Perceived competence and related factors affecting the development of the clinical competence of nursing students at two university sites in Namibia: a cross-sectional study.

BACKGROUND: Ensuring that nursing students graduate with the required clinical competence in nursing is a global challenge. To address this challenge, several studies have looked at various aspects of competency and competency development, however there is scanty evidence on factors affecting development of clinical competency in nursing students. Therefore the, purpose of this study was to investigate nurses' perceived competence and related factors affecting the development of clinical competence of nursing students at two university sites in Namibia. METHODS: A cross-sectional design was utilised. Simple random sampling was applied and 272 nursing students at two university campuses in Namibia were selected. An online questionnaire was used. Data were collected between April and May, 2022, over a period of six weeks, and were analysed using Statistical Package of Social Sciences (SPSS) version 27. Chi-square and Spearman correlations were used to assess the associations and correlations, respectively, among the variables. Logistic regression was used to assess the factors associated with the development of clinical competence using a p-value < 0.05 confidence interval. RESULTS: Forty-seven percent (47%) of the students were found to be competent while more than half (53%) were not. A Chi-square test found a statistically significant difference between students studying at different campuses and between different year levels (p = < .05). A regression analysis showed that nursing educators' competence (ß = .128; p = .36) had a positive influence on nursing students' competence levels, unlike the mode of learning (ß = -.140; p = .013), which negatively predicted the development of clinical competence. No significant relationship was found between the development of clinical competence and teaching approaches, assessment, feedback, constructive alignment, theory-practice gap and reflective practice (p = ˃.05). CONCLUSION: Educator's competence levels and the mode of learning were the two major factors that were more likely to influence the development of clinical competence among nursing students. Therefore, it is recommended that nursing training institutions prioritise the development of educators' competence and apply various modes of learning to enhance development of nursing students' competence.

Nursing Students' Learning Engagement Experiences During the COVID-19 Pandemic in Namibia: Implications for Nursing Education.

Introduction: Ensuring strong student engagement in both traditional and virtual learning settings was essential for achieving positive educational results during the COVID-19 pandemic. However, fostering student engagement in both the traditional (face-to-face) and virtual learning environments has been accompanied by distinct challenges. There has been a lack of research specifically addressing the issue of nursing students' engagement within a blended learning setting in Namibia. Aim: To explore and describe nursing students' learning engagement experiences at a university campus in Namibia during the COVID-19 pandemic. Methods: A qualitative, descriptive, phenomenological study was employed to collect data from 10 purposively selected nursing students at a university campus in Namibia. Data from in-depth, face-to-face, individual interviews were collected using a semistructured interview guide. Data were analyzed using Colaizzi's seven-step method. Results: The findings of the study describe students' learning engagement experiences under four distinct themes: (a) conditions and contexts of engagement; (b) student acts of engagement: positionality of teacher- and student-facilitated engagement; (c) consequences of engagement in a blended learning environment; and (d) student engagement dispositions: students' initiatives. Conclusion: The research findings revealed that despite mental health challenges, both teacher-facilitated and student-facilitated engagement were necessary for positive learning engagement in the blended learning environment. Student-facilitated engagement was significantly responsible for enabling students to maintain focus, adhere to guidelines, and adapt to the blended learning environment. These findings are useful in understanding the challenges faced by students during the COVID-19 pandemic. The findings thus provide valuable data for future studies seeking to address challenges associated with the blended learning environment.

Nurses' barriers to the pressure ulcer risk assessment scales implementation: A phenomenological study.

AIM: The aim of the study was to explore nurses' barriers to the pressure ulcer risk assessment scales implementation. DESIGN: A qualitative descriptive phenomenological study. METHODS: The research participants comprised of 10 nurses at various medical and surgical departments in a teaching hospital northeast of Namibia. Data were collected between August and September 2022 through in-depth, semi-structured face-to-face individual interviews and analysed using Colaizzi's 7-step method. RESULTS: The interviews with nurses, led to two major themes being discovered: (1) factors hindering the effective prevention of pressure ulcers; (2) suggestions for improvements in the utilization of risk assessment scales. The participants noted that they had inadequate knowledge of the formal risk assessment scales; there were inadequate resources and insufficient staff; there were no policies or guidelines regarding the management of pressure ulcers, all of which influenced their utilization of pressure risk assessment scales. Education and training, the provision of equipment, the hiring of new staff and the formulation of policies/guidelines would thus improve the nurses' utilization of the scales. CONCLUSION: The findings of this study have uncovered three primary factors that have a detrimental impact on the utilization of risk assessment scales by nurses, that is their lack knowledge on pressure ulcer risk assessment scales; a shortage of staff and equipment; and an absence of policies/guidelines. The findings from this study provide valuable implications for guiding quality improvement initiatives aimed at enhancing the standard of care in Namibia and other resource-limited settings.

Nurses' Knowledge, Attitudes, and Practice of Cardiopulmonary Resuscitation at a Selected Training Hospital in Namibia: A Cross-Sectional Survey.

Background: Nurses play a key role in cases of cardiopulmonary arrest by promptly attending to and initiating cardiopulmonary resuscitation. Effective cardiopulmonary resuscitation thus requires nurses to possess appropriate attitudes, competencies, and adherence to the best nursing practice. Cardiac arrests are a prevalent cause of fatalities, being responsible for approximately 30% of deaths worldwide. Despite this statistic, however, research in this specific field is lacking in Namibia. Objective: The objective of this research was to examine registered nurses' knowledge, attitudes toward, and practice with regard to cardiopulmonary resuscitation at a selected teaching hospital in Namibia. Methods: A cross-sectional survey design using a self-administered questionnaire was utilized to purposively recruit 158 registered nurses from the inpatient and outpatient departments of a teaching hospital in Namibia. Descriptive and chi-square tests were performed using SPSSv26. Results: The results of the study indicate that a significant percentage of nurses have limited knowledge (14.7 ± 1.50), negative attitudes (36.2 ± 4.8), and poor practice (11.16 ± 1.18) when it comes to cardiopulmonary resuscitation. Their poor knowledge is strongly associated with poor practice (χ2 = 9.162, P = .002). The study further revealed a significant correlation between the departments in which the nurses worked and their practice of cardiopulmonary resuscitation, suggesting that the work environment is a crucial factor in determining a nurse's approach to emergency care. Conclusion: The findings of study indicate that the cardiopulmonary resuscitation practice in the selected hospital is unsafe due to the registered nurses' poor knowledge and negative attitudes. It is strongly recommended that hospital managers and policy-makers take steps to formulate guidelines that mandate regular cardiopulmonary resuscitation training at predetermined times.

The interplay between self-regulation, learning flow, academic stress and learning engagement as predictors for academic performance in a blended learning environment: A cross-sectional survey.

Aim: To examine the correlations between self-regulation, learning flow, academic stress and learning engagement as predicting variables for academic achievement in a blended learning environment in Namibia. Design: Cross-sectional survey. Methods: Data were collected from 166 randomly selected undergraduate nursing students through an online survey between January and February 2023, and were analysed using IBM SPSS AMOS version 28.0. The data were explored through factor, parallel and confirmatory factor analyses. The relationship between the study factors and the total score of the scale was analysed using the Pearson correlation coefficient. Results: The results indicate that the two factors identified in the factor analysis are consistent with the theoretical proposition in this research. Factor 1 comprises items C1 to C24, which pertain to self-regulation (SR), while factor 2 consists of items D1 to D9, which relate to learning flow (LR). The findings demonstrate that self-regulation significantly predicts both flow and stress, as well as learning engagement. Additionally, there is a significant relationship between stress and self-regulated learning, as well as between stress and learning flow (r = 0.23-0.26; p= < .05). However, none of the study constructs were found to predict academic achievement. Conclusion: Although self-regulation significantly predicted flow, stress and learning engagement, a non-significant association exists between all the study constructs and academic achievement. The results of this study have significant implications for improving the development of a positive learning environment that fosters active student engagement. Future studies should investigate correlation by conducting large-scale studies. Impact: This study makes a valuable contribution to the current body of literature concerning academic achievement within the context of undergraduate nursing education. The insignificant relationship between the study variables and academic achievement indicate that these elements are not of considerable significance in enhancing educational achievements in blended learning surroundings in Namibia. Patient or public contribution: One hundred and sixty-six undergraduate nursing students participated in the survey. The data collected were analysed and interpreted by a skilled statistician.

Undergraduate Students' Knowledge, Attitudes and Willingness to Receive COVID-19 Vaccines: A Survey of Convenience Sample in Namibia.

Introduction: The global consequences of the COVID-19 pandemic cannot be overstated. Vaccinations are one of the leading strategies to protect against the virus, and it is likely that students' understanding and desire to be vaccinated can be major factors in helping contain the pandemic. Nonetheless, no studies looked into the vaccine attitude, knowledge and willingness in Namibia. Objectives: To assess and describe the association between knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines in the school of education, nursing and economics and management science at the university campus in Namibia. Methods: The study employed a cross-sectional descriptive study from 200 undergraduate university students using a convenience sampling. Data analysis was done using SPSSv28 and descriptive statistics were used to depict trends in data while a Pearson's correlation determined the relationship between the study variables. Results: The data showed that 54.2% (1.54 ± 0.49) of the participants had adequate knowledge concerning the vaccine, while 57.1% and 58.6% had a negative outlook and were unwilling to get vaccinated. A moderate positive correlation was observed between attitudes and willingness to take COVID-19 vaccines (r = .546, P =<.001), while a negative relation existed between knowledge and attitudes (r = -.017, P =>.001). Conclusions: This study has provided valuable insight into the knowledge, attitudes, and willingness of undergraduate students to receive COVID-19 vaccines. Despite more than half of the participants having appropriate knowledge, they had an unfavourable outlook toward COVID-19 vaccination. It is recommended that further studies focus on how factors such as incentives, religion and cultural values affect their desires to be vaccinated.

Barriers and Facilitators Affecting the Uptake of COVID-19 Vaccines: A Qualitative Perspective of Frontline Nurses in Namibia.

Aim: Vaccinations remain one of the most effective measures to prevent and control the spread of COVID-19, while also reducing hospitalizations and deaths, yet many are unwilling to be vaccinated. This study explores the barriers and facilitators affecting the uptake of COVID-19 vaccines among frontline nurses. Design: A qualitative, explorative, descriptive, and contextual research strategy was employed. Methods: A sample of 15 nurses were selected via purposeful sampling to the point of data saturation. The participants were nurses at the COVID-19 vaccinations Centre in Rundu, Namibia. Data were collected using semistructured interviews and analyzed thematically. Results: Three themes and 11 subthemes were identified, namely: (a) barriers, (b) facilitators, and (c) measures to increase the COVID-19 vaccine uptake. Barriers included living in deep rural areas, unavailability of vaccines, and misinformation, whereas scared of death, availability of COVID-19 vaccines, and family influence and peer pressure emerged as facilitators to the uptake of COVID-19 vaccines. Adoption of vaccination passport as a requirement to work premises and as an international travel requirement were the measures proposed to increase the COVID-19 vaccine uptake. Conclusion: The study found several facilitators and barriers to COVID-19 vaccine uptake among frontline nurses. The identified barriers cover the individual, health system, and social factors hindering the COVID-19 vaccine uptake among frontline nurses. Whereas fear of COVID-19 deaths, family influence, and availability of vaccines were found to promote COVID-19 uptake. This study recommends targeted interventions to improve the uptake of COVID-19 vaccines.

Nursing students' experiences and expectations of clinical learning: A qualitative study.

BACKGROUND: Clinical learning is an important component of nursing education that can support the development of competence. Nursing students have expectations before clinical learning, however if these expectations are not matched with their experiences, then development can be hampered. OBJECTIVE: To explore nursing students' expectations and experiences of their clinical learning experiences. DESIGN: Qualitative descriptive design. SETTINGS: The study was conducted at a large teaching hospital in Namibia. PARTICIPANTS: Fifteen first to fourth year undergraduate nursing students who were allocated to a teaching hospital in Namibia. METHODS: The participants were purposively sampled among the teaching hospital's undergraduate nursing students. Data were collected between June to November 2021 through in-depth, semi-structured interviews that lasted between 35 and 45 min each. Data were analyzed using thematic analysis. RESULTS: The data analysis identified four themes: clinical outlook and role, supporting/role modelling, clinical teaching and learning, and linking theory and practice. CONCLUSION: The expectations and experiences of nursing students regarding the clinical environment were mixed. The findings demonstrated the need to moderate students' expectations, as well as to reorganize the clinical learning environment to enhance students' learning. Further studies should look at the standardization of student expectations based on the context of their clinical learning environment, and how this can improve learning experiences.

Nursing students' perception on their readiness to combat gender-based violence during the COVID-19 pandemic.

Background: Gender-based violence (GBV) is a critical public health concern, demanding for global coordinated efforts. While nursing students form part of a healthcare team with significant roles in identifying and responding to abused victims, studies assessing their readiness to combat GBV are limited in Namibia. Aim: To assess undergraduate nursing students' perceptions and to determine the relationship of the study variables to readiness to combat GBV during the coronavirus disease 2019 (COVID-19) pandemic in Namibia. Setting: This study was conducted at a university satellite campus in Namibia. Methods: A cross-sectional survey was used to collect data from 105 third and fourth-year undergraduate nursing students using ADKAR model. Data were analysed using Statistical Package for the Social Sciences, version 27.0, for descriptive statistics and logistic regression in determining relationships between study variables. Results: The study results show a mean readiness of 1.65 ± 0.19. Most respondents perceived themselves ready (73.3%), whereas 26.7% were not. Readiness was common with reinforcement (89.5%) and awareness (84.8%), knowledge (81.9%) and desire (76.2%) subscales. Predictors of readiness in this study were gender and age (R 2 = 0.40; R 2 = 0.37; p ≤ 0.05). Conclusion: The results of this study highlight that age and gender were significant predictors for readiness among the undergraduate students in Namibia. The results highlight the importance of GBV education in a nursing curriculum. A qualitative design is recommended for future studies. Contribution: The results of this study will support global efforts in strengthening the health system response on GBV incidences.

Awareness of varicella-zoster virus among undergraduate students at the University of Namibia.

Although varicella-zoster virus (VZV) is preventable and curable, the disease remains a public health problem in Namibia. Access to vaccination in the country remains a challenge for many citizens including students. No previous study has been conducted to assess awareness on the prevention and control of VZV in Namibia. The overall purpose of the study was to investigate the awareness of hostel students on prevention and control measures for VZV in Namibia. The objective of the study was to assess and describe the awareness of hostel students on the prevention and control measures for VZV in Namibia. A quantitative descriptive study using an online questionnaire was used. Simple random sampling was used to select 165 respondents. Descriptive statistics and a non-parametric Kruskal Wallis test were performed to test the mean differences between variables and the significance of the data. A great proportion of the respondents, 70.7% (n=118), were aware that VZV is caused by a virus (0.71±0.45) while 76% (n=127) (0.76±0.42) were aware that VZV can be vaccinated against. The study found a strong association between aetiology (p=0.03), available information (p=0.00), mode of transmission (p=0.02), and knowledge on contagious diseases (p=0.03). The results were inconclusive as to whether the level of awareness is high or low, owing to the differences in scores for each variable. The study recommends that a mobile clinic be established on campus to offer health education information.

Nursing students' understanding of health literacy and health practices: a cross-sectional study at a university in Namibia.

BACKGROUND: A poor understanding of health literacy and inadequate health practices among nurses can be detrimental to a population's health. The starting point of solving this problem is through the provision of methodical health literacy and health practice education in the nursing curriculum. This study explored nursing students' understanding of the concept of 'health literacy' and their health practices at a university in Namibia. METHODS: A descriptive cross-sectional study was carried out among 205 nursing students. A simple stratified sampling method was used and data were collected using a self-reporting Understanding of Health Literacy (UHL) questionnaire. Pearson correlation, independent t-test and One-way ANOVA were used to analyse the data. RESULTS: The overall mean Understanding of Health Literacy score was 13.04 ± 1.52. The majority (n = 157; 76.5%) of the students were found to have adequate health literacy scores, 21.5% had moderate health literacy scores, and only 2% had inadequate health literacy scores. The overall mean health practice score was 32.4 ± 5.50. Most (n = 106; 51.7%) of the students were found to have poor health practices, 44.4% had average health practices, and just 3.9% had good health practices. There was no significant relationship between the health literacy levels and health practices of the students (p = 0.63). CONCLUSIONS: Nursing students have a good understanding of the concept of health literacy, but more effort can be made to translate this understanding into health literacy skills. There is a need to investigate the contributing factors to poor health practices, as well as develop strategies that can support good health practices among nursing students. These health literacy skills could then be transferred into the students' professional careers as nurses.

Awareness of varicella-zoster virus among undergraduate students at the University of Namibia

Although varicella-zoster virus (VZV) is preventable and curable, the disease remains a public health problem in Namibia. Access to vaccination in the country remains a challenge for many citizens including students. No previous study has been conducted to assess awareness on the prevention and control of VZV in Namibia. The overall purpose of the study was to investigate the awareness of hostel students on prevention and control measures for VZV in Namibia. The objective of the study was to assess and describe the awareness of hostel students on the prevention and control measures for VZV in Namibia. A quantitative descriptive study using an online questionnaire was used. Simple random sampling was used to select 165 respondents. Descriptive statistics and a non-parametric Kruskal Wallis test were performed to test the mean differences between variables and the significance of the data. A great proportion of the respondents, 70.7% (n=118), were aware that VZV is caused by a virus (0.71±0.45) while 76% (n=127) (0.76±0.42) were aware that VZV can be vaccinated against. The study found a strong association between aetiology (p=0.03), available information (p=0.00), mode of transmission (p=0.23), and knowledge on contagious diseases (p=0.03).The results were inconclusive as to whether the level of awareness is high or low, owing to the differences in scores for each variable. The study recommends that a mobile clinic be established on campus to offer health education information.

Undergraduate nursing students' self-reported professional behaviour at the University of Namibia.

BACKGROUND: Development of professional behaviour in nursing students is an important part of a nurse's overall competence. Self-evaluation is one way of measuring professional behaviour amongst nursing students. However, studies on self-reported professional behaviour of nursing students are limited in Namibia. AIM: This study aimed to investigate nursing students' self-reported professional behaviour at the University of Namibia. SETTING: The setting was a university campus offering a Bachelor of Nursing Science degree in Namibia. METHODS: A quantitative descriptive contextual design was used with 100 nursing students. Data were analysed descriptively using a non-parametric Kruskal-Wallis and ANOVA tests of variance and statistical significance. RESULTS: High mean scores were found in the areas of utilising evidence-based solutions (4.78 ± 0.58), promoting clinical teaching (4.46 ± 0.94), willingness to implement quality improvement initiatives (4.34 ± 0.518), and protecting health, safety and patient's rights (4.28 ± 0.55). The lowest mean scores were recorded in projecting professional image (2.22 ± 1.27), rendering evidence-based care (4.08 ± 0.44). The study found statistical significance difference between self-reported professional competency (p = 0.01) and quality care improvements (p = 0.02). CONCLUSION: In this study, nursing students' self-reported professional behaviour was rated high (mean scores > 4.0 out of 5). Despite this high rating, it cannot be concluded that the students were professionally competent. We recommend that professional behaviour be measured from both students' and nurse educators' or patients' perspectives. CONTRIBUTION: The findings from this study provide supplementary evidence on self-reported professional behaviour with implications on nursing education and practice.