Patient aggression experienced by professional nurses in acute psychiatric ward: South Africa.

Background: Aggression of patients in hospital wards has become an endemic problem and professional nurses are particularly at high risk. Aim: This article presents the types of patient aggression experienced by professional nurses working in an acute psychiatric ward in Vhembe District, South Africa. Setting: Vhembe District, South Africa. Methods: A qualitative approach using exploratory, descriptive and contextual research design was used. Four hospitals were purposively selected and 10 professional nurses were conveniently sampled to participate in the study. Individual interviews were used to collect data, which were then analysed through Tesch Open Coding Method. Measures to ensure trustworthiness and ethical considerations were adhered to throughout the study. Results: This study shed some light on the professional nurses' lived experiences regarding the types of aggression from patients in an acute psychiatric ward in Vhembe District. The types of aggression are physical aggression, destructive behaviour and verbal aggression. Conclusion: The findings show that the types of aggression to which professional nurses are exposed are overwhelming and the consequences are shocking. As a result, the health of professional nurses is compromised. Therefore, this study recommends further studies to determine the kind of support needed by professional nurses working in an acute psychiatric ward and to investigate the impact of aggression from patients in acute psychiatric ward with regard to the quality of care. Contribution: This article contributes to the body of knowledge regarding patients' aggression in acute wards in Vhembe District, South Africa.

The psychosomatic experiences of women who had intrauterine foetal death in rural South Africa.

BACKGROUND:  Intrauterine foetal death (IUFD) is a traumatic event leading to substantial grief reactions with a variety of experiences in an expectant woman. After delivery, these experiences have shown to impact the mother's psychological well-being, where she experiences post-traumatic stress, sadness, anxiety and depression. The psychosomatic experiences before labour commenced are not known. OBJECTIVES:  This study explored the psychosomatic (mind-body connection) experiences of women who had an IUFD before labour commenced in rural areas of Limpopo province, South Africa. METHOD:  A qualitative approach with an explorative descriptive design was carried out among all 10 consented participants who were selected using a purposive sampling technique. The sample consisted of women who delivered an IUFD as reflected by the hospital register from the selected hospitals. Data were collected at the participants' homes through in-depth individual interviews guided by one open-ended central question as follows, 'Please share with me your experiences of IUFD before you went into labour', and analysed using Tesch's open coding method. RESULTS:  Two themes reflecting the psychosomatic (mind-body connection) experiences of women who had an IUFD emerged from the analysis. The themes are danger alerts and emotional responses. CONCLUSION:  This qualitative study revealed that women could relate a lack of or decreased foetal movement as the danger alert or warning sign that the baby was in danger before labour commenced. Upon noticing that something was wrong with the baby, a message was sent to the women's minds, which equally affected and activated their emotional dimensions. An investigation regarding the kind of support needed by women after being informed of an IUFD is recommended.

A Mixed Methods Protocol for Developing Strategies to Improve Access to Health Care Services for Refugees and Asylum Seekers in Gauteng Province, South Africa.

Access to healthcare is a fundamental human right for all people, including refugees and asylum seekers. Despite the provision in the Refugee Act of South Africa, which allows refugees to enjoy the same access to health services as the citizens of the Republic, refugees still encounter challenges in accessing such services in Gauteng province. This protocol aims to develop strategies to improve access to health care services for refugees and asylum seekers in Gauteng province, South Africa. The study will be conducted in three phases. An exploratory sequential mixed methods design will be employed in phase 1 of the study; the initial study will be based on a qualitative approach followed by a quantitative approach. Phase 1 (a) of this study will employ a qualitative approach in Gauteng province among conveniently sampled health practitioners as well as purposively sampled refugees and asylum seekers. Interviews will be used to collect data that will be analyzed thematically. Phase 1 (b) will adopt a quantitative approach based on the findings from the initial qualitative study. The ethical principles of informed consent, anonymity, privacy, confidentiality, and avoidance of harm will be adhered to throughout the research process. Phase 1 (c) will be meta-inference and conceptualization. Phase 2 will focus on the development of strategies using strength, weakness, opportunities, and threats analysis and a build, overcome, explore, and minimize model to guide the process. In Phase 3, the Delphi technique will be used to validate the developed strategies. The conclusion and recommendations will be based on the findings of the study.

Professional Nurses' Experiences of Student Nurses' Absenteeism during Psychiatric Clinical Placement in Limpopo Province, South Africa: A Qualitative Study.

Psychiatric clinical placement is as essential as other placements in any discipline in nursing education as it allows student nurses to correlate theory to practice. Several research studies have been conducted on nurses' experiences of the clinical supervision of students, but absenteeism is still a challenge globally. In this study, professional nurses' experiences of student nurses' absenteeism from psychiatric clinical placements in Limpopo Province, South Africa, were examined. Three designated specialty mental institutions in Limpopo Province were the sites of the study. Explorative, descriptive, and contextual designs were used in a qualitative approach. A qualitative approach was used because the study sought professional nurses to narrate their experiences through in-depth, semi-structured interviews, which could only be achieved through a qualitative approach. A total of eleven professional nurses, four from two specialized psychiatric hospitals and three from one specialized psychiatric hospital, were purposively sampled and interviewed. These nurses participated in in-depth interviews that were used to gather data, which were then thematically analyzed. One theme and three sub-themes on professional nurses' experiences of the absenteeism of student nurses during psychiatric clinical placement were revealed. The theme was student factors leading to absenteeism, while the sub-themes were fear of mental health care users, negative attitudes towards psychiatric nursing science, and students' lifestyles. Based on the findings, student nurses' absenteeism can be caused by many factors. A qualitative study should be conducted to seek strategies to mitigate the absenteeism of student nurses during clinical placement in the psychiatric hospitals of Limpopo Province.

Title: Caring for Children with Cerebral Palsy: A Challenge to Caregivers in Rural Areas of South Africa.

BACKGROUND: In South Africa, children with cerebral palsy are nested within a family setting by immediate relatives, particularly in the rural areas. These immediate relatives are regarded as caregivers and are not trained with regard to providing care to children with special needs. Therefore, they have to find ways to adapt to their new roles of caregiving using the available resources. The aim of this paper is to present the challenges encountered by caregivers of children with cerebral palsy in rural areas of South Africa. METHODS: This qualitative, explorative, descriptive, and contextual study included 10 caregivers for children with cerebral palsy who were purposively recruited from the three respective hospitals in Vhembe District within Limpopo Province. Data were collected through individual in-depth interviews and analysed using a thematic approach. Ethical considerations and measures to ensure trustworthiness were upheld throughout the study. RESULTS: Four themes emerged from the study, namely economic problems facing caregivers; health problems encountered by caregivers; maltreatment of caregivers by community members, as well as access to transport for caregivers and children. CONCLUSION: Participants narrated that caring for a child with cerebral palsy is not an easy task for the caregiver, particularly in the rural areas of South Africa. They encounter various challenges as they strive to provide quality care to the children that they are caring for. An investigation is recommended concerning the kind of model which should be developed to support caregivers in caring for children with cerebral palsy in the rural areas.

Psychiatric Clinical Placement: Agony for College Nursing Students in South Africa.

(1) Background: Clinical placements in psychiatric nursing science (PNS) are as important as other placements in any discipline in nursing education as they allow students to correlate theory to practice. Nursing students' absenteeism has become a grave concern in psychiatric institutions in South Africa. This study investigated the clinical factors leading to student nurses' absenteeism in the Limpopo College of Nursing during the psychiatric nursing science clinical placement. (2) Methods: A quantitative approach using a descriptive design was followed, where 206 students were purposively sampled. The study was conducted at the Limpopo College of Nursing situated in Limpopo Province, with five campuses offering a four-year nursing program. College campuses were used to access students since this was an easy way of accessing them. Data were collected through questionnaires of structured questions and analyzed using SPSS version 24. Ethical considerations were adhered to throughout. (3) Results: The correlation between clinical factors and absenteeism was determined. The main reported factors for absenteeism were student nurses being treated as a workforce in the clinical areas; shortage of staff in the clinical areas; inadequate supervision of student nurses by professional nurses; and being inconsiderate of student nurses requests for days off in the clinical area. (4) Conclusions: The findings revealed that student nurses' absenteeism is caused by different factors. The Department of Health should find a way of not overworking students due to a shortage of staff in the wards but consider them for experiential learning. A further qualitative study should be conducted to develop strategies to mitigate student nurses' absenteeism in psychiatric clinical placement.

How do family members perceive re-integration of male state patients into their families in South Africa? A qualitative analysis.

BACKGROUND: State patients are admitted to a psychiatric hospital after being declared as such by the magistrate courts as a result of not found fit to stand trial for the offence they had committed. After successful rehabilitation of state patients at the psychiatric hospital, they need to be re-integrated into their families. Family members' perceptions regarding re-integration of male state patients are not largely explored in the scientific body of knowledge. AIM: The aim of the study was to determine the perceptions of family members regarding reintegration of male state patients into their families. SETTING: This study was conducted in Vhembe District of Limpopo province, South Africa. METHOD: A qualitative approach using explorative, descriptive and contextual designs was adopted. In-depth interviews were conducted with 10 family members who were purposefully sampled, and data were thematically analysed using Tech Open Coding method. RESULTS: Three themes emerged, namely, family members understand re-integration; family members' expectations from a mental healthcare user; and threat to re-integration as perceived by family members. CONCLUSION: Data revealed that family members have varied perceptions regarding re-integration. These perceptions were based on the behaviour displayed or an offence committed by the mental healthcare user before admission and how participants experienced it. The study recommends that an investigation is to be conducted on the kind of support family members need regarding re-integration of state patients into their families.