Research Articles (Nursing Science)

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Knowledge of nurse educators working in higher education regarding the “undetectable = untransmissible” concept in HIV care : a scoping review
Foromo, Robert Muraga; Mulaudzi, Fhumulani Mavis; Nyandeni, Sinethemba (Orapuh, Inc., 2025)
INTRODUCTION : The Undetectable = Untransmissible (U=U) concept, which emphasises sustained HIV viral suppression through effective antiretroviral therapy, has gained global acceptance. However, awareness and understanding of U=U among nurse educators, particularly within academic healthcare institutions, remain limited. This study aims to assess nurse educators’ understanding of HIV, specifically in relation to the U=U concept, within academic healthcare settings. PURPOSE : This scoping review aimed to evaluate the current knowledge of nurse educators working in higher education regarding the U=U concept in HIV care. METHODS : A comprehensive literature search was conducted using English-language keywords across multiple databases, including PubMed, Scopus, Web of Science, EBSCOhost, and ProQuest. The search focused on publications published between January 2010 and April 2025. The review followed the Arksey and O’Malley framework and adhered to PRISMA-ScR guidelines. RESULTS : A total of 38 articles were identified as potentially eligible for inclusion. However, 30 were excluded after full-text screening for reasons such as incorrect topic, setting, outcome, population, or publication year. Consequently, eight articles met the inclusion criteria. Four major themes emerged: curriculum development and implementation; knowledge and beliefs about U=U; communication barriers; and strategies for improvement. CONCLUSION : Academic healthcare institutions should empower nurse educators with structured training programmes on HIV-related topics, enabling them to educate students effectively and help reduce new infections and stigma. This review highlights barriers to implementation and identifies effective strategies for enhancing U=U education in nursing, bridging the gap between policy and practical application.
Knowledge, attitudes, and practices of women and men towards infertility : a scoping review
Mabitsela, Vangile Naney; Musie, Maurine Rofhiwa; Sepeng, Nombulelo Veronica (Bentham Open, 2025-01-13)
BACKGROUND : Infertility is a serious concern with emotional and medical implications, affecting millions of couples worldwide. Despite its prevalence, there are still misconceptions and a lack of knowledge and awareness surrounding infertility. OBJECTIVES : The objective of this review is to synthesize the existing literature on knowledge, attitudes, and practices of men and women towards infertility. METHODS : The scoping literature review followed the Arksey and O’Malley’s framework, which included formulating the research question, locating relevant studies, selecting studies, charting data, and synthesizing the results. The databases used were MEDLINE, Africa-Wide Information, Academic Search Complete, Family & Society Studies Worldwide, CINAHL, APA PsycInfo and Google Scholar. Thematic analysis was utilized to analyse the findings of this review. RESULTS : Twelve studies were included in this scoping review. The analysis of these studies produced six themes: women’s concerns regarding infertility, lack of knowledge and awareness regarding infertility, different types of educational information on reproductive health, attitudes towards infertility, practices related to infertility and gender-based treatment, responsibilities, and consequences of infertility. CONCLUSION : The review revealed that men and women consulting in healthcare facilities reported several misunderstandings and information gaps regarding infertility. Regarding attitude, the review found that most men and women demonstrate a positive attitude towards infertility as a disease and regarding the use of fertility drugs for conception. Furthermore, the review found that most men were willing to adopt necessary lifestyle and health practices to enhance or improve their fertility. The use of alternative therapy was also a prominent healthcare option amongst most men and women. Lastly, infertility has been known to cause marriages into divorce or polygamy.The results highlight the need for better healthcare to properly treat infertility. Furthermore, the review identified the need for education programs to address the stigma and misconceptions associated with infertility.
Indigenous placenta disposal : the views of midwives and traditional birth attendants/indigenous knowledge holders in Tshwane District, Gauteng Province, South Africa
Moeti, Cecilia; Mulaudzi, Fhumulani Mavis; Rasweswe, Molatelo M. (Bentham Open, 2025-01-16)
BACKGROUND : Prior to the development of modern obstetric services, indigenous people had their own ways of disposing placenta, which are still practiced in some communities. However, persistent gaps exist in the South African healthcare system that deals with the integration of indigenous knowledge and Western medical services due to constraints in knowledge and expertise. METHODS : A qualitative approach using explorative design guided by the 5D appreciative inquiry model was employed. The participants were ten midwives, four traditional midwives, and six indigenous knowledge holders, who were recruited through a purposive sampling method. Data were collected through semi-structured individual interviews. Content data analysis was followed. RESULTS : Knowledge of the indigenous placenta disposal was discovered from the data, although some of the midwives had no idea. It was also discovered that indigenous placenta disposal is regarded as a valuable practice that should be respected, and the legislature on indigenous placenta disposal should be recognised and acknowledged. CONCLUSION : The findings have demonstrated the significance of understanding and appreciating the various indigenous placenta disposal methods, and the need to legislate the historical impact on its beliefs and practices. This paper has thus aimed to explore and describe the views of the midwives and traditional birth attendants/indigenous knowledge holders in the Tshwane district, Gauteng province, South Africa.
Facilitating the development of clinical reasoning skills amongst undergraduate student nurses through action research
Van Wyngaarden, Angeline; Leech, Ronell; Coetzee-Prinsloo, Isabel M. (Stellenbosch University, 2026-06-06)
Student-centered teaching and learning practices encourage critical thinking and clinical reasoning skills in nursing education, but these practices are challenging for nurse educators. This study followed an action research approach, which involved collective, self-reflective inquiry by the participating nurse educators to identify educational practices that will foster the development of clinical reasoning skills among undergraduate student nurses. This paper describes the action research applied, outlining the implementation and outcomes which led to a co-constructed action plan. Four challenges: teaching, learning, and assessment; the clinical learning environment; continuous professional development and support; as well as the selection of nurse educators and students was addressed. This reflective process contributed to nurse educators evaluating their own pedagogy and adapting their teaching and learning practices to foster clinical reasoning skills among nursing students.
Perspectives of South African midwives on their learning needs pertaining to intrapartum cardiotocograph interpretation
Lukhele, Sanele; Mulaudzi, Fhumulani Mavis; Gundo, Rodwell (Elsevier, 2026-09)
AIM : To explore and describe the perspectives of South African midwives on their learning needs for intrapartum cardiotocograph (CTG) interpretation. BACKGROUND : Intrapartum CTG monitoring and interpretation is standard care for women who are considered at high risk. Its purpose is to detect foetal heart rate abnormalities and monitor uterine contractions. Midwives must be knowledgeable and competent in the skill of CTG interpretation, as this is a means of monitoring foetal wellbeing during labour. Midwives are expected to be trained in this skill by the time they graduate and become independent practitioners. SETTING(S) : This study was conducted in four hospitals in Gauteng Province, South Africa: two district and two central hospitals. METHODS : A qualitative, descriptive and contextual approach was used in this study. Data was collected from 30 nurse midwives working in the labour ward through focus group discussions and one-on-one semi-structured interviews carried out between August and October 2023. Thematic analysis was used to analyse the data. ATLAS.ti was used to manage the data during analysis. FINDINGS : Three themes were identified: inadequate CTG training, factors affecting midwives’ confidence during CTG interpretation, and avenues for empowerment. CONCLUSION : The findings of the study demonstrate that more efforts need to be made to upskill the level of training of midwives in the skill of CTG interpretation at undergraduate level as well as post-qualification. This will make midwives knowledgeable and competent practitioners in the skill of CTG interpretation. Furthermore, it will improve their clinical reasoning skills, thereby improving maternal and neonatal outcomes.
The holistic management of menopausal symptoms among indigenous women in the Gauteng province
Aphane, Maphefo Sophy; Mooa, Ramadimetja Shirley; Rasweswe, Molatelo M. (AOSIS, 2026-03-13)
BACKGROUND: Menopause is a natural process with exacerbating symptoms for some women. Indigenous practices offer culturally rooted options that need systematic evaluation for safety and efficacy, while hormonal therapy, though effective, carries recognised risks and requires monitoring. An evidence-informed understanding of both approaches is essential for safe, individualised and effective menopausal care. AIM: To investigate the role of indigenous traditional knowledge practitioners in the holistic management of menopausal symptoms among indigenous women in the Gauteng province, South Africa. Setting: Selected homes of the participants in the Tshwane district, Gauteng province. METHODS: A qualitative focused ethnography approach utilised purposive and snowball sampling to select 10 indigenous knowledge users and holders and 10 traditional health practitioners. Data were collected through in-depth interviews and non-participant observation and analysed using Brewer’s ethnographic analytical framework with computer-assisted qualitative data analysis software. RESULTS: Pitsa (Pot) as a holistic traditional remedy and cultural existentialism emerged as main themes with three sub-themes. Cultural existentialism is a philosophy that situates menopausal meaning-making and care practices within the framework of cultural identity, heritage and shared traditional knowledge. CONCLUSION: The study shows that Pitsa is perceived by indigenous women as a cultural practice that supports their holistic menopausal experience. It is valued more for identity, meaning-making and cultural support than for proven clinical effectiveness. Recognising such an indigenous knowledge system in menopausal health discourse is important, alongside further empirical evaluation of its clinical effects. CONTRIBUTION: The study highlights the need for understanding and supporting the practices preferred by menopausal women.
Stakeholder recognition and response to human trafficking victims in emergency departments : a descriptive qualitative study in South Africa
Van Rooy, Leanne; Heyns, Tanya; Filmalter, Cecilia Jacoba (Elsevier, 2026-09)
INTRODUCTION : Human trafficking is currently an international crime and one of the most urgent human rights issues. Understanding stakeholders' experiences is critical to developing a care pathway that improves recognition and response. Globally limited qualitative research exists on stakeholders’ experiences of human trafficking in the Emergency Department. This study aims to explore and describe the experiences of stakeholders in recognizing and responding to victims of human trafficking. METHOD : Descriptive qualitative study reported using COREQ. Three online focus groups (29–40 min) were audio-recorded, transcribed, and thematically analyzed following Braun and Clarke. RESULTS : The research team identified six codes: care pathways and policies for guidance, interprofessional collaboration, healthcare professionals’ responses, screening and triage, training and education, and a trauma-informed approach. These codes were then synthesized into three main themes: the need for clear guidance, including policies and procedural frameworks; education, covering screening, triage, recognition of red flags, and awareness; and interprofessional and multisectoral collaboration with coordinated referrals. CONCLUSION : Contextually appropriate, standardized care pathways for identifying and managing human trafficking victims are recommended for South African and broader African healthcare settings. These should be co-designed with healthcare professionals and survivors and aligned with existing systems to promote integrated care. Ongoing training and strengthened multisectoral collaboration are essential to ensure trauma-informed, coordinated, and effective responses.
Determining the level of resilience amongst critical care transport professionals in a fixed-wing air ambulance environment
Basson, Karien; Coetzee-Prinsloo, Isabel; Van der Wath, Annatjie; Masenge, Andries (Elsevier, 2026-06)
INTRODUCTION: Critical care transport within a fixed-wing air ambulance environment is characterised by its demanding and unpredictable nature, distinguishing it from conventional hospital environments. Critical care transport professionals must exhibit resilience to effectively fulfil their responsibilities and excel under stressful conditions. This study examined the level of resilience amongst flight nurses, doctors, and paramedics operating in a fixed-wing air ambulance environment in Africa. METHODS: A quantitative, cross-sectional, descriptive study was conducted using a self-administered survey incorporating the Connor–Davidson Resilience Scale (CD-RISC-25). RESULTS: A total of 48 responses were collected in 2024 from five fixed-wing air-ambulance organisations based in South Africa. Seven constructs related to resilience were measured: hardiness, coping, adaptability and flexibility, meaningfulness and purpose, optimism, emotion regulation, and cognition and self-efficacy. CONCLUSION: The findings suggest that participants generally demonstrated a high level of resilience. Mean scores on the CD-RISC subscales ranged from 6.52 to 22.81, with standard deviations ranging from 1.07 to 3.44. No significant difference in resilience levels was observed between teams comprising mixed professions and those of the same profession. However, optimism was more pronounced in mixed-profession teams than in same profession teams.
Midwives’ competence in interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng : an explanatory sequential mixed-methods study
Lukhele, Sanele; Mulaudzi, Fhumulani Mavis; Gundo, Rodwell (Elsevier, 2025)
BACKGROUND : Cardiotocograph (CTG) tracing is a routine intrapartum care procedure for women who have been diagnosed with high-risk pregnancy. The aim of the CTG is to identify fetuses that are at risk in order to expedite delivery. PURPOSE : To asssess midwives’ competence in the interpretation of the intrapartum cardiotocograph at public hospitals in Gauteng. METHODS : An explanatory sequential mixed-methods approach was used. During phase one, 122 midwives in Johannesburg and Tshwane District filled in self-administered questionnaires, and during phase two, 30 midwives took part in semi-structured qualitative interviews. The data from both phases was analyzed separately and then integrated using the Pillar Integration Process. RESULTS : The Pillar Integration Process led to the identification of six pillars: 1) substandard CTG interpretation training leads to a lack of understanding of key concepts; 2) absence of norms and standards pertaining to CTG interpretation training; 3) Essential Steps in Managing Obstetric Emergencies (ESMOE) training does not result in improved CTG interpretation scores; 4) lack of standardization of CTG interpretation guidelines causes confusion among interpreters; 5) level of knowledge of foundational concepts of CTG interpretation affects clinical judgment; and 6) CTG interpretation skill is a combination of understanding of CTG characteristics, fetal heart rate pattern, fetal physiology and clinical context. CONCLUSION : The results highlighted a knowledge deficit in CTG interpretation and shortfalls in the current CTG training programs. This can be remediated by the development of a CTG training program which is benchmarked with existing programs which have demonstrated good knowledge scores of participants over a long period.
Support expectations of nurses working in the COVID-19 ICU
Khumela, Morendeni Mavis; Coetzee-Prinsloo, Isabel M.; Filmalter, Cecilia Jacoba (IFE Centre for Psychological Studies, 2025-12)
BACKGROUND : In 2020, the World Health Organization (WHO) developed interventions to support health care workers on an individual level to mitigate the psychological stress experienced as a result of working in COVID-19 units. The onus of implementing the WHO support interventions is on the health care organization, and whether those interventions address the needs of critical care nurses is unclear. There seemed to be discord between the support provided by health care organizations as proposed by WHO and the expectations of critical care nurses. SAMPLE SIZE : Thirty (30) Registered Nurses, 1 Enrolled Nurse, and 9 Enrolled Nursing Assistants were invited to participate in the study. Twelve (12) Registered Nurses, two (2) Enrolled nurses and one (1) Enrolled nurse assistant who worked with COVID-19 ICU. METHODS : The study was conducted in a private, independent and non-profit hospital in Pretoria, Gauteng Province, South Africa. The researcher adopted an appreciative appraisal approach, using the constructivist paradigm and a qualitative descriptive explorative research design. For the literature review, various database searches were conducted and two electronic databases were utilized, namely PubMed and MEDLINE. Findings were synthesised using convergent thematic analysis. DATA ANALYSIS : Data was analysed by thematic analysis to identify themes and subthemes. Themes were extracted after reading and re-reading, analysing and interpreting the data. RESULT : The participant nurses expected organizational, managerial, financial, psychological, and peer support to mitigate the stressors experienced by working in the COVID-19 critical care units. CONCLUSION : The findings of this study should assist operational managers to pay attention to work-related stress, contributing factors and early identification of nurses who need support working in the COVID-19 critical care unit. Nursing management should design and implement policies with focused strategies to support health care workers’ psychological wellbeing, especially during the COVID-19 pandemic. The study should contribute to a proactive approach to upscale the mental health of health care workers. Psycho-educational strategies to train nurses on ways to mitigate psychological stress in a professional level are recommended.
Family support needs for people living with hypertension
Darkwa, Irene Owusu; Coetzee-Prinsloo, Isabel M.; Nesengani, Tintswalo Victoria (IFE Centre for Psychological Studies, 2025-06)
Hypertension, a non-communicable disease (NCD), poses a public health threat globally, especially in low-middle- income countries, including Ghana. Family members contribute immensely to the management of chronic diseases such as hypertension. To achieve optimal control of hypertension, a Psychoeducational programme may be adopted as a non-pharmacological strategy to complement the management of hypertension by family members. The study aimed to explore and describe the psychoeducational support needs of family members of people living with hypertension in the Greater Accra Region of Ghana. Qualitative, explorative and descriptive design was employed for this study and a semi-structured interview method was utilised to collect data from two health facilities. Twenty-two (22) participants were purposively sampled, and face-to-face interviews, each lasting 30-60 minutes were conducted until saturation was achieved. Qualitative content analysis (QCA) was used in analysing data. Three main themes emerged: healthcare information, education, and financial support. The respective categories of these main themes are the administration of medication, follow-up visits, monitoring of blood pressure (BP), dietary requirements, communication channel for care or emergency, education on lifestyle modification, education on medications, education on risks and complications of hypertension, education on stress and relaxation technique, education on traditional medicine, medical expenses and transportation fees for follow-up visit and National Health Insurance Scheme Services. Results: The psychoeducational support needs emerged suggesting the need to develop a programme to complement the existing programmes for managing hypertension. Recommendations: A well-structured psychoeducational programme should be developed and integrated into routine hypertension management. The programme should focus on accurate healthcare information, self-management education, and practical skills to improve family member’s care giving capacity and reduce the caregiver burden.
Factors motivating PLWHIV to disclose HIV status to sexual partners : a scoping review
Molato, Boitumelo J.; Meno, Omphemetse F.; Sepeng, Nombulelo Veronica; Mokgaola, Isaac O.; Gause, Gopolang; Sehularo, Leepile A. (IFE Centre for Psychological Studies, 2025-06)
INTRODUCTION : Human immunodeficiency virus (HIV) is a public health problem that has destroyed the lives of many people worldwide. As it continues to spread, disclosure of HIV status is fundamental to mitigate the spread of the virus, expedite various types of support, and improve and well-being of people living with HIV (PLWHIV). Disclosure is a process that takes place without coercion, as PLWHIV should do it voluntarily. Various people are disclosing their HIV statuses to their partners for different reasons. Literature revealed that the majority of PLWHIV disclosed their HIV statuses to their partners in Sub-Saharan Africa. MATERIAL AND METHODS : This study adopted a scoping literature review to achieve the objectives. The following five steps of scoping literature review were the blueprint to guide this study, namely identifying the research question, identifying the relevant studies, selecting studies, charting data and finally collating, summarising and reporting the results. RESULTS :This review revealed two themes and six sub-themes. The first theme was facilitation of support, with sub-themes for partner support, emotional support, social support, and financial support. The second theme was health promotion, with sub-themes for protecting loved ones from infection and enhancing medication adherence. CONCLUSIONS : The PLWHIV disclosed their HIV statuses to partners to support them through the entire journey of the illness. The support received from the partners included financial support to enable them to travel to the respective facilities to collect medication. In addition, they needed social and emotional support during difficult times. The findings of this study may assist policymakers in formulating policies and guidelines supporting PLWHIV, which discloses their status to their beloved partners. Furthermore, the findings can further inform health promotion activities carried out by healthcare professionals.
Factors influencing the use of family planning methods for prevention of pregnancy among undergraduate students : a scoping review
Kekana, Mmaphuthi Alidah; Sepeng, Nombulelo Veronica (IFE Centre for Psychological Studies, 2025-06)
BACKGROUND : The number of unwanted pregnancies among students in institutions of higher learning around the world continues to increase each year, despite the accessibility of family planning methods, highlighting persistent gaps in knowledge and use. Previous studies have examined specific factors influencing contraceptive use, but few have comprehensively analysed how demographic, sociocultural, and individual barriers intersect to shape these behaviours. This review addresses this gap by synthesizing recent evidence on factors influencing family planning use among undergraduate students and critically evaluating inconsistencies and research gaps within the existing literature. METHODS : The following databases were used to search for articles: PubMed, MEDLINE, CINAHL, Academic Search, Africa wide, Health Source: Nursing Academic Edition, and APA Psych Info via EBSCOhost and Google Scholar. Google Scholar was used to search for grey literature. Articles published between 2014 and 2024 were selected based on predefined criteria to report recent evidence in this topic. MeSH terms were searched using the following keywords: factors, contraceptives, undergraduate students, and influencing. RESULTS : Of the four hundred and sixty-three (463) identified articles twenty-four (24) met the inclusion criteria. Five (5) themes were identified, namely: demographic variables as contributing factors influencing the use of family planning methods for prevention of pregnancy, knowledge and attitudes regarding the use of family planning for prevention of pregnancy, risk factors and concerns associated with unintended pregnancies, the myths, barriers and stereotypical behaviors impending the use of family planning methods for prevention of pregnancy, and lastly, the usage patterns, type and preferred methods of family planning for prevention of pregnancy. The review highlights contradictions within the literature, such as varying perceptions of risk and the effectiveness of educational interventions, and identifies significant gaps in addressing sociocultural barriers. CONCLUSION : By critically examining how various factors interact to influence undergraduate students’ use of family planning, this review adds to the body of knowledge already in existence. Unlike previous research, it highlights the compounding effects of cultural myths and demographic disparities while identifying subtle gaps in knowledge and access. Practical implications include integrating affordable and accessible family planning services with tailored, culturally sensitive sexual and reproductive health education. Addressing these barriers is essential for reducing unintended pregnancies and promoting equitable reproductive health in academic settings.
Community health workers’ knowledge of Ubuntu informed care in tuberculosis, HIV, and AIDS in Gauteng Province
Gundo, Rodwell; Sepeng, Nombulelo Veronica; Lavhelani, Robert; Moeta, Mabitja; Musie, Maurine Rofhiwa; Seretlo, Raikane J.; Mulaudzi, Fhumulani Mavis (AOSIS, 2025-02-20)
BACKGROUND : Community health workers (CHWs) work with community members who experience various health problems. They assist community members to lead a healthy life and achieve an acceptable health status. To achieve this, there is a need for CHWs to apply Ubuntu philosophy when providing care related tuberculosis (TB), Human Immunodeficiency Virus (HIV), and acquired immunodeficiency syndrome (AIDS). OBJECTIVES : The aim of this study was to assess CHW's knowledge of Ubuntu-informed Care in tuberculosis, HIV, and AIDS Services in Gauteng province, South Africa. METHOD : A total of 380 CHWs were recruited from a district in Gauteng province to participate in a training on the management of TB, HIV and AIDS. A questionnaire with 40 multiple choice questions was administered to the CHWs before the training. SPSS version 28 was used to analyse the data. RESULTS : The scores ranged from 9 to 33 out of 40 (M = 21.6, s.d. = 4.2). Out of the 380 participants, 274 (72.1%) passed the pretest while 106 participants (27.9%) failed. The highest mean scores were achieved by female participants (M = 21.6, s.d. = 4.3), participants aged 21-30 years (M = 21.8, s.d. = 4.1) and participants with additional course qualification after Grade 12 (M = 23.5, s.d. = 3.4). CONCLUSION : The findings highlight the need for targeted training interventions to improve the knowledge of CHWs on TB, HIV and AIDS. CONTRIBUTION : This study adds to the literature on the need for inclusion of Ubuntu when caring for people living with HIV and TB.
Exploring undergraduate nursing students’ experiences of evidence searching skills during nursing training : a focus group study in Tshwane, South Africa
Abdullahi, Fatima Isa; Nesengani, Tintswalo Victoria; Maree, Carin (Elsevier, 2026)
BACKGROUND : Information literacy is essential in undergraduate nursing education and clinical practice to ensure the appropriate use of advanced technological resources that promote informed clinical decision-making and safer, high-quality patient care. However, challenges include identifying high-quality evidence, evaluating reliability, assessing resources, and a lack of specific guidelines for embedded training in nursing curricula to support the implementation of evidence-based practice. AIM : To explore undergraduate nursing students’ experiences of evidence searching skills during nursing training at a South African university. DESIGN : A qualitative descriptive design using focus group discussions. METHODS : Data were collected using a semi-structured interview guide. Seven focus group discussions were conducted with 46 undergraduate nursing students from all year groups. The participants were purposively selected. Discussions were audio-recorded and analyzed using reflexive thematic analysis. FINDINGS : Four themes emerged: (1) awareness of the need for evidence-searching skills, (2) obtaining knowledge and skills related to evidence-searching skills, (3) training opportunities, and (4) students’ recommendations for strengthening evidence-searching skills. CONCLUSION : Undergraduate nursing students recognized the theoretical importance of evidence searching but lacked the ability to navigate scholarly databases due to limited exposure to context-specific training, leading to the adoption of ineffective habits, including reliance on AI tools. The current first-year training is inadequate to ensure nursing proficiency. To ensure patient safety and promote evidence-based practice, the study recommends a scaffolded, progressive training program that includes practical workshops to help students access, critically evaluate, and ethically apply scientific evidence in academic and clinical settings, thereby supporting lifelong learning, academic integrity, and professional practice. This aligns with global efforts to deliver safer, higher-quality care.
Exploring the training needs of nurses in enhancing the self-concept of patients with spinal cord injury in a selected rehabilitation hospital in Gauteng, South Africa
Mahlaole, Khanyisile Agnes; Bhana-Pema, Varshika; Musie, Maurine Rofhiwa; Dlamini, S. (Elsevier, 2026)
BACKGROUND : Patients with spinal cord injuries (SCI) often experience changes in self-concept during rehabilitation, impacting health outcomes and hospital stay duration. OBJECTIVE : To explore and describe nurses’ training needs to enhance the self-concept of SCI patients in a rehabilitation hospital. DESIGN : Exploratory, descriptive, qualitative design. SETTING : A government-owned rehabilitation hospital in Gauteng, South Africa. PARTICIPANTS : 20 purposively sampled nurses from various categories. METHODS : Semi-structured individual interviews were conducted and analysed using Tesch’s method. RESULTS : Four themes emerged: knowledge of self-concept, identification of altered self-concept, interventions to enhance self-concept, and training needs. Nurses demonstrated inconsistent understanding and relied on personal skills without formal training. CONCLUSIONS : Specialized training is essential to equip nurses with strategies to enhance patients’ self-concept, improving rehabilitation outcomes. SOCIAL MEDIA ABSTRACT : Nurses need training to support spinal cord injury patients’ self-concept during rehabilitation. RECOMMENDATIONS : Nursing education Institutions to incorporate self-concept knowledge and enhancement skills into their training programmes. Physical rehabilitation hospitals to conduct continuous professional development on self-concept care of patients with spinal cord injury to create awareness and skill development.
Developing a followership innovation implementation strategy for nurses : an applied implementation research study
Mamba, Welile Magnificent; Fourie, Willem; Botma, Yvonne; Heyns, Tanya (Elsevier, 2026)
INTRODUCTION : Followership training for nurses is critical because it improves the nurse leader–follower dyad, healthcare team functioning, and patient outcomes. However, leadership training has traditionally received priority in healthcare, and the follower role has been neglected. The reason is that followership is classified as passive role that requires no development. AIM : The aim of the research was to develop a followership innovation implementation strategy for nurses working in a hospital. METHODS : We adopted implementation research using an explorative descriptive qualitative design. Data were collected through a stakeholder analysis workshop from ten purposively selected stakeholders. The workshop was audio-recorded and data were analysed using deductive thematic analysis. Insights from stakeholders were incorporated into thematic areas adapted from the domains of the Consolidated Framework for Implementation Research and Implementation Research Logic Model. RESULTS : The innovation was a followership training programme for nurses, and the inner context was the selected hospital where training would be implemented. The external setting comprised the university, higher education council, and nursing council that would partner with the hospital during implementation. Individuals included the research team, hospital in-service department, and nurses who would receive training. The implementation process incorporated a pre-implementation plan. CONCLUSION : Implementation research frameworks are instrumental in developing evidence-based implementation strategies in the nursing discipline. Successful implementation of the followership innovation can promote collaboration between nurse leaders and followers. Future research needs to implement and investigate the impact of the followership innovation among nurses.
Coping strategies of caregivers of children with chronic renal failure on automated peritoneal dialysis at a hospital in Gauteng, South Africa
Khumalo, Sibongile Patricia; Van der Wath, Anna Elizabeth; Raikane, Seretlo; Sepeng, Nombulelo Veronica (Elsevier, 2026)
BACKGROUND : Renal failure is a common chronic condition which affect both adults and children worldwide and is characterized by a gradual loss of kidney function over time. There are several ways to treat kidney failure and one of the methods is automated peritoneal dialysis (APD), which is mainly used in children. Children with chronic renal failure are cared for by caregivers at home. When a child is diagnosed with chronic renal failure, the caregivers’ lives change drastically, and they must adapt to this change of caring for the child undergoing APD. AIM : The study aimed at exploring and describing the coping strategies of caregivers of children with chronic renal failure on APD at the selected academic hospital in the Gauteng Province, South Africa. METHODS : An exploratory-descriptive design was used to conduct this study. The study used purposive sampling to select a total number of ten participants. These participants were invited for face-to-face interviews conducted using a semi-structured interview guide. The interview questions were open ended to allow participants to provide rich information. A digital audio recorder was used to record the interviews. Data was analysed using thematic analysis. FINDINGS : Five themes emerged from the data: Psychological coping strategies, social and emotional support systems, spiritual coping strategies, substance use as a coping mechanism and recommended informational support systems by caregivers. CONCLUSION : Although caregivers use various coping strategies associated with caring for children on APD, they require additional effective coping strategies and support from the hospital, family members and support groups.
Conceptualisation of relational care through cultivating attentiveness : the butterfly effect in mental health nursing
Ramalisa-Budeli, Rudo; Du Plessis, Emmerentia; Scholtz, Suegnèt (Elsevier, 2026)
BaACKGROUND : Attentiveness as the foundation of care fosters authentic connections between mental health nurses and their patients. This paper highlights the transformative impact of attentiveness and relational care in mental health nursing by providing a concept analysis for relational care through cultivating attentiveness. Nurses in this setting are susceptible to systemic challenges that impact their provision of care; therefore, clarity of this concept may inform and empower nurses to navigate complex challenges while they render compassionate relational care. PURPOSE : To conceptualise relational care through cultivating attentiveness as experienced and understood by mental health nurses in South Africa. METHOD : Walker and Avant’s iterative steps of concept analysis. Twelve papers including dictionaries and thesauruses were included in this concept analysis. CONCLUSION : By linking relational care to cultivating attentiveness, this study highlights that this concept has a transformative impact on the health outcomes for patients and the patient’s relationship with the nurse. Attentiveness is an evolving and intentional effort that nurses should cultivate to foster trust, empathy and connection.
Experiences of human trafficking survivors when managed in an emergency department : a descriptive qualitative study
Van Rooy, Leanne; Filmalter, Cecilia Jacoba; Heyns, Tanya (Elsevier, 2026-06)
AIM : To explore and describe human trafficking survivors’ insights and lived experiences as victims in an ED to inform recognition and response to their needs. BACKGROUND : Numerous survivors reportedly visited the emergency department while being trafficked. The voice of the survivors needs to be heard to understand the perspectives of care, specific needs, and prevent re-traumatization. DESIGN : Descriptive qualitative design. METHODS : 12 semi-structured interviews were conducted with human trafficking survivors. The data were analyzed using thematic analysis. RESULTS : Four themes emerged from the data: distress, apprehension, intimidation, and oblivious healthcare professionals. DISCUSSION : Survivors experienced significant distress and apprehension, largely driven by intimidation related to the ongoing presence and control of traffickers. These experiences were exacerbated by healthcare professionals’ limited awareness, which hindered identification and disclosure. CONCLUSION : Implementing trauma-informed care and ongoing training is essential to foster trust, improve identification, and support victims in the emergency department. HIGHLIGHTS • Survivors of human trafficking experience high levels of distress and apprehension and are intimidated by their traffickers and constrained from disclosing their status. • Healthcare professionals’ limited awareness of human trafficking constrained their ability to recognize vulnerability and respond effectively. • Addressing these gaps through trauma-informed care, targeted training, and ongoing awareness among healthcare professionals is essential to create a safer environment, foster trust, and improve the identification and support of human trafficking victims.

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