Enablers to enhance school-based adolescents with intellectual disabilities' learning: A narrative approach.

Society has always understood individuals with intellectual disabilities from a stance of deficiency, resulting in limited expectations and prospects for school-going adolescents with intellectual disabilities. The study used the social model of disability to explore teachers' perceptions of enablers to enhance school-based adolescents with intellectual disabilities' learning and took cognisance of a wave of policies aimed at including adolescents with intellectual disabilities in mainstream education. A qualitative narrative approach was used for the study. Using a narrative methodological framework, unstructured interview questions were posed to elicit teachers' perceptions of enablers to enhance adolescents with intellectual disabilities' learning. A non-probability purposive sampling method was used to select teachers working with school-based learners with intellectual disabilities. Five themes emerged from the analysis: therapeutic setting; learners' resilience; parental support; teaching strategies; and community involvement as enablers for enhancing learning for adolescents with intellectual disabilities. Policy implications are also provided in the study.

Transition of adolescents with intellectual disability from schools for learners with special educational needs: Parents views for the preparedness.

BACKGROUND: Studies on preparedness of parents of adolescents living with intellectual disabilities transitioning from school to adulthood are scarce in sub-Saharan Africa. This study explored views of parents on their preparedness to handle adolescents transitioning from special schools to adulthood. METHODS: Descriptive qualitative method was used to collect views of parents of adolescents with intellectual disability on their preparedness to handle transition of their children from school into community life. Content analysis was used to analyse the data. FINDINGS: Twelve female and two male participants expressed concerns on lack of transition plans, adolescent's future, culture and beliefs and inadequate community support. Views of parents of younger children and those of parents of older children were similar. CONCLUSION: Parents were unprepared for transition of their children from school to community life. Multidisciplinary approach including family involvement and community support is necessary to enhance the transition of adolescents with intellectual disability.

The TEAM model for mental health promotion among school-going adolescents.

OBJECTIVE: This paper reports on the process followed in developing the "TEAM" (an acronym for the proposed intervention) model for the promotion of mental health among school-going adolescents. METHODS: A sequential explanatory mixed method combining both quantitative and qualitative approaches was used to gain in-depth understanding of the experiences of adolescents, school health nurses and teachers in dealing with emotional and social problems in high schools. Data collection was conducted in 4 phases from 2012 to 2015 and included a desk review of literature, qualitative interviews with 12 school teachers; qualitative interviews with 10 school health nurses and quantitative interviews with 347 adolescents. The quantitative tool that was used for the study was based on the Social and Emotional Learning Model. RESULTS: Key findings from the study revealed inappropriate handling of emotions by adolescents, leading them to form destructive groups (gangs); involvement in alcohol and substance abuse; disrespect; and adolescent pregnancy. CONCLUSION: A universal team-oriented collaborative model that will assist adolescents to shift negative energy and attitudes to positive and productive lifestyles is required. The TEAM model centres all the activities of a collaborative and focused team on the facilitation of a sense of belonging, ownership and complete engagement of pupils in schools that will contribute positively to social and emotional well-being.

Communication skills intervention: promoting effective communication between nurses and mechanically ventilated patients.

BACKGROUND: Patients in the Intensive Care Unit (ICU) often experience communication difficulties - usually associated with mechanical ventilation - resulting in psychological problems such as anxiety, fear, and depression. Good communication between nurses and patients is critical for success from personalised nursing care of each patient. The purpose of this study is to describe nurses' experience of a communication skills training intervention. METHODS: A convenience sample of twenty intensive care nurses participated in the study. Data was collected by means of interviews with nurses. Data from the interviews were analysed using qualitative thematic content analysis. RESULTS: Six themes emerged: (1) acceptance of knowledge and skills developed during workshops; (2) management support; (3) appreciation of augmentative and alternative communication (AAC) devices; (4) change in attitudes; and (5) the need to share knowledge with others and (6) inclusion of communication skills workshop training as an integral part of an orientation programme for all nurses. CONCLUSION: The findings of this study indicated that the application of augmentative and alternative communication devices and strategies can improve nurse-patient communication in intensive care units. Therefore, the implementation of communication skills training for intensive care nurses should constantly be encouraged and, indeed, introduced as a key element of ICU care training.

HIV and AIDS-related stigma and discrimination in two referral hospitals in Ethiopia.

The aim of the study was to determine the magnitude of HIV and AIDS-related stigma and discrimination (SAD) and its associated factors in healthcare settings. Primary data were collected from June to September 2014 from two referral hospitals located in north-west Ethiopia. The study used pre-test/post-test design with a non-equivalent control group using a quantitative approach. Healthcare professionals were divided into strata and then, using the stratified random sampling technique, the study participants were selected from each stratum. The median age of study respondents in the treatment group was 32.2 years with standard deviation (SD) of 7.74. The regressions of stigma for the pre-tests of the first hospital and second hospital participants' knowledge about SAD-related issues and perceived risk of HIV infection were found to be significantly associated with stigma in the first hospital. In the first hospital, healthcare professionals who felt HIV risk of infection at different contact points with HIV-positive patients were more than 13 times more likely to present stigmatising attitudes towards the patients (OR = 13.46, p = 0.005). In the second hospital, only perceived risk of infection was significantly associated with stigma (p = 0.036). Interventions to lessen HIV and AIDS-related SAD in healthcare settings must focus on improving the knowledge, attitudes and practices of healthcare professionals as well as overcoming the institutional barriers existing in the healthcare settings through staff training and hospital strategy development.

The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia.

BACKGROUND: There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. METHODS: This was a quantitative and cross-sectional community based study design which employed a stratified two-stage cluster sampling technique to determine the sample. Data was collected using structured questionnaire administered to 870 women aged 15-49 years. Weighted 'backward selection' logistic regression models were employed to identify predictors of adequacy of antenatal care. RESULTS: Majority of slum residents did not have adequate antenatal care services with only 50.3, 20.2 and 11.0 % of the slum resident women initiated antenatal care early, received adequate antenatal care service contents and had overall adequate antenatal care services respectively. Educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.7 times more likely to receive overall adequate care compared to those with no formal education. Similarly, clients of private healthcare facilities were 2.2 times respectively more likely to receive overall adequate antenatal care compared to those clients of public healthcare facilities. CONCLUSION: In order to improve ANC adequacy in the study area, the policy-making, planning, and implementation processes should address the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Exploring Communication Challenges Between Nurses and Mechanically Ventilated Patients in the Intensive Care Unit: A Structured Review.

BACKGROUND: Mechanical ventilation is a necessary procedure for patients with a range of illnesses and conditions. Mechanical ventilation affects voice production, leaving patients unable to communicate their needs with nurses and family. The communication difficulty causes distress, frustration, and anger if not attended to. AIMS: This structured review sought to identify communication challenges which exist between nurses and mechanically ventilated patients in intensive care units (ICU) and hence explore possible solutions to improve these communication challenges. METHODS: A electronic search of MEDLINE, CINAHL, and PsycINFO was conducted to identify relevant literature on nurse-patient communication challenges in the ICU published between January 2005 and December 2014. Studies meeting the inclusion criteria were retrieved in full, reviewed, and study quality assessed. RESULTS: Six studies were identified for inclusion in the review. Analysis identified five core influences on communication in the ICU: patient's consciousness level, nature of nurse-patient interactions, communication methods, staff skills and perceptions, and the intensive care physical environment. LINKING EVIDENCE TO ACTION: An evidence-based and multifactorial communication intervention encompassing staff skills development and training, development of relevant patient materials or devices and collaborations with relevant health professionals like speech and language therapists has the potential to improve nurse-patient communication in the ICU and hence improve patient outcomes.

Individual and relational dynamics perceived to influence the sexual behaviour of adolescents in Ethiopia: a qualitative study.

Background: There are 1.2 billion adolescents in the world today, more than ever before, making up 16% of the world's population and nearly one-fourth of the total population in Sub-Saharan Africa. Adolescents are facing life-threatening health challenges attributed to sexual and reproductive health issues such as unwanted pregnancies, unsafe abortions, and sexually transmitted infections, including the human immunodeficiency virus, and acquired immunodeficiency syndrome. The aim of this research is to explore the individual and relational levels of factors that drive adolescents to engage in risky sexual behaviour. Methods: A qualitative phenomenological study design was used from February to June 2020. Adolescents and health professionals were selected purposefully. A total of 12 individual in-depth interviews, five focus group discussions with adolescents, and eight key informant interviews with health professionals were conducted using a semi-structured guide. Data analysis was performed using thematic analysis with ATLAS Ti version 7 software. Credibility, dependability, transferability, and confirmability were used to ensure the trustworthiness of the data. Results: In this study, two themes were identified; individual level factors such as sexual desire and emotion driven sex, limited knowledge of sexual and reproductive health, and a permissive attitude towards sexual activities drive adolescents to engage in risky sexual behaviour; and relational level factors such as, limited family support and involvement, negative peer pressure and influence, male partner dominance during the partnership, and pressuring females to engage in sexual intercourse were perceived factors influencing adolescents to engage in risky sexual behaviour. Conclusion: Various individual-level and relational-level factors are influencing adolescents to engage in risky sexual behaviour. Socially and culturally acceptable, comprehensive sexual education should be provided for in-school and out-school adolescents to enhance their knowledge, attitude, and skill about sexual and reproductive health. Interventions at the peer and partner level should be considered to enhance the life skills that enable them to resist pressure from peers and their partners. Child-parent communication on sexual and reproductive health matters should be promoted.

Qualitative enquiry on factors affecting antibiotic prescribing at primary healthcare facilities in Addis Ababa, Ethiopia.

Background: The major driver of antibiotic resistance is the huge increase in antibiotic prescribing, especially in low- and middle-income countries. Aim: This study aimed to explore factors affecting antibiotic prescribing at primary healthcare facilities in Addis Ababa, Ethiopia. Methods: The study was part of a three-phased explanatory sequential mixed method design. The study was conducted in five primary healthcare facilities through in-depth interviews of 20 prescribers and 22 key informants using pre-prepared interview guides. The data were analysed through thematic content analysis by applying ATLAS.ti 9 software. Results: The antibiotic prescribing decision of prescribers was shown to be affected by various factors. The factors related to prescribers include not updating oneself on antibiotic use and antibiotic resistance, not reviewing patient history, not considering the concerns related to antibiotic resistance during prescribing, and competency problems. The patient-related factors were low awareness about antibiotics, lack of respect for prescribers, and pressure on prescribers. The shortage of antibiotics and laboratory reagents, a lack of updated antimicrobial resistance information, patient load, inadequate capacity, private sector practice, inadequate follow-up and support, and health insurance membership were the system-related factors. Appropriate interventions should be designed and implemented to address the identified factors and improve the prescribing practice.

Posttraumatic stress disorder among spouses of patients discharged from the intensive care unit after six months.

The Intensive Care Unit (ICU) can be traumatic, not only for patients, but also their closest relatives, especially spouses. Within Botswana, a developing country with very few ICUs and not so sophisticated machinery or a generalised lack of counselling for relatives, the ICU experience can be more traumatic. This study reports on the proportion of spouses who continued to experience mental distress, including the incidence of posttraumatic stress disorder, at six months after the discharge of their spouse from an intensive care unit. Mixed data collected approaches were used on a convenience sample of 28 spouses of patients who had been hospitalised at the Princess Marina Hospital ICU, Gaborone, Botswana, in the six months prior to the interview sessions. Participants were interviewed six months after the discharge of their spouse from the Intensive Care Unit using the PCL-S (PTSD Checklist). All the patients had been mechanically ventilated and had been hospitalised in the ICU for more than three days. Fifteen spouses reported intrusive memories of ICU and avoided reminders of the experience six months later. Ten spouses reported feeling anxious for a short while after their spouse's discharge but that they had come to terms with the experience. In order to mitigate the trauma experienced by spouses the study suggests that pre- and post-counselling for close relatives, especially spouses, should be implemented at the point of hospitalisation, during admission, and after discharge for a period of at least six months.

Cost of wound dressing: Implication for enrollment into the National Health Insurance scheme, Nigeria.

BACKGROUND:  Enrollment into the National Health Insurance scheme (NHIS) still poses a challenge in Nigeria despite the established Group, Individual and Family Social Health Insurance Programme (GIFSHIP) during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES:  This study examined the direct cost of wound dressing and enrollment into the health insurance scheme among hospitalised patients. METHOD:  A descriptive cross-sectional research design was utilised to investigate the cost of wound dressing and enrollment into health insurance scheme among hospitalised patients in three selected hospitals of South-West Nigeria. The study was conducted from March 2021 to June 2021, and 190 patients were recruited via an interviewer-administered questionnaire. Ethical approvals were obtained from the hospitals while COVID-19 preventive protocols and ethical principles of autonomy, confidentiality and non-maleficence were observed. RESULTS:  Majority of the respondents (91%) were not on any healthcare insurance scheme, only 4.2% were enrolled in NHIS while over 70% could not personally pay for their wound dressing. The minimum average cost of wound dressing materials per week and per acute care episode was ₦10 000.00 (Nigerian naira) and ₦50 000.00, respectively, while the minimum average cost for hospitalisation per week and per acute care episode was ₦18 000.00 and ₦130 000.00, respectively, ($1.00 equaled ₦600.00, June 2022). CONCLUSION:  A lack of health insurance coverage is a precursor of 'out of pocket' payment. A political will is required to scale up enrollment of the indigenous population into the NHIS in Nigeria.Contribution: Many hospitalised patients are not enrolled in the NHIS and they are at a higher risk of catastrophic healthcare expenditure.

Use of home remedies for the treatment and prevention of coronavirus disease: An integrative review.

Background and Aims: Home remedies are understood to mean medications or tonics prepared at home to treat certain ailments without any prescription or professional supervision. Reliance on home remedies increased during coronavirus disease 2019 (COVID-19). The aim of this integrative review was to identify home remedies used to treat and prevent COVID-19 and discuss implications for nursing practice and health related to the safety and efficacy of home remedies. Methods: Cooper's integrative review method guided this study to identify home remedies used to prevent and treat COVID-19. Google Scholar, BMC, EBSCOhost, Medline, Academic Search Ultimate, Web of Science Core Collections, Science Direct and Global Health were used to search for relevant information on the use of COVID-19 home remedies from 2019 to 2022. The Critical Appraisal Skills Program (CASP) checklist was used to select studies that had to be included. The eligibility criteria included studies on home remedies, written in English from 2019 to 2022. Findings of qualitative, quantitative and mixed-methods research were extracted, and narrative thematic data synthesis was applied. Results: Eleven articles which met the inclusion criteria were found in nine countries: Ghana (1), South Africa (1), Tanzania (1), Togo (1) and Zimbabwe (1), Bangladesh (1), Hong Kong (1), India (2), Iran (1), and Pakistan (1). Findings showed that home remedies are used for the prevention of COVID-19 infection, treatment of COVID-19, and boosting immunity. Conclusions: Home remedies have been found to be more pronounced across all sectors and social strata. More research is needed on the use of home remedies for life-threatening outbreaks. Policymakers and healthcare workers are challenged to encourage the use of home remedies in the prevention of other ailments and epidemics that might occur in the future.

Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia.

BACKGROUND: Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks. AIM: To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia. SETTING: The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia. METHODS: A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied. RESULTS: Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents. CONCLUSION: Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.

Challenges and coping strategies among young adults living with perinatally acquired HIV infection in Botswana. A qualitative study.

BACKGROUND: Due to antiretroviral therapy, many people with perinatally acquired HIV are surviving into young adulthood which is a critical period of human development. Research conducted in various settings globally has shown that young adults living with perinatally acquired HIV (YALPH) face multiple challenges related to HIV infection while also confronting the same challenges of young adulthood faced by other HIV-negative youth. However, there is a paucity of information on YALPH in Botswana and what needs to be done to improve their health and wellbeing. Therefore, this study explores the challenges and coping strategies of YALPH in order to inform health policies and programming in Botswana. METHODS: In-depth interviews were conducted with 45 YALPH (ages 18-27 years) who were enrolled on antiretroviral therapy at the Botswana-Baylor Children's Clinical Centre of Excellence (Botswana-Baylor Clinic). The Botswana-Baylor Clinic is the largest centre for pediatric, adolescent, and young adult HIV treatment and care in Botswana. The maximum variation sampling method was used to select information-rich participants. The questions focused on the challenges YALPH faced and how they coped with HIV. The data was analyzed using content analysis. RESULTS: The results showed that the majority of YALPH had suppressed HIV viral load and perceived themselves to be in good physical health and functioning. They did, however, face numerous challenges, including occasional or longstanding poor antiretroviral therapy adherence, disabilities and impairments, poor school performance and attainment, unemployment, financial stressors, fear of stigma, disclosure worries and concerns, and limited social support. The most vulnerable YALPH included those with disabilities and impairments, those transitioning out of residential care, young parents, the unemployed, and those with maladaptive coping strategies. The YALPH mainly used adaptive coping strategies. The most commonly used maladaptive coping strategies were self-distraction and venting. CONCLUSION: Interventions to prevent, screen for, assess, and manage the challenges identified by this study are critical to improving the health and well-being of YALPH. In addition, diverse interventions that can contribute to the development of adaptive coping mechanisms and reduce the likelihood of maladaptive coping in YALPH should be sought.

Discrimination against South African adolescents orphaned by AIDS.

This article describes the discrimination against adolescents orphaned by AIDS. A qualitative phenomenological approach using reflective diaries was used to extract how this population is discriminated on. Fifteen adolescents ages 14 to 18 living in an urban area in South Africa participated in the study. Data were collected as part of a larger study in which a peer-based mental health intervention was designed for use with adolescents orphaned by AIDS. Colaizzi's seven stages were used to analyze the data from the reflective diaries. Analysis revealed that adolescents orphaned by AIDS experienced physical, social, and institutional expressions of stigma leading to discrimination. Adolescents were discriminated on by peers, caregivers, and teachers. The results of this study show that adolescents orphaned by AIDS face discrimination; further studies on the topic with a larger sample are needed to verify these findings.

Determinants of health-related quality of life in young adults living with perinatally acquired HIV infection in Botswana.

Background: Due to the successful antiretroviral therapy (ART) programme in Botswana, large numbers of perinatally HIV-infected adolescents are emerging into young adulthood. Young adulthood is a critical period of human development. However, there is lack of information on the factors affecting the health-related quality of life (HRQOL) of young adults living with perinatally acquired HIV (YALPH) in Botswana. Objectives: The objective of this study was to assess the HRQOL and its determinants among YALPH who were enrolled on ART at Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Method: A cross-sectional study assessed the HRQOL of 509 YALPH aged 18-30 years using the WHOQOL-HIV BREF. Data about other variables of interest were abstracted from medical records. Bivariate analyses were performed using t and Chi-square tests to determine the associations between demographic and clinical variables and general HRQOL. The variables that were associated with the general HRQOL at P-value < 0.1 were included in the multivariable analysis using the logistic regression approach. Results: The majority of participants had good general HRQOL (78.4%). The highest mean HRQOL score was in the Physical domain (5.4 [± 2.9]) and the lowest in the Environment domain (13.8 [± 2.7]). The factors that were significantly associated with the general HRQOL included: level of education attained (P = 0.012), employment status (P = 0.069), viral load suppression (P = 0.073) and self-reported illness (P = 0.001). Conclusion: Interventions that effectively increase educational attainment, employment opportunities, ART adherence, and prevention or management of illness are needed to promote good HRQOL among YALPH in Botswana.

The burden of secrecy among South African adolescents orphaned By HIV and AIDS.

HIV thrives in an atmosphere of silence and secrecy. The stigma, real or feared, of HIV/AIDS is often a barrier to support and care that adolescent orphans need. The purpose of this article is to describe the burden of silence borne by adolescents orphaned by HIV and AIDS. A phenomenological study using photography and photo-elicitation was done among orphaned adolescents. Fifteen adolescents orphaned by HIV and AIDS, living in an urban area of South Africa, participated in the study. Participants photographed objects, such as graveyards, hearses, and a room where a parent committed suicide. These photographed objects were grouped as symbols of death. Nature and people also were photographed. Photo-elicitation revealed the psychosocial impact that results from the secrecy about parental cause of death. Implications for mental health practitioners are also discussed.

Emotional violence among women in intimate relationships in Botswana.

A Heideggerian hermeneutic phenomenological approach was used to investigate the lived experience of women in Botswana who had experienced emotional abuse in intimate relationships. Hermeneutic phenomenology is concerned with the human experience as it is lived. Ten educated Botswana women who had formal employment and have been in intimate relationships for longer than ten years, narrated their life experiences with abusive men. Extensive interviews took place over a six month period. Sociocultural practices in Botswana emerged as salient factors that contribute to emotional abuse and predispose women to mental illness. Entwined in these cultural practices are issues of age, ethnicity, payment of lobola (bride price), financial standing, change of name, and relocation to the man's residence. Education and employment seem to worsen the abuse. Depression and anxiety are common results of abuse. Understanding how the sociocultural factors perpetuate abuse can assist nurses in the way they provide health care services to women.

Nurses' perceived role in healthcare transition of adolescents with intellectual disabilities.

BACKGROUND: Nurses' role in the transition of adolescents living with intellectual disabilities (IDs) has always been neglected. The primary role of nurses is to promote health, provide nursing care, alleviate suffering and rehabilitate. Improving the quality of life for individuals with ID when they undergo the healthcare transition process from adolescence to adulthood was previously not considered a priority. OBJECTIVES: To investigate the nurses' perceived role in healthcare transition of adolescents with ID into adulthood. METHOD: A qualitative descriptive design using semi-structured interviews with 18 nurse participants was used. The sample included 25 nurses working in care and rehabilitation centres and non-governmental organisations in Tshwane district, Gauteng province, South Africa. RESULTS: Three main themes that emerged from the analysis were support systems, advocacy and health promotion. CONCLUSION: The findings of this study clearly show the need for a strong healthcare support system to facilitate a successful transition process of adolescents with ID. The study findings support the view that nurses can play a key role in assisting individuals with ID and their families in dealing with the challenges of healthcare transitioning into adulthood.

Foreign nurse educators' lived experiences of incivility: The case for Botswana.

BACKGROUND: In light of current economic prosperity and subsequent attainment of upper-middle-income country status, Botswana attracted nurse educators from other African countries. Within this cross-cultural environment, anti-immigrant sentiments have catalysed incidents of incivility, affecting the quality of teaching and learning outcomes. OBJECTIVES: The aim of this study was to explore experiences of incivility amongst foreign nurse educators and how it impacts their work and livelihood. METHOD: This study employed a qualitative approach, using interpretive phenomenology. In-depth interviews using a developed guide were conducted with 13 foreign nurse educators working as nurse educators in Botswana. Thematic analysis was conducted in accordance with interpretive phenomenology, where transcriptions were drafted after each interview. RESULTS: Three themes emerged from the study findings: hostile behaviour, discrimination and inequitable application of procedures and processes. Discrimination as a theme has two sub-themes, namely, workplace injustice and individual injustice. CONCLUSION: The study found that foreign nurse educators working in Botswana experience incivility. From the findings, the study strongly recommends application of equitable job opportunities to all employees, including foreign nurse educators who are employed to meet the shortage of nurse educators in Botswana. The researchers are of the opinion that the nurse educator shortage will persist in Botswana, partly because of the nursing profession rendered unattractive by hostile social interactions amongst nurse educators' exclusion of foreign nurses from benefits enjoyed by local nurse educators, workplace injustice targeting foreign nurse educators, as well as inequitable application of policies and processes that affect foreign nurse educators.