qualitative, exploratory, and descriptive design was used in three phases. Methods: The setting was in the labour wards of a designated central academic cluster of hospitals in Tshwane District, Gauteng. Population, Data collection and Data analysis: Phase 1: The population was novice midwives in a labour ward during the first six months of practice; labour ward operational managers and maternity area managers. Data were collected by means of individual interviews and scribing of the notes. The information received was interpreted by means of thematic analysis through an open coding system. Phase 2: Results of Phase 1 initially employed to formulate the first outline of induction strategies through Nominal Group Technique with operational and area managers. Phase 3: Midwifery experts refined and validated the developed induction strategies using an e-Delphi Technique. Significance of the study: Induction strategies will form part of the crucial knowledge base that will be used as a framework to capacitate novice midwives in improving patient care outcomes in a labour ward.
Experiences of undergraduate university nurse lecturers on the online assessment of the affective domain during covid-19 pandemic in city of Tshwane
(University of Pretoria, 2025-01) Mashao, Kapari Constance; Mooa, Ramadimetja Shirley ; daureen.moepi@gmail.com; Moepi, Daureen
Introduction and background: Clinical assessment, which is an integral part of the affective domain, is usually conducted in a controlled environment where a nurse lecturer has close contact with a student nurse while performing the nursing skill or procedure. Due to COVID 19 pandemic in 2020, training institutions around the world came to a complete halt, and teaching and learning went completely online. In South Africa, Nursing Education Institutions (NEIs) introduced technology-based pedagogy to ensure that students have access to teaching, learning, and assessment while observing lockdown protocols. It was easy to deliver cognitive skills through online classes; however, due to its complexity, assessing the affective domain online became a challenge. Aim of the study: The overall aim of this study is to explore the experiences of undergraduate lecturers on assessing affective domain online during COVID-19 pandemic at universities. The findings will be used by stakeholders to better understand how nurse lecturers assessed the affective domain online during the COVID-19 pandemic and other future pandemics. Universities that require virtual assessment, due to decentralized training to reach students in rural areas. Method: A qualitative descriptive phenomenology design was used in this study. The study was conducted at a university offering an undergraduate nursing degree in the city of Tshwane. Participants who fit the inclusion criteria were selected. Data was collected through individual interviews, using a semistructured interview guide. The steps of content data analysis were followed to analyse the collected data. Trustworthiness was ensured basis of the criteria of credibility, transferability, dependability, confirmability, and authenticity. Significance: The study might contribute to the existing limited body of evidence on the assessment of the affective domain online. The South African Nursing Council might use the findings to develop teaching standards and policies. The findings of the study will support universities that offer decentralized training to reach students in rural areas.
A mixed methods study to develop a self-care management tool for both people living with diabetes and their families
(University of Pretoria, 2024-12) Bhana-Pema, Varshika; Legodi, Heather; jd-vdh@hotmail.com; Jumat, Jennifer Denise
Introduction and background: The progressive nature of Diabetes Mellitus requires lifelong selfcare, which refers to the deliberate decisions and practices of the people living with diabetes (PLWD) and supporting family. The essence of self-care is to prevent risks and complications, but health education programs are lacking, and support for care is weak. Aim and objective: To create a self-care tool that will support and improve self-care habits, it was necessary to investigate how PLWD perceive self-care and how the family is involved. Research design and methods: This Mixed methods study followed a qualitatively driven, descriptive and explanatory approach. In Phase 1, 104 individuals living with diabetes provided data using the DSSQ-Fv. Phase 1 reliability analysis revealed that the five constructs obtained high Cronbach Alpha values, ranging from 0.803 to 0.989, and had good discriminating power. Phase 2 Stage 1 data collection involved conducting fifteen telephone interviews after a focus group with four individuals. Phase 2 Stage 2 data collection involved four family members in a focus group, and eight telephone interviews were conducted afterwards. Coding, categorisation, and theming were used in the analysis process. Phase 3 involved the Delphi consensus-building process being used to collect information from ten experts. Results: The general self-care regimen was deemed inadequate. Most PLWD concentrate primarily on the diet, paying little attention to medication or exercise as a means of controlling blood sugar levels. An easy-to-use self-care tool was developed. Conclusion: The study revealed inadequate self-care behaviours and a weakness in DSME/S. Developing a daily self-care regimen is necessary to enhance self-care practices.
Exploring and describing the facilitators and barriers during shift handover between critical care nurses in a private hospital in Gauteng
(University of Pretoria, 2024-10) Coetzee-Prinsloo, Isabel M.; Leech, Ronell; marlini007@gmail.com; Naidoo, Marlini
Abstract Introduction: Nurses conduct shift handover to exchange vital patient care information at the beginning, during, and at the end of each shift. This can be done verbally, in writing, or via phone or video calls. Critical care nurses often prefer bedside handovers for better correlation with the patients’ clinical condition and records. Objective: To explore and describe the facilitators and barriers during shift handover between critical care nurses in a critical care unit. Method: The researcher used an exploratory descriptive qualitative design to study critical care nurses with more than six months of experience in direct nursing care of critically ill/injured patients at a private hospital in the Gauteng province. Nurses completed a self-reported narrative guide, which was collected on alternate days from a sealed container in the unit manager’s office. Participants: The participants were registered and enrolled nurses working in the adult critical care unit with a minimum of six months of critical care experience. Results: The study identified four facilitators and six barriers during the shift handover process between critical care nurses (CCN). The facilitators that enhanced and streamlined the shift handover (SHO) included effective teamwork, clear communication, detailed handover procedures, and comprehensive handover notes. Conversely, the barriers that hindered or obstructed the flow of information during the SHO process were identified as ineffective communication, lack of comprehensive handover, incomplete handover notes, negative attitudes, unrealistic workload and tardiness. Conclusion: The study aimed to explore facilitators and barriers that influence handover practices, with recommendations to address the barriers for the benefit of the organisation and patients. Additionally, optimal handover practices may lead to improved patient feedback and higher nursing staff satisfaction and provide valuable insights for management.
An exploration of the indigenous neonatal care practices of mothers and caregivers in Vhembe District, Limpopo Province
(University of Pretoria, 2020-07) Mulaudzi, Fhumulani Mavis; Rikhotso, Richard; mashtule@gmail.com; Tulelo, Patience Mashudu
Background South Africa is amongst countries with high neonatal mortality rates. The Department of Health has introduced strategies to promote good neonatal care practices within the healthcare institutions around the country. On the other hand, different communities throughout the country still adhere to their own indigenous neonatal care practices in caring for their neonates at home after discharge from clinics/hospitals. Some of these practices could prove to be beneficial to the neonates’ health, while others may pose a health risk to the very neonates. Purpose The study explores and describes indigenous neonatal care practices of mothers and caregivers in Vhembe District, Limpopo Province. Methodology A qualitative, explorative and descriptive research design approach was employed to collect data from 18 participants situated in three Makhado villages across Vhembe District in Limpopo Province, South Africa. Given the heterogeneity of both the participants and the research sites, the purposive and snowball sampling methods were used for their selection according to the researcher’s predetermined range of criteria. Semi-structured one-on-one interviews were made use of in collecting data over an interrupted period of two weeks (one week in August 2019 and another in February 2020) at Siloam District Hospital’s post-natal ward and at the participants’ homes in selected villages of Makhado district. Additional to the interview guide, an audio recorder and field notes were also utilised to maximise the data collection instruments, after which the same data was analysed according to its emerging patterns of themes and sub-themes. Findings The study found that indigenous health practices were the primary mechanism for caring for neonates in Vhembe District, and that not all such practices were harmful or unsafe. This study revealed further that women use indigenous neonatal care practices across age groups, social standing and level of education. Younger mothers receive guidance from the older women in their family or community, but also adopted biomedical options to some extent.
Community health workers' perceptions of factors contributing to loss to follow-up of patients on antiretroviral therapy and residing in an informal settlement in the Tshwane district
(University of Pretoria, 2024-11) Bhana-Pema, Varshika; Nesengani, Tintswalo Victoria; mukwevhomulaloj@gmail.com; Mukwevho, Mulalo Julia
Introduction Antiretroviral therapy is a lifelong combination of at least three medications administered and taken by people living with the Human Immunodeficiency Virus to decrease the viral load and halt disease development. Antiretroviral therapy reduces the morbidity and mortality rates associated with Human Immunodeficiency Virus (HIV). Adherence to Antiretroviral therapy improves patients' quality of life, reduces drug resistance, lowers the occurrence of opportunistic infections, halts disease progression, and lowers hospital re-admissions and death. Community health workers play a key role in antiretroviral therapy care, bridging the gap between healthcare facilities and individuals living with human immunodeficiency virus. They provide support, education, and assistance to ensure medication adherence, disease management, and continuity of care. Through their dedication and empathy, they contribute significantly to improving health outcomes and reducing the impact of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in communities. Purpose of the study To explore and describe community health workers' perceptions of factors contributing to the loss of follow-up of patients on antiretroviral therapy living in an informal settlement in the Tshwane District. Research design and methodology The study was conducted in an informal settlement in Tshwane District. A qualitative, exploratory, descriptive, and contextual research design was adopted. Purposive sampling was utilised to sample study participants, and in-depth, face-to-face, individual interviews were conducted with 15 Community Health Workers. Data collection proceeded until saturation was attained. Tesch’s method of qualitative data analysis was utilised to analyse the data. The measures of trustworthiness were used to ensure quality throughout the study. Findings Five themes were articulated from the findings. The findings encapsulated a number of systemic and individual-related factors, which contributed to loss to follow up of patients on antiretroviral therapy. Theme one was ‘Individual-related factors’, theme two was ‘Negative consequences of being on ART’, theme three was ‘System-related factors’, the fourth theme was ‘Attitudes, behaviours and practices at the health facilities’, and lastly the fifth theme was ‘Recommendations to improve follow-up’. Numerous pieces of literature from all across the world, as well as from South Africa, backed up the study's conclusions. Based on the findings, we identified and advised actions for the community, health facilities, the Department of Health, and future studies.
Psychological experiences of nurses caring for patients living with cancer in public hospital Gauteng Province, South Africa
(University of Pretoria, 2024-11) Van der Wath, Anna Elizabeth; Lavhelani, Ndivhaleni Robert; maphumu97@gmail.com; Mthethwa, Phumzile
The psychological issues in oncology units may affect nurses’ well-being and the quality of care rendered resulting in adverse events, poor therapeutic outcomes and decreased patient safety. Oncology is demanding and stressful, especially on a psychological level. Understanding and considering the situation will improve nurses’ psychological state, enhance the quality of care, and prevent staff turnover. Therefore this study explored and described the psychological experiences of oncology nurses caring for patients living with cancer in a public hospital Gauteng Province, SA.
An exploration of support needed by nursing students to develop their professional dignity
(University of Pretoria, 2024-09) Van Wyk, Neltjie C.; Van der Wath, Anna Elizabeth; shilengei@yahoo.com; Shilenge, Isabel Hlupheka
Introduction: Nursing students develop their professional dignity during training with the support of their lecturers and professional nurses who supervise them during work-integrated learning. If left unguided and unsupported, such development will not be attained. To find their voice in the nursing profession, support and guidance are needed. Aim: The aim of the study was to explore and describe the support that nursing students need from their lecturers and professional nurses who supervise them during work-integrated learning to develop their professional dignity. Research design and methods: A qualitative, exploratory-descriptive research design was followed. A non-probability sampling method was applied in the selection of participants. Fourteen participants were interviewed. Face-to-face semi-structured individual interviews were conducted. Recording of the interviews and the writing of field notes were carried out with the permission of the participants. A thematic analysis was performed to analyse the data. Findings: The findings yielded four categories: a) improve work-integrated learning experiences, b) value students’ professional development, c) cooperate to benefit students’ professional growth and d) manage resources optimally. The categories were discussed with literature integration. Recommendations were formulated based on the study findings.
Nursing students' appreciation of clinical supervision during work-integrated learning
(University of Pretoria, 2024-11) Van Wyk, Neltjie; Lavhelani, Ndivhaleni Robert; mphambanyenimugwari@gmail.com; Mugwari, Mphambanyeni Julia
Introduction and background: Clinical supervision is a critical support factor in the success of nursing students’ development during work-integrated learning. Quality clinical supervision and good relationships among all involved facilitate students’ clinical performance. A poor fit between the expectations of the supervisors and those of the students may jeopardise the outcome of clinical supervision. However, the nursing students of the designated nursing education institution often complained of receiving little or no supervision during work-integrated learning. Aims: To explore and describe the aspects of clinical supervision during work-integrated learning that nursing students of designated nursing education institution appreciate. Methods: Qualitative research with an appreciative inquiry approach was used to explore and describe the aspects of clinical supervision that undergraduate nursing students of a designated nursing education institution appreciated. The sample comprised of purposively selected students enrolled for a Diploma in Nursing on level 2 and 3, for the academic year 2021/2022. Four focus group interviews were done with a semi-structured interview guide and 45 student participants were involved. A thematic data analysis was done and ethical considerations were maintained throughout the study. Results/Findings: Thirteen categories and sub-categories related to nursing students’ appreciation of clinical supervision during work-integrated learning emerged, based on the findings of the study. Conclusion and Recommendation: A conducive clinical learning environment should be established to enable proper guidance of nursing students to acquire professional knowledge and skills. Collaboration between nursing education institution and clinical facilities should be well established to facilitate effective communication.
The use of evidence provided by healthcare professionals as expert witness in sexual violence trials in Gauteng province, South Africa
(University of Pretoria, 2024-07) Mooa, Ramadimetja Shirley; Rasweswe, Melitah Molatelo; maggyshabangu8@gmail.com; Shabangu, Maggy
Introduction: In South Africa, healthcare professionals provide care to sexual violence victims across health care settings. One of such settings are Thuthuzela Care Centres. Thuthuzela Care Centres are non-stop facilities that have been introduced as a critical part in South Africa’s anti- rape strategy aiming to reduce secondary victimization. Healthcare professionals working for this Centres are usually asked to appear in court to provide expert evidence and testimony about sexual violence cases. Aim: The overall aim of the study was to explore “the use of evidence provided by healthcare professionals as expert witness in sexual violence trials in Gauteng province, South Africa”. Methodology: A qualitative case study methodology was followed in this study. Data were collected through eight semi-structured interviews with nurses and medical doctors working in different Thuthuzela Care Centres around Gauteng. Data was using Braun and Clarke (2006) thematic analysis framework Three main themes emerged as: (1) commanded to appear in court, (2) being on the stand and the (3) aftermaths of expert witnessing. Each theme has three sub- themes. Results: The findings indicate that expert witness experiences are related to each other. They are being served with a subpoena before appearing in court to give expert testimony, they all received a subpoena that informs them that they are needed in court. They consult with the attorney for preparation prior to their court appearance. It was also found that the defence lawyers distress the expert witnesses by cross-questioning and grilling them during the trial. Implications: The issue of using nurses and medical doctors as expert witnesses in sexual violence trials is a problem worth researching in South Africa because there is scanty literature and their use in prosecution of perpetrators is not clear. Conclusion: This study explored expert witnessing in cases of sexual violence trials. Due to their knowledge and skills nurses and doctors are considered to be expert during trials of sexual violence. Therefore, expert witnesses’ role calls for the continuous various forms of relevant training that can uplift their competencies and knowledge base in cases of sexual violence. Attorneys, police officers and healthcare professionals need to work together as a team like the way Thuthuzela Centres are structured. This approach is very helpful collection of evidence from the victims that will help in building strong cases. Additionally, the approach is expected from expediting the cases that are taken to court. Victims will be able to attend not cancelling cases and victim will gain more trust with justice system. The high rate of sexual violence in South Africa has shown in this study that there is a gap in the training of healthcare professionals in providing expert testimony in sexual violence trials in courtrooms. It is evident by the cases that drag long and some cases do not qualify to go to court.
Knowledge, attitudes and practices of men and women regarding infertility in the City of Tshwane, Pretoria, South Africa
(University of Pretoria, 2024-06-15) Sepeng, Nombulelo Veronica Jr; Musie, Maurine Rofhiwa Jr; vangile.seroto@gmail.com; Mabitsela, Vangile Naney
Background: Infertility affects millions of couples and individuals around the world. Despite this, there is minimal evidence of the knowledge, attitudes and practices among men and women regarding infertility in South Africa, particularly in the City of Tshwane, Pretoria. Aim: The aim of this study was to determine the level of knowledge, attitudes, and practices among men and women regarding infertility in the City of Tshwane, Pretoria, South Africa. Research design and methods: The descriptive quantitative research design was adopted for this study. A self-administered questionnaire was used to collect data from men and women in primary health care settings in the Tshwane District of the Gauteng Province. Stratified sampling was utilised to sample men and women who met the inclusion criteria. The sample size was 377. The researcher captured raw data on an Excel spreadsheet and sent it to a statistician for data analysis. Statistical Package for Social Sciences Statistics (IBM SPSS) version 28 software was used to analyse the data. Findings: The study found that most respondents had a good understanding and knowledge regarding the causes of infertility. About (67.4%) of respondents indicated that the menstrual cycle is likely to cause infertility among females, and 64.4% indicated that semen abnormalities are likely to cause infertility among males. However, several misconceptions were noted, such as infertility is a disability (69.2%) and that females (30.5%) are to blame for infertility than men (7.4%). Both men and women had a positive attitude toward infertility. About (79.5%) regarded infertility as a medical condition. Furthermore, most of respondents were open to modifying their lifestyles and utilising cutting-edge techniques like invitro fertilisation (90.7%) to increase fertility. When confronted with infertility, (90%) of women showed a strong Abstract vi Vangile Naney Mabitsela preference for using spiritual or religious wellbeing as a coping mechanism. Additionally, (79.2%) of men supported the use of traditional medicine if they became infertile. Conclusion: The results of this study revealed that most women and men who participated in the study had knowledge and positive attitudes regarding infertility. Despite this, there were still misconceptions about how past contraceptive use and lifestyle decisions affect fertility. These findings highlight the need to educate the general population about infertility, its causes, and available treatments. Education is crucial for addressing the myths and misconceptions related to infertility. In addition, men and women had differing approaches to coping with infertility. Women tended to rely on spiritual or religious practices for their well-being, whereas men preferred traditional medicine.
Implementation of maternal guidelines to reduce preventable intra-partum death at a selected public hospital in Gauteng
(University of Pretoria, 2023-11-01) Isabel, Coetzee-Prinsloo; Mariatha, Yazbek; mokonemeldah@yahoo.co.za; Mokone, Meldah Makhoba
INTRODUCTION Maternal death during pregnancy, childbirth, and the postpartum period is a tragedy with a catastrophic impact on families and serves as an important indicator of a health care system. More than one-third of maternal deaths occur during the intrapartum period and the majority of these deaths are largely preventable. Women continue to die from largely preventable causes despite global and national maternal care guidelines in place to reduce preventable maternal deaths. A preventable intrapartum death is a possible and probable potentially avoidable maternal death due to substandard care and missed opportunity. Reducing preventable intrapartum maternal deaths requires effective implementation of essential intrapartum guidelines such as monitoring of labour and childbirth, early identification of abnormalities, timely intervention, and treatment of complications. AIM The study aimed to determine the causes of preventable intrapartum maternal deaths, implement selected intrapartum maternal care guidelines, and evaluate the outcomes of the implemented guidelines at a selected public hospital in Gauteng province. RESEARCH DESIGN AND METHODOLOGY The researcher selected a sequential mixed methods research design and conducted the study in three phases. Using multiple approaches allowed the researcher to generate quality data and to gain an insight into the phenomenon under investigation. Phase 1 involved the collection of quantitative data with the use of a PPIP tool to retrospectively audit the preventable intrapartum maternal deaths between January 2018 and December 2021 in the labour unit at the selected public hospital. In Phase 2, the researcher in collaboration with the midwives implemented specific intrapartum guidelines based on the findings from Phase 1. Implementation research is a scientific investigation into the processes and factors that influence the implementation of evidence-based programmes and policies in real-world situations. Implementation research prompts researchers to describe both the implementation strategy techniques used to promote implementation of the evidence-based intervention and the effectiveness of the intervention that was being implemented. The objective of implementation research is to improve the quality of care and health outcomes of patients by implementing guidelines or health care programmes. In Phase 3, a focus group interview was used to evaluate the outcomes of the implemented intrapartum guidelines to reduce preventable intrapartum maternal deaths. Qualitative content analysis of transcripts, interviews and reflective dairies was used during data analysis. FINDINGS Phase 1 found that a total of forty-eight intrapartum maternal deaths were potentially preventable. Obstetric haemorrhage (37.5% n=18) and hypertensive disorders (31.2% n=15) in pregnancy were shown to be the most common causes of preventable intrapartum maternal deaths. Using a bottom-up approach in Phase 2, the researcher and the midwives selected specific intrapartum maternal guidelines at a consensus workshop. The three specific maternal guidelines to be implemented throughout the intrapartum period were: use of the partogram, management of hypertensive diseases, and management of obstetric haemorrhage from retained placenta. The implementation phase lasted from February 2023 until June 2023. Phase 3 had three sections for evaluation of the outcomes of the implemented maternal guidelines, the individual narrative interviews and the focus group interviews. Using the PIPP audit tool, four (4) intrapartum maternal deaths that had happened during the implementation phase were audited. Two (2) intrapartum maternal deaths were preventable. A content data analysis was conducted on the 20 individual narrative interviews. The interviews yielded four interrelated themes: (1) Adherence to selected intrapartum maternal care guidelines; (2) Improved decision-making, (3) Effective intrapartum maternal care guidelines, and (4) Barriers to effective implementation of the intrapartum maternal care guidelines. Using content data analysis, eleven themes emerged from the focus group interviews, namely (1) Available and accessible intrapartum maternal guidelines, (2) Value the multidisciplinary approach. (3) Support clinical evidence-based practice, (4) Relevant intrapartum maternal care guidelines, (5) Awareness of the use of evidence-based midwifery practice, (6) Dissemination of results from implemented intrapartum maternal care guidelines, (7) Engaging relevant stakeholders, (8) Adequate infrastructure, (9) Adequate staffing, (10) Availability of medical equipment and consumables, and (11) Clinical audits. CONCLUSION This study was conducted at a selected public hospital in Gauteng Province in South Africa. To improve clinical practice and intrapartum maternal care to achieve the best intrapartum patient outcomes, the researcher believes and hopes that this study will provide policymakers, clinical governance, midwives, nursing service managers, clinicians and other health care providers an insight into the significance of incorporating research into clinical practice. Keywords: Implementation, guidelines, intrapartum, preventable maternal death, midwife, labour unit
Assessment of knowledge, attitudes, and practices of undergraduate students regarding family planning methods in a selected institution of higher learning
(University of Pretoria, 2024-06-14) Sepeng, Nombulelo Veronica; alidah.kekana@up.ac.za; Kekana, Mmaphuthi Alidah
ABSTRACT Introduction and background: The number of unwanted pregnancies among students in institutions of higher learning around the world continues to increase each year despite the awareness and accessibility of family planning methods. As a result, there is minimal evidence from studies done to assess the level of knowledge and determine the attitudes and practices of undergraduate students regarding family planning, particularly at the selected institution of higher learning in Gauteng Province. Aim: The aim of the study was to assess the level of knowledge and determine the attitudes and practices of undergraduate students regarding family planning in a selected institution of higher learning. The objectives of this study were to: • To assess the knowledge of undergraduate students regarding family planning in a selected institution of higher learning. • To determine the attitudes of undergraduate students regarding family planning in a selected institution of higher learning. • To determine the practices of undergraduate students regarding family planning in a selected institution of higher learning. Research design and methods: The study used a quantitative descriptive design. The population was undergraduate students, and the sample size was 400 students. A questionnaire was used to collect data, and descriptive statistics was used to analyse the data. The researcher adhered to ethical considerations and rigor. Results of the study: The results of this study revealed that about (n=98.2%) of the respondents had higher knowledge regarding family planning. About (n=82%) of the respondents indicated that they have good access to the services and family planning method that is offered for free. About (n=26.2%) of respondents indicated that healthcare professionals were the largest source of knowledge and advised students to use the method. However, the majority of the respondents, (n=65%), indicated that they are afraid of family planning side effects. About (n=7.8%) reported that they are not using the methods of family planning because they do not know enough about them. About (n=82.8%) of the respondents indicated that birth control/family planning should be available at schools. About (n=44%) of the respondents indicated that they are using family planning methods to prevent pregnancies, and (n=18%) were using the methods to prevent Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus (HIV). About (n=94.8%) of the respondents indicated that it is important to know the methods of birth control/family planning before starting sexual relationships. About (n=0.25%) of the respondents indicated that they fell pregnant at the ages of 15 and 17 years. Conclusion: The findings showed that there was a good level of knowledge about family planning methods. Positive attitudes were identified related to ease of access, methods being easy to use, and prevention of pregnancies and STIs, including HIV. However, the fear of side effects was a hindrance to the use of family planning methods. Early pregnancies among undergraduates’ students indicated an early sexual debut, which was due to a lack of awareness and proper knowledge regarding family planning methods. Key terms/concepts: attitudes; family planning; institution of higher learning; undergraduate students.
Assessing knowledge of the professional nurses in primary health care regarding climate change in Nkangala District of Mpumalanga Province
(University of Pretoria, 2024-03-15) Mooa, R.S.; Sepeng, Nombulelo Veronica; marriotmabena@gmail.com; Mabena, Marriot Mmama
Introduction: Climate change has been described as a health issue and the United Nations has endorsed this concept as the ‘Sustainable Development Goals number 13’. Given its associated burden of diseases, climate change could be reframed as a predominant health issue, one necessitating an urgent health sector response. Despite its magnitude to human health, literature review revealed that majority of nurses struggled to understand how climate change would affect public health. Additionally, some nurses did not have knowledge of the relationship between health and climate change particularly in limited resource constrained countries like South Africa in Nkangala district of Mpumalanga province. Aims and Objectives: This study aimed to assess the knowledge of professional nurses in Primary Health Care (PHC) regarding climate change in Nkangala District, Mpumalanga Province. Research design: The researcher employed, a non-experimental descriptive research design to assess the knowledge of the professional nurses in PHC regarding climate change. Method: The study population was the total number of professional nurses working at the PHC facilities in Nkangala District of Mpumalanga province. The sample size of this study was 177 professional nurses working in different PHC facilities. Data were collected using questionnaires. Data was captured in an Excel sheet, and sent to statistician for analysis. Data of this study were analysed through Statistical Package for the Social Sciences. Descriptive statistics was used to analysed data. Results: Primary Health Care (PHC) nurses in Nkangala district of Mpumalanga province, displayed varying knowledge regarding climate change. Most of the respondents acknowledged that health related illnesses other climate change related health impacts are already occurring due to climate change. On the other hand, few respondents mentioned the association of malnutrition and disruption of services during extreme weather events with climate change. The majority of the respondents also acknowledged that the nursing iv Marriot Mmama Mabena Abstract profession has a role to play in curbing climate change and its effects. Hence the need to learn about climate change in the classroom and re-enforce it in the clinical setting. Conclusion: Most respondents indicated varying degrees of knowledge regarding climate change and its health impacts and acknowledged that they have a role to play in curbing climate change and its impacts. Therefore, it is necessary to include environmental health into the nursing curriculum to ensure uniformed knowledge and skills. Significant of the study: The study results will be used to inform the curriculum for Primary health care professional nurses based on study findings of their knowledge in climate change. Policy makers may adopt the findings of this to integrate climate change in the training of nurses.
Development of guidelines for feeding practices for children aged 2-5 years in Bulawayo province in Zimbabwe
(University of Pretoria, 2024-03) Coetzee, Isabel M.; Leech, Ronell; ychauraya@gmail.com; Chauraya, Yevonnie
Introduction and background Feeding practices are parental-feeding interactions which determine how, when and why children are fed. Poor feeding practices are more significant determinants of malnutrition in children than lack of food. Globally, 20 million children under 5 are malnourished, resulting in morbidity and mortality. Despite food supply strategies and programmes, 92% of all deaths in children under 5 in Zimbabwe are attributed to malnutrition. At the designated hospital, 35% of children aged 2-5 years have malnutrition, and 10% die from malnutrition-related illnesses. Global guidelines for feeding practices in children, such as the ten steps to successful breastfeeding and the baby-friendly hospital initiatives, focus on 0-2 years with scanty information on 2-5 years when it is the age range for rapid growth and development. Aim Develop guidelines for feeding practices for children aged 2- 5 years in Bulawayo province in Zimbabwe. Objectives were to Determine caregiver health literacy regarding current feeding practices for children aged 2-5 years in Bulawayo province in Zimbabwe. Explore stakeholder views regarding feeding practices for children aged 2-5 years. Obtain stakeholder suggestions for guidelines for feeding practices for children aged 2-5 years. Develop guidelines for feeding practices for children aged 2-5 years in Bulawayo province in Zimbabwe. Study design Mixed methods sequential explanatory design. Abstract iv Yevonnie Chauraya 2023 Methods The study was conducted in three phases. Quantitative, a questionnaire was used to collect data on feeding practices used by approximately 260 caregivers of children aged 2-5 years. The statistician assisted with data analysis. Qualitative, consensus meeting to obtain views of 12 stakeholders about current feeding practices and obtain suggestions for the content of a guideline for feeding practices. Integration of the results of the two phases led to the drafting of guideline statements in phase 3. Three experts participated in a Delphi technique to reach a consensus on the final guidelines. Significance of the study. The body of knowledge on feeding practices for children aged 2-5 and research may be improved, reducing morbidity and mortality from malnutrition. Nurses’ care and clinical practice may also be improved.
Coping strategies for nurses when caring for mental health care users with violent and aggressive behaviour in mental health care institutions in North West province
(University of Pretoria, 2024-08-01) Van der Wath, Annatjie; Sepeng, Nombulelo Veronica; dsehularo3@gmail.com; Sehularo, Motlagomang Patience
Introduction: Violent and aggressive behaviour of mental health care users continues to be a serious global nursing problem. When nurses are confronted with violence and aggression in mental health care institutions, it affects them and their ability to perform as a team, as well as to perform their daily tasks and duties. The study aimed to explore and describe the coping strategies of nurses when caring for MHCUs displaying violent and aggressive behaviour in mental health care institutions in North West province. Methods and design: A qualitative-exploratory-descriptive and contextual research design was used. Th1e study population included 11 nurses who were caring for, treating and rehabilitating mental health care users with violent and aggressive behaviour in two mental health care institutions in North West province. A non-probability purposive sampling technique was used to select the nurses who met the inclusion criteria for participation from the study population. Face-to-face semi-structured individual interviews supplemented with field notes were used to collect data. A digital audio-recorder was used to record the interviews. Six steps of thematic analysis were used, namely: becoming familiar with the data, generating the initial codes, searching for themes and sub-themes, reviewing the themes, defining the themes, and writing up. Findings: Four themes emerged from the face-to-face semi-structured individual interviews and field notes, namely: factors contributing to violence and aggression, negative experiences in caring for mental health care users displaying violent and aggressive behaviour, coping strategies used by nurses and suggestions to enhance effective coping with violent and aggressive behaviour. Effective coping strategies mentioned by nurses include problem-focused coping strategies, appraisal-focused coping strategies and social-focused coping strategies. Conclusion: The findings of this study may benefit nurse practitioners, researchers and educators. Recommendations were made for the training of nurses and for nursing management to support nurses to cope more effectively with violence and aggression.
Experiences of nurses caring for mental health care users with intellectual disability in a selected hospital
(University of Pretoria, 2023-12) du Plessis, M A R; van der Wath, A E; talifhanimurovhi@gmail.com; Murovhi, Talifhani Princess
Introduction: The caring experiences of nurses has an effect on their attitudes towards mental health care users (MHCUs) with intellectual disability (ID). Negative experiences may result in ineffective treatment, affecting the self-esteem and treatment participation of MHCUs and their caregivers. The caring experiences of nurses working with MHCUs with ID in a selected hospital in Limpopo province were not known. Objectives: The aim of the study was to explore and describe the experiences of nurses caring for MHCUs with ID at a hospital in Limpopo province. The findings informed recommendations for nurses caring for MHCUs with ID with reference to nursing practice, education and research. Methods: A qualitative descriptive exploratory design was employed to conduct the study. Semi-structured interviews were conducted and the research sample consisted of eight participants guided by the principle of data saturation. In this research thematic analysis was employed as a primary method for data analysis. During the research process, information was gathered from nurses caring for MHCUs with ID. Qualitative data analysis was used to derive the findings. Trustworthiness was attained via credibility, dependability, confirmability, authenticity and transferability. Findings: Following an analysis of the data, four themes were identified: caring experiences, challenging experiences, coping experiences, and measures to improve caring for MHCUs with ID. The participants stated that more staff members should be employed and they must be trained in how to care for MHCUs with ID.
Development of accreditation criteria for freestanding midwife-led birth centres in South Africa
(University of Pretoria, 2024-04-03) Yazbek, Mariatha; Maree, Carin; stellax01@gmail.com; Jordaan-Schlebusch, Christél
In recent years, privately owned, freestanding midwife-led birth centres have been established in South Africa, in addition to the existing hospital and obstetrician-led facilities. Midwife-led birth centres aim at individualised care and natural birth in a home-like setting. Still, in South Africa, there were no standardised criteria for the accreditation of privately owned, freestanding midwife-led birth centres by an independent midwife network at the time of this research. Accreditation of such centres has the potential to set a benchmark for high-quality, safe care that could lead to the expansion of birth-centre care and more equitable access to those centres for South African families. The aim of this study was to develop accreditation criteria through a three-phase multimethod study. Ménage’s model for evidence-based decision-making in midwifery served as a guidepost. The first phase consisted of a scoping review of research articles, guidelines, legislation and the scope of practice of midwives to explore factors that contribute to good outcomes and positive experiences for women and newborns at midwife-led birth centres. The results were collated, summarised, and used to contribute to the formulation and verification of accreditation criteria in Phase 3. Phase 2 began with input from couples or individuals who had experienced care at privately owned midwife-led birth centres. Through semi-structured focus groups and postpartum written narratives, clients from three distinct birth centres discussed their experiences and perceptions of safety and support at those facilities. Following this, a stakeholder analysis was conducted to identify experts in midwife-led birth centres and maternity care in South Africa and abroad. Fourteen stakeholders took part in a nominal group technique session to reach consensus on quality measures that should be incorporated into the accreditation criteria. In Phase 3, accreditation criteria were drafted based on the insights gathered from the preceding phases. Subsequently, consensus on the formulated accreditation criteria was obtained from the stakeholders involved in Phase 2 through the e-Delphi technique. Criteria deemed 'very important' or 'essential' by a minimum of 70% of participants were included in the final version. The final accreditation criteria include governance-, staff-, facility-, clinical care-, and quality control- aspects that prioritise the safety of women and newborns. Adopting these criteria on a national or provincial level might lead to more research on safety, client experiences and the economic viability of these birth centres.
Placental findings in term singleton stillbirths in a selected public hospital in Mpumalanga Province - descriptive study
(University of Pretoria, 2024-07-22) Yazbek, Mariatha; Musie, Maureen; oumavee@gmail.com; Vilane, Johannah Ouma
Background Stillbirth remains a global challenge and traumatic loss to women, families, communities, nurses and society at large despite all efforts made to reduce it. Globally 2.6 to 3 million stillbirths occur each year. Unexplained intrauterine deaths are the most common primary cause of perinatal deaths in South Africa. The placenta plays a key role in maintaining a healthy pregnancy. Malperfusion of the placenta may result in lesions associated with stillbirths. Placental lesions reflect various physical, social and environmental exposures which can be identified during an examination of the placenta. The researcher examined the placentas in singleton-term stillbirths in a single-site descriptive study to describe placental lesions of stillbirths in the selected hospital. Aim and objectives This study describes macroscopical and microscopical placental lesions of stillbirths in a selected public hospital in the eMalahleni sub-district in the Nkangala district in Mpumalanga Province with a perspective on the history of socioeconomic status, nutritional status, lifestyle, and others such as environment and season. Research design and methods A quantitative non-experimental observational descriptive study was conducted by examining the placentas of 89 term stillbirth babies in the labour ward for macroscopic lesions. A questionnaire was used to capture clinical data from patient files on variables of interest related to macroscopic and microscopic lesions for stillbirth cases. IBM SPSS Statistics version 28 package was used to analyse the data. Findings Statistical association and significance were found between the following variables: stillbirth and number of antenatal care visits (0.0035); birth weight and mid-upper arm circumference (0.013); birth weight and maternal vascular malperfusion (0.001); birth weight and birth attendant (0.034); type of stillbirth and birth attendant (0.033); type of stillbirth and previous obstetric history (0.038); cord insertion and smoking/substance abuse (0.012); cord insertion and haemoglobin (0.029); cord length and meconium histiocytes (0.031); cord diameter and syphilis (0.030); placental weight and onset of labour (0.012); placental weight and foetal vascular malperfusion (0.004); colour of membranes and maternal inflammatory response (0.002); colour of membranes and meconium histiocytes (0.000), and colour of membranes and syphilis (0.053). Significance and Conclusion Examination of the placenta may help to define the causes in more than 90% of stillbirth cases, inform the research and decrease stillbirth rates. Key terms/concepts: Placental findings, placental lesions, term singleton stillbirths, unexplained stillbirths, stillbirth.
Challenges faced by nurses and parents to facilitate parent-infant bonding and attachment in a Neonatal Intensive Care Unit during COVID-19 pandemic
(University of Pretoria, 2024-03-18) Rossouw, Seugnette; Maree, Carin; Ntombijulia@icloud.com; Mokwayi, Ntombizodwa Julia
Background Infants who are admitted to the Neonatal Intensive Care Unit (NICU) are a medically vulnerable population who are at risk for developmental delays, behaviour difficulties and reduced parent-infant bonding and attachment. The bonding and attachment relationship that forms between parents and their infant is a sensitive process and should be initiated and maintained immediately after birth. The COVID-19 pandemic caused several pandemic-related adversities such as hospital restrictions to parental visits, limited parental contact time with their infants and physical distancing between parents and infants. These COVID-19 related risk mitigation strategies lead to a break in the bonding and attachment process resulting in poor weight gain, failure in exclusive breastfeeding and lack of parent-infant emotional and physiological connection. Aims and objective The aim and objective of this study is to explore and describe the challenges faced by nurses and parents to facilitate parent-infant bonding and attachment in a NICU as a result of the COVID-19 pandemic. Research design A qualitative, explorative and descriptive design was used. In the study, the researcher used face-to-face interviews and Microsoft Teams™ meetings with parents and face-to-face interviews with neonatal nurses to explore and describe the challenges of facilitating parent-infant bonding and attachment in the NICU during the COVID-19 pandemic. Methodology The study was conducted in a public hospital within the Gauteng province in the NICU of the hospital. The population was parents who had infants in the NICU and all the neonatal nurses who were working in the NICU the COVID-19 pandemic. Convenient sampling was used. Data was collected using face-to-face and Microsoft Teams™ semi-structured interviews. Data was analysed using Tesch’s eight steps of data analysis. Findings Four themes emerged which are parent-infant bonding and attachment in NICU; factors facilitating parent-infant bonding and attachment challenges related to the COVID-19 pandemic; and consequences of challenges to facilitate bonding and attachment. Conclusion This study illuminates the significant challenges confronted by nurses and parents in nurturing parent-infant bonding and attachment within the NICU amid the COVID-19 pandemic. The findings highlight the intensified emotional and communicative responsibilities placed on nurses, emphasizing the imperative for supportive protocols and resources. Moreover, the necessity to adapt practices to incorporate virtual communication and parental involvement is underscored. The study also underscores the dual impact on parents, who grapple with heightened stressors alongside diminished engagement opportunities. Key terms /concepts: Attachment and Bonding, Challenges, COVID-19 Pandemic, Facilitate, Infant, Neonatal Intensive Care Unit, Parents, Nurses.

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