Curationis - Volume 38, Issue 1, 2015
Volume 38, Issue 1, 2015
Knowledge, attitudes and practices toward breast cancer screening in a rural South African community : original researchSource: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1172More Less
Objectives: The study assessed the knowledge, attitudes and breast cancer screening practices amongst women aged 30-65 years residing in a rural South African community.
Method: A quantitative, descriptive cross-sectional design was used and a systematic sampling technique was employed to select 150 participants. The questionnaire was pretested for validity and consistency. Ethical considerations were adhered to in protecting the rights of participants. Thereafter, data were collected and analysed descriptively using the Predictive Analytics Software program.
Results: Findings revealed that the level of knowledge about breast cancer of women in Makwarani Community was relatively low. The attitude toward breast cancer was negative whereas the majority of women had never performed breast cancer diagnostic methods.
Conclusion: Health education on breast cancer screening practices is lacking and the knowledge deficit can contribute negatively to early detection of breast cancer and compound late detection. Based on the findings, community-based intervention was recommended in order to bridge the knowledge gap.
Facilitative and obstructive factors in the clinical learning environment : experiences of pupil enrolled nurses : original researchSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1263More Less
Background: The clinical learning environment is a complex social entity that influences student learning outcomes in the clinical setting. Students can experience the clinical learning environment as being both facilitative and obstructive to their learning. The clinical environment may be a source of stress, creating feelings of fear and anxiety which in turn affect the students' responses to learning. Equally, the environment can enhance learning if experienced positively.
Objectives: This study described pupil enrolled nurses' experiences of facilitative and obstructive factors in military and public health clinical learning settings.
Method: Using a qualitative, contextual, exploratory descriptive design, three focus group interviews were conducted until data saturation was reached amongst pupil enrolled nurses in a military School of Nursing.
Results: Data analysed provided evidence that acceptance by clinical staff and affordance of self-directed learning facilitated learning. Students felt safe to practise when they were supported by the clinical staff. They felt a sense of belonging when the staff showed an interest in and welcomed them. Learning was obstructed when students were met with condescending comments. Wearing of a military uniform in the public hospital and horizontal violence obstructed learning in the clinical learning environment.
Conclusion: Students cannot have effective clinical preparation if the environment is not conducive to and supportive of clinical learning, The study shows that military nursing students experience unique challenges as they are trained in two professions that are hierarchical in nature. The students experienced both facilitating and obstructing factors to their learning during their clinical practice. Clinical staff should be made aware of factors which can impact on students' learning. Policies need to be developed for supporting students in the clinical learning environment.
Acceptability of neonatal circumcision by pregnant women in KwaZulu-Natal, South Africa : original researchSource: Curationis 38, pp 1 –5 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1433More Less
Background: Studies on voluntary medical male circumcision (VMMC) have provided convincing evidence on its efficacy to provide partial protection against female-to-male HIV transmission in circumcised men. The World Health Organization and UNAIDS subsequently formulated recommendations for VMMC implementation that included implementation of neonatal medical male circumcision (NMMC) to all infants up to two months old. Knowledge regarding the acceptability of NMMC by pregnant women who are candidates for grantingof consents for NMMC procedures or its ideal placement within health programmes is low.
Objectives: We sought to establish NMMC acceptability by pregnant women and the feasibility of its integration within Maternal, Child and Women's Health (MCWH) programmes to inform implementation guidelines.
Method: Nurses and counsellors at two public health facilities were trained to provide NMMC counselling and offer NMMC to 1778 pregnant women presenting for antenatal care services. Univariate and bivariate analyses were performed on data collected on NMMC acceptance and refusals. Thematic analysis was also performed on qualitative reasons for refusals.
Results: Acceptability of NMMC by women was high (82.9%). Refusals resulted from the need for consultations with partners and/or family members prior to consenting (41.3%), fear of the procedure (23.8%), cultural reasons (15.9%) and no reasons given (15.3%).
Conclusion: The acceptability of NMMC by pregnant women and its integration with MCWH services was feasible. However socio-cultural factors, including the need for further consultation prior to consenting for NMMC procedures and preference of traditional circumcision by some women, need to be addressed in order to increase uptakes.
Patterns of a culture of aggression amongst Grade 10 learners in a secondary school in the Sedibeng District, South Africa : original researchSource: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1233More Less
Background: A number of reports to the Department of Education indicated high levels of aggression in a Grade 10 A class in a secondary school in Sedibeng District, Gauteng. Teachers, the school management team, school governing body, school-based support team, parents, community leaders and learners seemed unable to manage this constructively. Neither the culture of aggression nor the influence of this phenomenon on those entrapped in it were understood. No published research reports could be found on cultures of aggression in South African secondary schools. There was therefore a dire need to explore and describe the culture of aggression in this specific Grade 10 A class.
Objectives: This article reports on patterns of a culture of aggression observed amongst learners in a Grade 10 class in a secondary school in the Sedibeng District of the Gauteng Department of Education.
Method: A qualitative, exploratory, descriptive and contextual research design was followed with an ethnographic approach. Purposive sampling was used to select participants. Data consisted of observations of 'rich points', interviews and field notes, and thematic data analysis and an independent coder were used.
Results: Findings reflected four patterns of a culture of aggression amongst learners, namely patterns of anger, bullying, fighting, and challenges to moral values. At the root of these were neglect of and non-adherence to human rights and a sound base of morals.
Conclusion: The challenge is to assist the involved learners to respect each other's human dignity, so that relationships can be developed in which those involved act with sensitivity towards each other's needs. Such relationships often also result in the development of self-respect and a nuanced future orientation as part and parcel of mental health.
The learning experiences of mentees and mentors in a nursing school's mentoring programme : original researchSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1145More Less
Background: A School of Nursing supports third-year undergraduate students (mentees) by means of a mentoring programme in which critical-care nursing students (mentors) are involved. However, the programme designers needed to find out what gaps were evident in the programme.
Objectives: The objectives of the study were to explore and describe the learning experiences of the mentees and mentors and to obtain recommendations for improving the programme.
Method: An action-research method was used to develop and to refine the student-mentoring programme and to identify student needs. However, for the purposes of this article a descriptive design was selected and data were gathered by means of a nominal-group technique. Fourteen mentees and five mentors participated in the research.
Results: The findings indicated that attention should be paid to the allocation and orientation of both mentors and mentees. Amongst the positive experiences was the fact that the mentees were reassured by the mentor's presence and that a relationship of trust developed between them. In consequence, the mentees developed critical thinking skills, were able to apply their knowledge and improved their ability to integrate theory and practice. Not only did the mentees gain respect for the mentors' knowledge and competence, but they also lauded the mentoring programme as a memorable and vital experience.
Conclusion: The findings indicated that several changes would be needed to improve the structure of the mentoring programme before a new group of mentees could be placed in critical-care units.
Source: Curationis 38, pp 1 –6 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1174More Less
Background: Disclosure of one's HIV status to a sexual partner can have significant health implications. From a health promotion point of view, disclosure is seen as a cornerstone for the prevention of HIV transmission between partners. Despite its importance as a strategy for controlling the spread of HIV, there are challenges that inhibit voluntary disclosure.
Objectives: In exploring factors associated with disclosure of HIV status, the study had two complementary objectives related to: (1) investigation of participants' views about HIV-positive status disclosure to sexual partners; and (2) a broader identification of factors that influence disclosure of HIV-positive status.
Method: The study explored factors associated with disclosure of the HIV status of people living with HIV to their sexual partners. Purposive sampling was used to select 13 participants living with HIV who attended a wellness clinic. Primary data were collected via an in-depth interview with each of the participants.
Results: The exploration showed that male participants were notably more reluctant to disclose to their sexual partners for fear of rejection; and secrecy was commonly reported around sexual matters. Female participants (who were in the majority) were relatively more willing to disclose their HIV status to their sexual partners. Despite the complexity of disclosure, all participants understood the importance of disclosure to their sexual partners.
Conclusion: There is a need for HIV prevention strategies to focus on men in particular, so as to strengthen disclosure counselling services provided to people living with HIV and to advocate strongly for partner testing.
Cracking the nut of service-learning in nursing at a higher educational institution : original articleSource: Curationis 38, pp 1 –9 (2015) http://dx.doi.org/10.4102/curationis.v38i1.117More Less
Background: The readiness of academics to engage in the service-learning (SL) institutionalisation process is not accentuated in research on SL institutionalisation in South Africa. The argument has been advanced that SL scholarship and willingness of key stakeholders are crucial for SL institutionalisation at the academic programme level.
Aim: The research focus of the study being reported here was on readiness of respondents to embed SL in the curricula of the nursing programme.
Method: This study used a quantitative, exploratory and descriptive design. A self-administered structured questionnaire was used to collect data from a stratified sample comprising 34 respondents. The data were analysed for descriptive statistics using SPSS 19.
Results: The demographic profile of the respondents indicated that 31 (66%) were between 31 and 50 years old; 36 (75.16%) had a minimum of 10 years' nursing experience; 19 (39.6%) had a master's degree, two (4.2%) had a doctorate; and 29 (60.4%) had been employed by the school for a maximum of five years. The results indicated that the nurse educators were in need of SL capacity-building because 9 (18.8%) had limited or no knowledge of SL and 24 (50%) confused SL with other forms of community engagement activities. However, only 15 (33%) of the clinical supervisors and 13 (27%) of the lecturers indicated a willingness to participate in such a programme.
Conclusion: The school was not ready to embed SL in the academic programme because of a lack of SL scholarship and willingness to remediate the identified theory-practice gaps.
Accessibility, affordability and use of health services in an urban area in South Africa : original researchAuthor Ethelwynn L. StellenbergSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.102More Less
Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right.
Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa.
Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data.
Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (X2) test.
Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
Perceptions of professional nurses regarding introduction of the Batho Pele principles in State hospitals : original researchSource: Curationis 38, pp 1 –9 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1128More Less
Background: The South African health care delivery system has shifted focus to primary health care since 1994. For this purpose the Batho Pele principles were introduced. Nurses claim, however, that since the introduction of these principles patients and their families have been making unnecessary and sometimes impossible demands of nursing staff. This article presents the perceptions of the professional nurses regarding the introduction of the Batho Pele principles in their workplace.
Objectives: To describe the perceptions of professional nurses regarding introduction of the Batho Pele principles and to recommend guidelines to facilitate measures to realise the objects of these principles.
Method: A qualitative, exploratory, descriptive and contexual research design was used. Six audio-taped focus group discussions and field notes were used to collect data from purposively sampled participants who have worked in the outpatient departments of hospitals in the Port Elizabeth Hospital Complex. Guba's model of trustworthiness was used to confirm integrity of the study, whilst the participants were kept anonymous, protected from harm and participated voluntarily. Data analysis was done using Tesch's data analysis spiral and with the involvement of an independent-coder.
Results: Three themes emerged, revealing that the professional nurses perceived the objectives of the Batho Pele principles as difficult to uphold due to the inadequate planning prior to their implementation. Inadequacy of human and material resources aggravated this perception.
Conclusion: Professional nurses are not happy with how things are in terms of introduction of the Batho Pele principles, but are optimistic of a positive change in the near future.
Source: Curationis 38, pp 1 –4 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1202More Less
Background: Reflection is recognised as an important method for practice development. The importance of reflection is well documented in the literature, but the requirements for reflection remain unclear.
Objectives: To explore and describe the requirements for reflection in the critical care environment as viewed by educators of qualified critical care nurses.
Method: A focus group interview was conducted to explore and describe the views of educators of qualified critical care nurses regarding requirements for reflection in the critical care environment.
Results: The themes that emerged from the focus group were buy-in from stakeholders - management, facilitators and critical care nurses, and the need to create an environment where reflection can occur.
Conclusion: Critical care nurses should be allowed time to reflect on their practice and be supported by peers as well as a facilitator in a non-intimidating way to promote emancipatory practice development.
Home-based carers' perceptions of health promotion on sexual health communication in Vhembe District : original researchSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1181More Less
Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women's groups provided health promotion skills and health education to communities and made a difference in health related behaviour change.
Objective: The purpose of the study was to explore and describe the home-based carers' perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture.
Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers' perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data.
Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication.
Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.
Educational background of nurses and their perceptions of the quality and safety of patient care : original researchSource: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1126More Less
Background: International health systems research confirms the critical role that nurses play in ensuring the delivery of high quality patient care and subsequent patient safety. It is therefore important that the education of nurses should prepare them for the provision of safe care of a high quality. The South African healthcare system is made up of public and private hospitals that employ various categories of nurses. The perceptions of the various categories of nurses with reference to quality of care and patient safety are unknown in South Africa (SA).
Objective: To determine the relationship between the educational background of nurses and their perceptions of quality of care and patient safety in private surgical units in SA.
Methods: A descriptive correlational design was used. A questionnaire was used for data collection, after which hierarchical linear modelling was utilised to determine the relationships amongst the variables.
Results: Both the registered- and enrolled nurses seemed satisfied with the quality of care and patient safety in the units were they work. Enrolled nurses (ENs) indicated that current efforts to prevent errors are adequate, whilst the registered nurses (RNs) obtained high scores in reporting incidents in surgical wards.
Conclusion: From the results it was evident that perceptions of RNs and ENs related to the quality of care and patient safety differed. There seemed to be a statistically-significant difference between RNs and ENs perceptions of the prevention of errors in the unit, losing patient information between shifts and patient incidents related to medication errors, pressure ulcers and falls with injury.
Parents' experience of childhood atopic eczema in the public health sector of Gauteng : original researchSource: Curationis 38, pp 1 –9 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1215More Less
Background: The World Allergy Organization found that 20% - 30% of the world's population suffers from an allergic disease. Most allergic patients are seen by non-allergy-trained healthcare workers. The public primary healthcare (PHC) management of childhood atopic eczema (CAE) in the central Gauteng district was the focus of the overall study. The focus of this article is the parents' experience of CAE and the management thereof. The research question was: What is the experience of parents living with a child with atopic eczema (AE)?
Objectives: The overall purpose was to develop validated PHC management guidelines for CAE. One of the objectives was to explore and describe the experiences of parents regarding the AE of their children and the management thereof.
Method: An embedded single case study design using a qualitative, explorative, descriptive and contextual strategy was employed. Data was collected through semi-structured individual interviews from a purposively selected sample and field notes. Ten parents were interviewed, after which data saturation occurred. Data were analysed according to Tesch's steps of descriptive data analysis. Lincoln and Guba's model was used to ensure trustworthiness.
Results: Three main themes were identified. This article focuses on theme one: The physical, emotional and social impact of CAE. Theme two identified the management challenges and theme three indicated recommendations regarding the management of CAE.
Conclusion: The facilitation of management of CAE focuses on developing PHC guidelines and addressing management challenges in order to achieve better controlled CAE.
Source: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1258More Less
Background: Although families caring for a mentally-ill family member may experience challenges, some of these families may display strengths that help them to overcome difficulties and grow even stronger in caring for their family member. In cases where these families are unable to cope, the mentally-ill family member tends to relapse. This indicated the need to explore the strengths of families that cope with caring for mentally-ill family members.
Objective: The purpose of this study was to explore and describe the strengths of families in supporting mentally-ill family members in Potchefstroom in the North-West Province.
Method: A qualitative, explorative, descriptive and contextual design was employed, with purposive sampling and unstructured individual interviews with nine participants. Tesch's eight steps of thematic content analysis were used.
Results: Twelve themes emerged from the data. This involved strengths such as obtaining treatment, utilising external resources, faith, social support, supervision, calming techniques, keeping the mentally-ill family member busy, protecting the mentally-ill family member from negative outside influences, creative communication, praise and acceptance.
Conclusion: Families utilise external strengths as well as internal strengths in supporting their mentally-ill family member. Recommendations for nursing practice, nursing education and for further research could be formulated. Psychiatric nurses should acknowledge families' strengths and, together with families, build on these strengths, as well as empower families further through psycho-education and support.
Cultural and health beliefs of pregnant women in Zambia regarding pregnancy and child birth : original researchSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1232More Less
Background: Health beliefs related to pregnancy and childbirth exist in various cultures globally. Healthcare practitioners need to be aware of these beliefs so as to contextualise their practice in their communities.
Objectives: To explore the health beliefs regarding pregnancy and childbirth of women attending the antenatal clinic at Chawama Health Center in Lusaka Zambia.
Method: This was a descriptive, cross-sectional survey of women attending antenatal care (n = 294) who were selected by systematic sampling. A researcher-administered questionnaire was used for data collection.
Results: Results indicated that women attending antenatal care at Chawama Clinic held certain beliefs relating to diet, behaviour and the use of medicinal herbs during pregnancy and post-delivery. The main beliefs on diet related to a balanced diet, eating of eggs, okra, bones, offal, sugar cane, alcohol consumption and salt intake. The main beliefs on behaviour related to commencement of antenatal care, daily activities, quarrels, bad rituals, infidelity and the use of condoms during pregnancy. The main beliefs on the use of medicinal herbs were on their use to expedite the delivery process, to assist in difficult deliveries and for body cleansing following a miscarriage.
Conclusion: Women attending antenatal care at the Chawama Clinic hold a number of beliefs regarding pregnancy and childbirth. Those beliefs that are of benefit to the patients should be encouraged with scientific explanations, whilst those posing a health risk should be discouraged respectfully.
Determining professional nurses' knowledge on the performance management and development system in Tshwane : original researchAuthor Moselene A.R. Du-PlessisSource: Curationis 38, pp 1 –7 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1186More Less
Background: The implementation of the Performance Management and Development System (PMDS) is seen as being vital to the quality of care, resource management and inter-professional work. However, there is evidence that, at present, professional nurses lack the knowledge to implement such a system.
Objectives: The aim of this study was to explore and describe professional nurses' knowledge regarding the implementation of the PMDS in selected primary healthcare clinics in Tshwane.
Method: A quantitative, descriptive, exploratory design was used and convenience sampling was used to recruit respondents. A self-administered structured questionnaire was used to collect data from 39 professional nurses who were involved in managing the work performance of employees. The data were analysed quantitatively with Statistical Analysis System version 8.2 software.
Results: The respondents had limited knowledge about the implementation of the performance management and development system.
Conclusion: There is a need for educational initiatives before, during and after the implementation of the PMDS, such as quarterly PMDS workshops and routine catch-up training. These would address the lack of knowledge of respondents as seen from the results.
Source: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1255More Less
Background: As antiretroviral therapy (ART) is becoming increasingly available to people in developing countries, ART adherence challenges assume ever greater significance. Often underlying treatment failure is the fact that suboptimal adherence to ART is the strongest predictor of failure to achieve viral suppression below the level of detection.
Objectives: The study's main objective was to identify factors affecting ART adherence levels, as well as the impact on immunologic and virologic responses in adult patients in one rural district in Botswana.
Methods: A cross-sectional quantitative survey, was used. Structured interviews were conducted with 300 ART patients between November 2011 and February 2012. Data were analysed, then presented in charts, graphs and frequency tables.
Results: The prevalence of non-adherence to ART was 14.0%. Motivators of good adherence included disclosure of HIV-positive status to more than one person, frequent adherence counselling, self-efficacy for adherence to ART, positive interactions between patients and healthcare providers; and using adherence partners. Barriers to adherence were forgetfulness, transportation costs to and from the clinic, time away from work and side-effects. There was a strong positive correlation between adherence, CD4 counts and viral load. Adherence was closely tied to immunologic and virologic improvements. Respondents with poor adherence were likely to have unsuppressed viral loads (OR 12.98, 95% CI 4.9-34).
Conclusion: Adherence to ART is closely tied to virologic, immunologic, and clinical outcomes. Increases in adherence levels resulted in significant improvements in these outcomes. Near perfect adherence, however, is required to maximise the likelihood of long-term clinical success, which could pose challenges to many ART patients, especially in resource-limited rural settings.
Comparison between indigenous and Western postnatal care practices in Mopani District, Limpopo Province, South Africa : original researchSource: Curationis 38, pp 1 –9 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1252More Less
Background: Postnatal care begins immediately after the expulsion of the placenta and continues for six to eight weeks post-delivery. High standard of care is required during the postnatal period because mothers and babies are at risk and vulnerable to complications related to postpartum haemorrhage and infections. Midwives and traditional birth attendants are responsible for the provision of postnatal care in different settings, such as clinics and hospitals, and homes.
Methods: A qualitative, exploratory, descriptive and contextual research approach was followed in this study. Unstructured interviews were conducted with the traditional birth attendants. An integrated literature review was conducted to identify the Western postnatal care practices. Tesch's process was followed during data analysis.
Findings: The following main categories were identified: similarities between indigenous and Western postnatal care practices, and differences between indigenous and Western postnatal care practices. Based on these findings, training of midwives and traditional birth attendants was recommended in order to empower them with knowledge and skills regarding the indigenous and Western postnatal care practices.
Conclusions: It is evident that some indigenous postnatal care practices have adverse effects on the health of postnatal women and their newborn infants, but these are unknown to the traditional birth attendants. The employment of indigenous postnatal care practices by the traditional birth attendants is also influenced by their cultural beliefs, norms, values and attitudes. Therefore, there is an urgent need to train midwives and traditional birth attendants regarding the indigenous and Western postnatal care to improve the health of postnatal women and their babies.
Source: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1274More Less
Background: The effects of daily abuse and hardship on the streets lead to poor mental health in children living on the streets, resulting in them choosing ineffective and self-destructive coping strategies that impact their physical health and overall sense of wellbeing. The facilitation of the mental health of children living on the streets who are subjected to daily threats to their survival is thus crucial.
Objectives: The aim of this research was to explore and describe the lived experiences of children living on the streets of Hillbrow, Johannesburg.
Method: The research design was qualitative, exploratory, descriptive and contextual. A purposive sample was selected through a temporary shelter in Johannesburg, Gauteng, South Africa and consisted of 14 male children living on the streets. Data were collected using drawings, in-depth phenomenological interviews and field notes. The central interview opening statement was: 'Tell me about your life on the street'.
Results: The results obtained indicated that children living on the streets are threatened, exploited and exposed to physical, sexual and emotional abuse on a daily basis by the community, the authorities and other street dwellers. This leads to feelings of sadness, fear, anxiety, misery, despair, hopelessness, helplessness and suicide ideation, which in turn lead to drug abuse and criminal activities. In contrast, positive feelings of sympathy for other children living on the streets emerged and these children also displayed perseverance, resilience and a striving for autonomy.
Conclusion: Street life exposes children to a variety of experiences, both positive and negative. A striving after autonomy is clearly depicted by these children, who are able to tap into a range of responses, both on- and off-street.
Why do women not return for CD4 count results at Embhuleni Hospital, Mpumalanga, South Africa? : original researchAuthor Langalibalele H. MabuzaSource: Curationis 38, pp 1 –8 (2015) http://dx.doi.org/10.4102/curationis.v38i1.1266More Less
Background: According to the South African Policy and guidelines for the implementation of the PMTCT programme of 2008, all pregnant women who tested HIV-positive also had to have their CD4 count measured in order to inform the option of Prevention of Mother-to-Child Treatment (PMTCT): to be put on lifelong treatment or to be placed on temporary PMTCT. They were required to return for the results within two weeks, but some did not return, implying that they did not benefit from the programme. This study was conducted to establish their reasons for not returning.
Objectives: To explore the reasons given by women attending antenatal care for not returning for the results of their CD4 count done for PMTCT at Embhuleni Hospital and satellite clinics, Mpumalanga.
Methods: The study was a qualitative study using the free-attitude interview technique. Women who had not returned for their results were traced and interviewed on their reasons for not returning. Interviews were conducted in Siswati, audio-taped, transcribed verbatim and translated into English for analysis. Data saturation was reached by the eighth participant. A thematic analysis was conducted.
Results: The themes that emerged were: participants were not informed about the PMTCT process; poor service delivery from the healthcare practitioners; unprofessional healthcare practitioners' conduct; shortages of medication in the healthcare facilities; fear of social stigma; and poor patient socioeconomic conditions.
Conclusion: The reasons for not returning were mainly based on participants' experiences during consultations at the healthcare centres and their perceptions of the healthcare practitioners. Healthcare practitioners should adhere to the tenets of professionalism in order to address this problem.