Perspectives of nurses regarding pain assessment and management during routine infant vaccination in Ghana.

AIM: To explore the perspectives of nurses regarding pain and its management during routine infant vaccination at the Child Welfare Clinics in Ghana. DESIGN: Qualitative descriptive design. METHODS: Qualitative in depth, in-person interviews using a semistructured interview guide were conducted with 19 Registered Nurses who were were purposively sampled from three selected Child Welfare Clinics in hospitals in the Greater Accra Region of Ghana, The Tesch cotent analysis procedure was followed for the analysis of interview data. RESULTS: Nurses were aware that the injections they give infants are painful. They described how infants exhibit certain behaviours to express pain. Although nurses support infant pain management during vaccination, they rarely use evidenced-based pain interventions.

Learner pregnancies: views of parents in Madibeng Municipality, North West Province, South Africa.

Background: The learner pregnancy phenomenon is one of a variety of social phenomena faced by schools globally. In South Africa, the phenomenon has been increasing in intensity over the years, as shown in the increasing number of learner pregnancies reported by the Department of Basic Education. Due to its social consequences, learner pregnancy involves different stakeholders, such as teachers, parents and the community. Aims: The study aimed to explore the views of parents regarding learner pregnancy in schools of Madibeng Municipality, North West Province, South Africa. Methods: A qualitative, exploratory and descriptive study was conducted using a purposive sampling method. Four focus group interviews were held with a total of 25 participants, and data were analysed using Tesch's approach to content analysis. Findings: Parents reflected that parents have a responsibility to communicate and share sexual and reproductive information with their children so that the children can make informed decisions about their sexual practices. They further agreed that the responsibility for learner pregnancy management should extend to teachers, parents, nurses, school governing bodies, churches, the community and the government. Conclusion: Stakeholders such as parents, teachers and the community, as internal or external partners, should play a pivotal role in preventing and managing learner pregnancy in schools.

Challenges to ethical integration of reproductive health education in schools of Tshwane District, South Africa.

The Integrated School Health Policy was set to ensure the incorporation of a multi-disciplinary approach to health care in South African schools. However, the implementation of sexuality and reproductive health teaching and learning has not been without problems. Central to sexuality and reproductive health education is the common ethical application of the subject in teaching. School sexuality and reproductive health education have proved to be a sensitive issue across a socio-cultural environment. Compliance with ISHP programs in sexuality and gender orientation is related to the inclusion of a more comprehensive education for learners to cover human rights and sexual diversity. This paper aims to reflect on the ethical challenges related to the integration of reproductive health education and teaching in schools in the City of Tshwane. This study applied a descriptive exploratory quantitative research design. Data was collected using a survey questionnaire and a checklist, and applied stratified random sampling to select schools that participated in the study. Data were analysed using descriptive statistics which included frequencies and percentages (%). The results show that the absence of health care values in organisational strategies will challenge the ethical dimension relating to sexuality and reproductive health education. The ethical dilemma of teaching sexual and reproductive health in schools can prove to be a challenging exercise since its a sensitive issue in most societies. Sexuality and reproductive health education is compounded by a lack of clear guidelines in the ISHP programs and the diversity of stakeholders that do not hold a common or standardised ethical framework. Furthermore, lack of sufficient teacher preparation adds to the ethical dilemma in managing school ethical issues in general.

The experience of professional nurses working with newly qualified nurses placed for community service in public health facilities in the City of Tshwane, South Africa.

BACKGROUND: The newly qualified nurses (NQNs) were mandated to work for one year as community service nurses before being registered. During the placement, NQNs were supposed to be supervised and supported by professional nurses. On the contrary, professional nurses expected NQNs to be hands-on and provide quality care on completion of their training. Expectations of professional nurses created misperceptions regarding the objectives of community service. Therefore, exploring their experience would identify skills gap that is needed to be addressed. OBJECTIVES: This study explored and described the experiences of professional nurses working with NQNs placed for community service in the City of Tshwane. METHOD: A qualitative exploratory design was conducted. Individual interviews were carried out with 22 professional nurses in various public healthcare settings, such as a hospital, a community health centre and a clinic. Informed consent was obtained from all the participants and confidentiality and anonymity were maintained throughout the interviews. Creswell's data analysis process was implemented. RESULTS: Two themes emerged from this study, namely, experience of participants with NQNs and professional nurses. Participants experienced NQNs as not being competent to work independently and had to deal with unprofessional behaviour of NQNs. Participants supported NQNs, even though they were not empowered as mentors to NQNs. CONCLUSION: Participants were disappointed that NQNs were not competent and confident to work independently. They expressed their frustrations in behaviours displayed by NQNs. However, participants acknowledged NQNs' individual differences and were supportive towards them even though they were not empowered for such responsibility.

Resilience and social support of young adults living with mental illness in the city of Tshwane, Gauteng province, South Africa.

BACKGROUND: Young adults living with mental illnesses often experience a flood of powerful negative emotions, including anger, anxiety, and depression. Some of these young adults remain trapped in those negative emotions long after the stressful events that caused them have passed, while resilient young adults without mental illness are able to quickly bounce back to their normal emotional state. OBJECTIVES: The objective of the study was to explore social support of young adults living with mental illnesses in the City of Tshwane. METHODS: This was a qualitative explorative study done in the City of Tshwane in 2018 among young adults living with mental illnesses, using a semi-structured interview schedule. RESULTS: Those young adults living with mental illness who had support from family and friends were able to cope with stressful challenges and had a better outlook for the future, while those who perceived their relationship with friends and family as not supportive reported low self-esteem and difficulties dealing with challenging and stressful situations in their lives. CONCLUSION: Resilience was seen in those young people living with mental illness with support from family and friends, who had positive future prospects, those with high self-esteem, and those who were able to adapt to changing situations beyond their control.

Views of learners on prevention and management of pregnancies in schools of Madibeng municipality, North West province of South Africa.

Learner pregnancies have increased in recent years, despite improved access to reproductive health services, contraceptives and sexual and reproductive education. In this article, a pregnant learner refers to any person who gets pregnant while being admitted as a learner in primary or secondary schools of the South African basic education system. Currently in South Africa there is no formal collaboration between the Departments of Health and Education concerning learner pregnancy prevention and management in schools. This study, conducted in Madibeng Municipality schools, aimed to develop implementation guidelines of the policy on prevention and management of learner pregnancy in schools. This qualitative, exploratory and descriptive study used a purposive sampling method. Data collection yielded 17 individual interviews and data was analysed using content analysis by Tesch's approach. Learners reflected that they lacked support from schools regarding learner pregnancy prevention and management, with the majority agreeing that nurses should visit schools to assist with reproductive health matters such as learner pregnancy. The education system of South Africa has invested in sexual and reproductive education, but learner pregnancies have doubled despite more than a decade of extensive sexual and reproductive education in schools. Stakeholders outside the classroom should be engaged to improve learner pregnancy prevention and management as part of support to teachers and schools. Such stakeholders include parents, peer educators, youth and community organisations, non-governmental organisations, community healthcare nurses and other relevant stakeholders.

Compliance to the Integrated School Health Policy: Intersectoral and multisectoral collaboration.

BACKGROUND:  Implementation of the Integrated School Health Policy (ISHP) requires strong intersectoral collaboration on the part of key role players such as the Department of Health, Department of Basic Education and Department of Social Development. These departments and educational structures such as school governing bodies, teacher unions and learner organisations, academic institutions, civil society and development partner organisations are also expected to contribute to the development of sustainable and comprehensive school health programmes. OBJECTIVES:  The objective of this study was to describe the compliance of the schools in the City of Tshwane to the ISHP in 2015. METHOD:  A quantitative, explorative and descriptive study was conducted in the City of Tshwane using a questionnaire to determine the extent of compliance to the application of the ISHP in selected schools. RESULTS:  The results indicated a widespread non-compliance to ISHP programmes. There was insufficient stakeholder integration in the school health programmes at schools in the City of Tshwane. CONCLUSION:  The lack of collaboration with relevant stakeholders in school health service delivery will lead to a fragmented, uncoordinated and unsustainable approach to the execution of ISHP programmes. This might result in delayed or no detection and intervention in cases of, among others, mental, psychosocial and health challenges to learning, as well as development of nutrition-related conditions.

Men's reproductive health knowledge in Mankweng District, Limpopo Province.

BACKGROUND: Gender roles influence men's attitudes towards reproductive health, and society might assume that reproductive health issues, fertility and family planning are women's responsibilities. Moreover, literature shows that men have insufficient knowledge about reproductive health matters and some misconceptions about modern contraceptive practices. OBJECTIVES: The aim of the study was to describe reproductive health knowledge of men in Mankweng District and was conducted in 2015. METHODS: A descriptive research study was conducted by using quantitative approach. Data were collected by means of questionnaires. Cluster random multistage sampling was used to select villages in Mankweng District and convenient sampling was used to identify participants who met the inclusion criteria to participate on the study. RESULTS: A total of 200 questionnaires were distributed and returned; 197 (98.5%) of the returned questionnaires were eligible for analysis. The findings indicated that the majority of participants, 74% (n = 145), considered their partners to be unclean during menstruation, and 84.77% (n = 167) of participants did not know how to perform self-testicular examination. More than half of the participants, 55.83% (n = 67), were not in favour of vasectomy and had strong opinions about it; some of those who reportedly knew what a vasectomy involves had some misconceptions. CONCLUSION: The findings showed that despite participants' reported knowledge about some reproductive health matters their perceptions were unfavourable towards them. Despite men's sufficient knowledge about sexually transmitted infections (STIs) and ways to protect themselves against STIs men had limited knowledge about other male and female reproductive health matters.

The lived experiences and social support needs of first-time mothers at health care facilities in the City of Tshwane, South Africa.

BACKGROUND: Social support refers to the assistance people receive from others, and it is divided into four types of support. Given the increasing mortality and morbidity rates of mothers and neonates postpartum, this study intended to determine whether the social support needs of the first-time mothers were met after early discharge from health care facilities. OBJECTIVES: The objective of the study was to explore the lived experiences and social support needs of the first-time mothers after an early discharge from health care facilities in the City of Tshwane, Gauteng. METHOD: A qualitative explorative study was conducted to explore the lived experiences and social support needs of the first-time mothers. The population were first-time mothers who had a vaginal delivery and were discharged within 6-12 hours of delivery from health care facilities. Purposive sampling was performed and 14 semi-structured interviews were conducted, with those mothers who came for the prescribed three postnatal check-ups at the three health care facilities identified according to maternity services provided. Saturation of data for the three health care facilities was reached at the 14th interview. Data analysis was performed using the hermeneutic interpretive approach. RESULTS: Almost all participants had completed grades 11 or 12, but most were unemployed. The needs identified included the need for social support, lack of confidence, knowledge and skill to care for themselves and their newborn babies after early discharge. CONCLUSION: There is need to identify alternative types of social support for the first-time mothers, to ensure a normal adjustment to motherhood.

Prevalence of adolescent obesity at a high school in the City of Tshwane.

BACKGROUND: Obesity has been reported to be on the rise in the world and South Africa is no exception. In recent years obesity has been reported to contribute to the increasing number of people with hypertension and diabetes mellitus. Africa has the fastest growing number of overweight and obese adolescents, with indications that in 2010, it had more than doubled since 1990. Some people might perceive being overweight as being round and healthy which might contribute to the increased rate of obesity in South Africa. Physical and psychological changes that occur during adolescence can also be observed earlier during the preteen years (ages 9-12 years). During this time, peer groups and external appearance are of importance. Physical changes, such as obesity, might be perceived negatively by adolescents, affecting their self-esteem. OBJECTIVES: The purpose of the study was to determine the prevalence of adolescent obesity at a high school in the City of Tshwane. METHOD: A cross-sectional survey was conducted. Stratified random sampling was used and data were collected from 30% of the total population as recommended by the statistician. Data analysis was performed using descriptive analysis. Validity and reliability were ensured through calibrating the weight-monitoring scale and the measuring tape, which are collection tools. RESULTS: The results identified the prevalence of adolescent obesity at 8.57%. There is evidence of abdominal obesity and waist-hip ratio ≥ 1. The results show that there is a steady increase in obesity levels among adolescents. The poor response of parents was observed and could demonstrate the need to form stronger partnerships for weight reduction interventions. CONCLUSION: Evidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified.

Prevalence of adolescent obesity at a high school in the City of Tshwane

Background: Obesity has been reported to be on the rise in the world and South Africa is no exception. In recent years obesity has been reported to contribute to the increasing number of people with hypertension and diabetes mellitus. Africa has the fastest growing number of overweight and obese adolescents, with indications that in 2010, it had more than doubled since 1990. Some people might perceive being overweight as being round and healthy which might contribute to the increased rate of obesity in South Africa. Physical and psychological changes that occur during adolescence can also be observed earlier during the preteen years (ages 9­12 years). During this time, peer groups and external appearance are of importance. Physical changes, such as obesity, might be perceived negatively by adolescents, affecting their self-esteem.Objectives: The purpose of the study was to determine the prevalence of adolescent obesity at a high school in the City of Tshwane.Method: A cross-sectional survey was conducted. Stratified random sampling was used and data were collected from 30% of the total population as recommended by the statistician. Data analysis was performed using descriptive analysis. Validity and reliability were ensured through calibrating the weight-monitoring scale and the measuring tape, which are collection tools.Results: The results identified the prevalence of adolescent obesity at 8.57%. There is evidence of abdominal obesity and waist­hip ratio ≥ 1. The results show that there is a steady increase in obesity levels among adolescents. The poor response of parents was observed and could demonstrate the need to form stronger partnerships for weight reduction interventions.Conclusion: Evidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified

Health assessment of taxi drivers in the city of Tshwane.

BACKGROUND: Taxi driving seems to be a strenuous occupation. There was evidence-based paucity of literature on health assessment of taxi drivers. Meanwhile taxi drivers of South Africa were burdened by communicable and non-communicable diseases including high-level exposure to injuries and criminal attacks. Health assessment of this cohort group enables mitigation to engage in appropriation of relevant interventions related to the occupational needs of taxi drivers. OBJECTIVES: The objective of the study was to conduct health assessment of taxi drivers in the city of Tshwane to identify health risk factors. METHOD: An exploratory, descriptive and quantitative survey was conducted and anthropometric measurements of blood pressure, body mass index and waist circumference were monitored and recorded on a convenience sample of 69 taxi drivers in Tshwane Municipality. Consent was sought from individual taxi drivers who participated in the study, while taxi rank queue marshals assisted with smooth running of the process. Data were gathered using a questionnaire. Data analysis was performed using statistical STATA II with the assistance of a statistician. RESULTS: The study found that taxi drivers were obese, hypertensive, had type II diabetes-related risk factors, including unhealthy life style practices. The results indicate that the general health of taxi drivers impacts their occupation. CONCLUSION: The findings implicate that the health status of taxi operators in Tshwane was a serious concern and urgent concerted effort is needed to engage in lifestyle modification of taxi drivers. The need for health promotion and formalised occupational health services was recommended.

Exploring the meaning of caring amongst student midwives, professional midwives and educators in Tshwane, South Africa.

BACKGROUND: In spite of caring being the core of midwifery and nursing, there is a constant public outcry about uncaring behaviours of midwives towards clients. Local media reports and recent discussion in the health system have highlighted the concerns regarding caring behaviours of midwives. Thus, there is a need to compare the meaning of caring from the perspectives of student midwives, midwives and educators. AIMS: The aim of this article was to determine the meaning of caring from the perspectives of the undergraduate student midwives, the professional midwives, and the educators teaching midwifery in Tshwane. SETTING: The study was conducted at healthcare institutions which the undergraduate student midwives attended for work integrated learning and at nursing education institutions in Tshwane, South Africa. METHODS: The strategy was qualitative and exploratory in nature. The population comprised student midwives, professional midwives and educators. Purposive sampling was done. Focus group discussions were held with student midwives and professional midwives, whilst the naïve sketch form was used as data-collection instrument for educators. Content data analysis was done. The total sample realised was 38. RESULTS: The findings revealed that 'caring' was taken to mean being well conversant, up to-date and proficient in the field of work as well as considerate and respectful to others. The professional midwives indicated that they have seen colleagues demonstrate uncaring behaviour whilst educators emphasised respect as caring. CONCLUSION: The student midwives, professional midwives and educators described caring as being a competent nurse with compassion and respect for others.