Value-Sensitive Clinical Accompaniment in Community Nursing Science

Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field; community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population; with each group espousing different value systems. Both parties - students and community nurses - report that; due to these differences; value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science. The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory; descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings; participant observation and focus group interviews. Data were collected by means of video recordings; participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder; using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed; analysed and coded by the researcher and the external coder; using Tesch's steps of analysis (Creswell 1994:155-156). Lincoln and Guba's criteria (1985:290) for trustworthiness were applied to the study. The general findings indicate that clinical accompaniment in community nursing is not value sensitive and; as a result; guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed) were identified: respect during clinical accompaniment; value-sensitive communication and sensitivity to the quality of clinical accompaniment. People's thoughts often focus on the suicide victim immediately after a completed suicide. Yet; the real victims of such an event are those individuals who are left behind to cope with the aftermath of the suicide. This phenomenological psychological study explored the lived experiences of lateadolescent suicide survivors; particularly those negative experiences that seemed to worsen in the weeks and months after a significant other's completed suicide. The research participants were five female late-adolescents (aged 17-22 years) who were recruited by means of purposive sampling at a South African tertiary institution and at youth camps. Data collection consisted of collagefacilitated; face-to-face phenomenological interviews. In addition; some participants provided documentary material in the form of personal diaries; letters and poems. The data analysis was conducted according to Giorgi's phenomenological method. The following salient experiences emerged during the data analysis: guilt; self-blame; blaming others or God; anger; loss or restriction of 'self'; depression; suboptimal behavioural coping patterns; changes in relationship dynamics; and suicidality. The results of this study can be used by mental health professionals and caregivers to support adolescent suicide survivors effectively; in the midst of their mourning

Evidence-Based Nursing Interventions and Guidelines for Prone Positioning of Adult; Ventilated Patients: a Systematic Review

Although the prone positioning of a critically ill patient poses a challenge to nursing interventions; it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of the literature as explora-tion and description of the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients; and secondly to develop evidence-based nursing guidelines for the nursing process. This exploratory; descriptive and retrospective systematic review includes data from 45 clinical trials; with a total population of 2 148 patients. Data was extracted onto data abstraction forms; assessed for methodological quality and finally summarised in evidence tables. All statistical calculations for the meta-analysis were performed by the RevMan 4.2.8 program. Prone positioning showed significant (p 0.0001) increases in the partial pressure of oxygen in arterial blood (PaO2) weighted mean difference (WMD CI = 11.36; 31.8). The effects of complications; oxygenation and haemodynamic outcomes compared with the different prone-positioning protocols produced in conclusive results. Nursing guidelines for prone positioning were developed based on the best available evidence. The lack of related articles on nursing care of prone positioning was a drawback. Based on these results; recommendations are made towards further study on the nursing care of prone-positioned patients

The Experiences of Mothers who Lost a Baby during Pregnancy

The purpose of this study was to explore and describe the experiences of mothers who lost a baby during pregnancy and care given by doctors and midwives during this period. To realise this goal the researcher followed a qualitative; exploratory; descriptive and contextual approach. Data were collected by using in-depth unstructured interviews. The interviews were taped and transcribed verbatim. Data were analysed through open coding. Data were collected until saturation had occurred. All mothers who were interviewed described their experiences of the loss of a baby during pregnancy. Some shared the same experiences and others did not. In the findings of this research; it became clear that mothers with the loss of a baby during pregnancy had experienced hardships and difficult times during this period. They expressed the wish that people acknowledge their loss; be considerate; sensitive; and give them a listening ear and emotional support. On the other hand; mothers identified the inability of health workers to give them the appropriate support