Prevalence of and factors influencing postnatal depression in a rural community in South Africa

Background: Knowledge about postnatal depression (PND) and associated risk factors whichin fluence the development of PND is vital for early detection, intervention and prevention. Setting: The study was conducted in primary health care clinics (PHC) in the Witzenberg subdistrict, a rural community in South Africa. Objectives: Objectives of this study were to determine the prevalence of PND and to identify the contributing risk factors associated with PND. Methods: A descriptive cross sectional research design with a quantitative approach was applied. The target population was mothers, 18 years and older. A convenience sampling method was used to select a sample of 159 (10%) from a population of 1605 live births. Th eEdinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI), two validated self-rating questionnaires; including a questionnaire based on demographical, psychosocial and obstetrical data; were applied. The data was analysed using various statistical tests to determine statistical associations between variables using a 95% confidence interval. Results: PND was a serious health problem with 50.3% of the mothers who suffered from PND. A BDI analysis showed that of the participants who had PND; 28.8% was severe, 48.8% moderate and 22.5% mild. Factors influencing the development of PND included most participants (63.5%) were unmarried, 61.3% were unemployed and the majority (53.8%) had a history of a psychiatric illness. Significant associations between PND and unplanned and unwelcome babies (p 0.01); partner relationship (p 0.01), were identified. Conclusion: Prevention, early detection, appropriate referral and treatment of PND are critical in managing maternal, child and family well-being

Stigma and HIV Disclosure in the Cape Metropolitan Area; South Africa

Disclosure rates of HIV-positive status remain low and are considered to be related to stigmatisation. Determining the factors that influence a person's decision to disclose a positive status is essential to understanding the process of and ways to improve disclosure rates. This study investigated the factors that influence the disclosure of a person's HIV-positive status and focused on socio-demographic factors; stigma and discrimination; religion; culture; fear of abandonment and rejection as well as knowledge of the disease that may all influence disclosure rates. A facility based descriptive cross-sectional research design with a quantitative approach was applied using convenience sampling. The sample comprised 150 individuals which was 12.5 of the study population. A self-administered questionnaire comprising mainly closed-ended questions; with a limited number of open ended questions was designed; tested and utilised. Statistical associations were determined between the demographic factors and responses to the questions. The open ended questions were analysed thematically by means of content analysis to extract meaning. The results revealed that fear of stigmatisation; especially among the male participants; was a major reason for delayed or non-disclosure. The results of the total study sample also showed that the level of education influenced the fear of stigmatisation; those with secondary school level education were most afraid of this (29). There was a statistically significant association between fear of blame or discrimination and disclosure to the sexual partner. This fear was most often cited by the participants who had never married (19). The participants who feared blame or discrimination the most reported having no income (23). The findings of this study indicate that numerous factors influence HIV disclosure. Stigma of individuals who are HIV-positive remains a barrier to disclosure as well as fear of blame and discrimination. Recommendations were made to facilitate and increase disclosure rates. This should include community based support groups and advocating partners to attend voluntary counselling and testing together to minimise the fear of blame

Ethical Issues that Confront Nurses in Private Hospitals in the Western Cape Metropolitan Area

Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts; target setting; the shortage of nurses and expertise. Objectives: The objectives of the study were to identify ethical issues related to patient care; to describe ethical issues related to patient diversity; rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment.Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5) was drawn from all nurses and caregivers (N = 2990) working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables.Results: Results included (95) of respondents provided safe and committed care to their patients; (99) loved to care for their patients and (93) believed in the Nurses' Pledge of Service. Fifty percent (50) of the respondents indicated verbal abuse from patients and only (59) experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient