Predictors of burnout among HIV nurses in the Western Cape

Background: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients.Objective: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV.Method: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument ­ Nurse.Results: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001).Conclusion: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work

The Psychological Experience of Women who Survived HELLP Syndrome in Cape Town; South Africa

Background: Haemolysis; elevated liver enzymes and low platelet count (HELLP syndrome) is a high-risk pregnancy condition that could be fatal to mother and/or baby. It is characterised; as the acronym indicates; by haemolysis; elevated liver enzymes and low blood platelets.Objective: This study explored women in Cape Town's psychological experience of HELLP syndrome. Method: Six participants who previously experienced HELLP syndrome were interviewed. Using a grounded theory approach; themes emerged and a model illlustrating the psychological experience of HELLP syndrome was constructed. Results: The major themes that emerged were the perceived lack of information; a need to assign blame and a shift in focus. Themes of not knowing and trance and/or surreal experience underpin the cognitive aspects of the HELLP syndrome experience. Themes that expressed feelings of an inability to control; whirlwind and/or rapid pace and support acted together to bind the experience. Finally; emotions such as anger; ambivalence; disbelief; anxiety; guilt; loneliness and fear were present throughout the experience. Conclusion: This study developed an initial exploratory model representing the psychological experience of HELLP syndrome in a sample of South African women. Underlying this entire experience was a perceived lack of information which had a profound effect on numerous aspects of the experience ranging from where to locate blame to the varied emotions experienced