Experiences of parents of an adolescent with intellectual disability in Giyani, Limpopo province, South Africa.

BACKGROUND: Parents of adolescents with intellectual disability experienced stress caused by challenges that come from having such adolescents. Those challenges affected the parents physically and emotionally, depending on the severity of the adolescent's intellectual disability. Having an adolescent with an intellectual disability becomes a burden if the challenges were not resolved. AIM: This study aimed to explore and describe the experiences of parents of adolescents with intellectual disability in Giyani. SETTING: This study was conducted at the participants' homes in Giyani, Limpopo province, South Africa. METHODS: A qualitative, exploratory, descriptive and contextual design was utilised. The main question was 'How is it to have an adolescent with intellectual disability?' Eight purposively sampled parents participated, and data were collected through in-depth interviews, observations and field notes. Data were analysed by means of thematic coding and an independent coder was consulted. RESULTS: Four themes were identified. The study revealed that parents of adolescents with intellectual disability experienced negative emotional responses. Most parents reported a lack of support from family members and the community. They also reported caring challenges, yet some showed positive coping mechanisms. CONCLUSION: Parents of adolescents with intellectual disability experienced various challenges in caring for these children. A collaborative approach from relevant stakeholders could have a positive impact in supporting the parents of adolescents with intellectual disabilities.

Implementing a psycho-educational model to increase university lecturers' effectiveness to constructively manage experienced aggression.

BACKGROUND: The authors developed a psycho-educational model as a conceptual framework of reference for university lecturers to facilitate the constructive management of experienced aggression. The model must be implemented in a workshop and in practice to confirm the if the model is effective. AIM: This article describes the implementation of a psycho-educational model in a workshop and in practice, as well as the evaluation of the effectiveness of the psychoeducational model. SETTING: This study was conducted in a specific college at a university in Johannesburg in South Africa. METHOD: This study followed a qualitative, exploratory, descriptive, contextual and theory-generating research design. The psycho-educational model was implemented in three phases during a workshop and then for three months in practice by university lecturers. A purposive sample of university lecturers was applied. The effectiveness of the psycho-educational model was evaluated during and directly after the workshop, 1 week after the workshop and 3 months journal entries. Final evaluation was in a focus group after 3 months of implementation of the model in the workplace. RESULTS: The participating university lecturers found the implementation of the psycho-educational model, as a conceptual framework of reference to constructively manage experiences of aggression, effective, helpful and important. The model increased their understanding of aggression in their places of work and increased their effectiveness to constructively manage experiences of aggression in their workplace. CONCLUSION: The implementation and evaluation of the psycho-educational model underscored the need for affective and effective facilitative support for university lecturers to be able to constructively manage experienced aggression.

A psycho-educational model for university lecturers to facilitate the constructive management of aggression.

BACKGROUND: Experienced workplace aggression is a lingering phenomenon and comprises an extensive body of knowledge. Experiences of workplace aggression require constructive intervention and support. These interventions and support must aim to assist university lecturers to constructively manage experiences of aggression. AIM: The aim of this article is to describe the process followed to develop, describe and evaluate a psycho-educational model for university lecturers that could be used as a conceptual framework of reference to facilitate the constructive management of experienced aggression. SETTING: The model is applicable in universities where the university lecturers work and experience aggression. This study was conducted in a specific college at a university in Johannesburg in South Africa. METHOD: A theory-generating, qualitative, exploratory, descriptive and contextual design was applied to develop a psycho-educational model. The process included four steps: concept analysis, relationship statements, description of the model and evaluation of the developed model. The criteria of clarity, simplicity, generality, accessibility and importance were used during the evaluation of the model. RESULTS: The central concept in this study was to facilitate constructive management. The psycho-educational model as the conceptual framework of reference for facilitating the constructive management of experienced aggression was described and evaluated. University lecturers' destructive management of experienced aggression formed the basis for the psycho-educational model. CONCLUSION: The psycho-educational model provides a conceptual framework of reference for university lecturers that may assist them to constructively manage experiences of aggression in their places of work.

Experiences of parents with an adolescent abusing substances admitted to a mental health institution in Giyani, South Africa.

BACKGROUND: Substance abuse by adolescents may be a problem that contributes to their mental illness. Substance abuse does affect not only the individual who is abusing it but also friends, family and the whole community. The adolescent abusing substances may be mentally unstable and have unpredictable behaviour. There is no research on the experiences of parents with adolescents abusing substances in Giyani, South Africa. OBJECTIVE: The purpose of the study was to explore and describe the experiences of parents with adolescents abusing substances admitted to a mental health institution in Giyani. METHOD: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected by means of conducting individual, in-depth, phenomenological interviews, observations and field notes. The following central question was asked to the participants: 'How is it for you to have an adolescent who is abusing substances'. Data were analysed by using a thematic method of coding. An independent coder analysed data together with the researcher, and consensus was reached. RESULTS: Four themes emerged from the data: parents experienced uncontrolled thoughts regarding their adolescent abusing substances, not being able to control their adolescent abusing substances through discipline, negative feelings regarding their adolescent abusing substances and negative consequences regarding their adolescents abusing substances. CONCLUSION: From the study result, it is clear that parents with adolescent abusing substances need professional assistance and support as evidenced by the challenges faced in terms of promoting, maintaining and restoring their mental health. Psychiatric nurses should take responsibility to educate the community about substance abuse, for example offering school health programmes. Further research studies can also be conducted in other villages to gain a greater understanding of those parents' experiences with an adolescent abusing substances.

A model to facilitate self-management of human immunodeficiency virus in students within a university setting and promoting their mental health.

BACKGROUND: The introduction of antiretroviral treatment (ART) has resulted in people with HIV living longer. Antiretroviral treatment demands a lifelong commitment from patients not only in terms of adherence to the medication but also in relation to lifestyle changes in general. This poses a challenge to a student living with HIV (SLHIV) who only spends a few years at university before entering the workplace and relocating. It also means that the care, support and treatment received at the university will no longer be available to them as these services are only offered to enrolled students. It is imperative for practitioners at universities to help SLHIV effectively manage their illness. AIM: The aim of the article is to illustrate the process followed to develop a model that could serve as a frame of reference to facilitate the management of HIV as an integral part of the mental health of SLHIV within a university. SETTING: The model is designed for professional practitioners in university settings who support students living with HIV in managing their illness. METHODS: A theory-generative, qualitative, exploratory, descriptive and contextual study design was utilised. The central concept was derived from the experiences of practitioners and SLHIV by conducting individual interviews using appreciative inquiry. The common themes and categories identified in the interviews served as a basis for the identification of the central concept for the study. The process included the identification, definition and classification of the central concept and essential attributes. The conceptual framework was then described. Measures to ensure trustworthiness were also adhered to in the study and approval for the study was granted (Ethical clearance #2014-071). RESULTS: The central concept was identified as the 'facilitation of self-management'. It was defined and classified, and these definitions and classifications were used as the basis for the model. Thereafter, the model was described. CONCLUSION: The model can be used as a frame of reference to assist SLHIV in effectively managing their illness.

Towards community-based nursing: Mothers' experiences caring for their preterm infants in an informal settlement, Gauteng.

BACKGROUND: Pregnant women who experience preterm labour rush to public hospitals closest to the informal settlement in which they reside. Preterm infants are discharged when they reach a certain weight. Mothers take their preterm infants to their homes inside the informal settlements. Yet, preterm infants have special needs and require specific management. Research confirmed that nurses working in community clinics near informal settlements are unaware of the challenges faced by such mothers. Community nurses are at the heart of nursing, they work closest to the community and have a distinct opportunity to provide contextual, community-based care and support to these mothers, to promote good health and prevent diseases. AIM: This article aims to enhance community nurses' insight about the mothers' experiences in caring for their preterm infants post-hospitalisation. SETTING: The study was conducted in an informal settlement in Midvaal, Gauteng. METHODS: A qualitative, exploratory, descriptive and contextual research design was used. In-depth, phenomenological interviews were conducted with 10 purposefully sampled mothers to explore their experiences in caring for their preterm infants in an informal settlement. Data were analysed using Giorgi's coding method. Ethical approval was received from the University of Johannesburg. Measures were applied to ensure trustworthiness. RESULTS: Three themes emerged: mothers experienced intrapersonal responses, interpersonal responses and numerous physical challenges in taking care of their preterm infants. CONCLUSION: Study findings revealed that mothers experienced several responses in caring for their preterm infants. Sharing their experiences can enhance community clinic nurses' insight to provide contextual health education.

Experiences of grandmothers caring for female adolescents living with HIV in rural Manzini, Eswatini: a caregiver stress model perspective

The HIV pandemic has immense effects on the Eswatini population. The burden of caregiving rests on women, typically grandmothers who are elderly and dealing with chronic diseases themselves. The purpose of this study was to explore and describe the experiences of grandmothers in Eswatini caring for female adolescents living with HIV. The study draws on phenomenological fieldwork of six case studies of grandmother­granddaughter pairs who were purposively sampled. Data were collected through in-depth individual interviews that commenced with broad questions: "How is it for you to care for a female adolescent living with HIV?" for the grandmothers, and "How is it for you to live with HIV?" for female adolescents. Data were transcribed verbatim and analysed thematically following the elements of the caregiver stress theory. Drawing on the caregiver stress model, grandmothers and female adolescents experienced input stimuli of financial difficulties related to daily provisions for food and transport fare. Control processes experienced by grandmothers and female adolescents related to feelings of loss, grief, fear, hopelessness and isolation along with suicidal ideation for female adolescents. Regarding output stimuli, grandmothers and female adolescents developed psychological unrest related to difficulty accepting the HIV diagnosis and concerns about the future. Grandmothers experienced ill health due to the demands of the caregiving role. It is recommended that family, financial and psychological support be made available for grandmothers to lighten the duty of caregiving

A model to facilitate self-management of human immunodeficiency virus in students within a university setting and promoting their mental health

Background: The introduction of antiretroviral treatment (ART) has resulted in people with HIV living longer. Antiretroviral treatment demands a lifelong commitment from patients not only in terms of adherence to the medication but also in relation to lifestyle changes in general. This poses a challenge to a student living with HIV (SLHIV) who only spends a few years at university before entering the workplace and relocating. It also means that the care, support and treatment received at the university will no longer be available to them as these services are only offered to enrolled students. It is imperative for practitioners at universities to help SLHIV effectively manage their illness.Aim: The aim of the article is to illustrate the process followed to develop a model that could serve as a frame of reference to facilitate the management of HIV as an integral part of the mental health of SLHIV within a university.Setting: The model is designed for professional practitioners in university settings who support students living with HIV in managing their illness.Methods: A theory-generative, qualitative, exploratory, descriptive and contextual study design was utilised. The central concept was derived from the experiences of practitioners and SLHIV by conducting individual interviews using appreciative inquiry. The common themes and categories identified in the interviews served as a basis for the identification of the central concept for the study. The process included the identification, definition and classification of the central concept and essential attributes. The conceptual framework was then described. Measures to ensure trustworthiness were also adhered to in the study and approval for the study was granted (Ethical clearance #2014-071).Results: The central concept was identified as the 'facilitation of self-management'. It was defined and classified, and these definitions and classifications were used as the basis for the model. Thereafter, the model was described.Conclusion: The model can be used as a frame of reference to assist SLHIV in effectively managing their illness

The Culture of Nurses in a Critical Care Unit.

Critical care nurses have to adapt to a fast-paced and stressful environment by functioning within their own culture. The objective of this study was to explore and describe the culture of critical care nurses with the purpose of facilitating recognition of wholeness in critical care nurses. The study had a qualitative, exploratory, descriptive, and contextual design. The ethnographic study included data triangulation of field notes written during 12 months of ethnographic observations, 13 interviews from registered nurses, and three completed diaries. Coding and analysis of data revealed patterns of behavior and interaction. The culture of critical care nurses was identified through patterns of patient adoption, armor display, despondency because of the demands to adjust, sibling-like teamwork, and non-support from management and medical doctors. An understanding of the complexity of these patterns of behavior and interaction within the critical care nursing culture is essential for transformation in the practice of critical care nursing.

Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

BACKGROUND: Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. OBJECTIVES: The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. METHOD: A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. RESULTS: The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. CONCLUSION: This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

A model for the role of defined spirituality in South African specialist psychiatric practice and training.

The current bio-psycho-social approach in South African psychiatry refers to Engel's extended model of health care. It forms the basis of the existing collaboration between medicine, nursing, psychology, occupational therapy and social work. Psychiatry also has to bridge the multi-cultural, multi-religious and spiritual diverse reality of everyday practice. It has become important to establish how, within accepted boundaries, spirituality should be incorporated into the model for practice. Referring to methods described for nursing theory development, a defined core concept was used to construct a model. It may contribute to the discourse on spirituality in local psychiatry, health and mental health.

A psycho-educational model to enhance the self-development and mental health of classical dancers.

There is substantial evidence that some classical dancers have difficulty with their personal lives and with their lives as performers. Specifically, a consistent emphasis on performance-orientation has been linked to the development of potentially maladaptive dispositions. A pilot study was conducted to explore the life-world of the classical professional dancer through semi-structured interviews with nine dancers from two professional ballet companies in South Africa. The results indicated that the profession had strongly influenced their sense of self, relationships with others, and future-orientation. The findings of the pilot study are important for what they suggest about the tendency of classical dance to stimulate the setting of externalized goals that may lead to self-destructive behaviors such as eating disorders, depression, maladaptive perfectionism, and problems with career transitions. These findings were used to develop a model that aims at preparing pre-professional dancers to deal with such problems by promoting their sense of empowerment, self-development, and self-actualization as individuals and as artistic performers. What remains is for the model to be tested in practice, procedures and protocols established for training the personnel who will actualize it, and appropriate criteria identified for the assessment of self-development. Then the model can be disseminated for general use.