Mental health challenges experienced by LGBTI+ community in Gaborone: A phenomenological study.

Background: Mental health challenges have affected the entire global population including individuals identifying as lesbian, gay, bisexual, transgender, intersex and others (LGBTI+). There is documented evidence of a high prevalence of mental health challenges among LGBTI+ community across the globe, but in Botswana there is dearth of literature pertaining to the phenomenon of LGBTI+ mental health challenges. Aim: The study was aimed at exploring and describing the mental health challenges experienced by some people identifying as the LGBTI+ community in Gaborone, Botswana. Setting: The study was conducted in Gaborone in Botswana. Methods: The study adopted a qualitative, phenomenological, descriptive design with 15 participants identified through snowball sampling. LEGABIBO, the LGBTI+ advocacy organisation, served as gatekeeper after Health Research and Development Division under the Ministry of Health and Wellness gave the ethical clearance of the study. Data were collected through unstructured telephonic interviews and recorded with a digital voice recorder. Results: The study established that some LGBTI+ individuals experienced mental health challenges like experiences of depression, experiences of gender dysphoria, and loneliness and isolation. Conclusion: It is concluded that individuals identifying as LGBTI+ experience mental health challenges that stem from being stigmatised and discriminated among others. Contribution: The findings of the study provide information that may be used in dealing with mental health issues of individuals identifying as LGBTI+. Furthermore, the findings may inform nursing practice, research and education issues on LGBTI+ as well as influence health policy in addressing the mental health issues of those identifying as LGBTI+.

Family members' experiences of courtesy stigma associated with mental illness.

Background: The stigma of mental illness has been in existence from medieval times to date and it is extended to families of people diagnosed with mental illness. Families with a member diagnosed with a mental illness experience courtesy stigma of mental illness and it affects the quality of their lives. Aim: This study aimed to explore and describe the experiences of courtesy stigma of families with a member diagnosed with a mental illness in Lobatse, Botswana. Setting: The study was conducted at a psychiatric hospital in Lobatse, Botswana. Methods: A qualitative contextual phenomenological design was used for this study. The population comprised of members from families with a person diagnosed with a mental illness and the sample size was 15 participants. Semi-structured in-depth individual interviews were conducted telephonically. Results: The study yielded three main themes and related subthemes. The themes were: families' experiences of received stigma, families' experiences of stigma by association, and families' experiences of internal stigma. Conclusion: Families with a member diagnosed with mental illness experience received stigma, associated stigma and internal stigma. The families experienced that they received dehumanising labels from the public because of their association with their mentally ill family members. Contribution: With the insights gained from the findings of this study, programmes can be developed that raise awareness on stigma of mental illness and to promote support of families of people diagnosed with a mental illness.

Unfair labour practice on staff in primary health care facilities, North West province, South Africa: A qualitative study.

BACKGROUND:  Unfair labour practices on staff is a worldwide concern which creates conflicts and disharmony among health workers in the workplace. It is found that, nursing staff members are unfairly treated without valid reasons in primary health care (PHC) facilities and predominantly in the developing countries and South Africa is not an exception. OBJECTIVES:  The purpose of the study was to explore and describe the experiences of operational managers regarding unfair labour practices on staff by their local health area managers, and describe the perceptions of operational managers towards such treatment. METHOD:  A qualitative, descriptive, exploratory and contextual research approach was considered appropriate for the study. The population of the study comprised operational managers working in PHC facilities in the North West province, South Africa. Purposive sampling was used to select participants for the study and focus group interviews used to interview 23 operational managers. Ethical measures were applied throughout the study. RESULTS:  The six phases of thematic analysis were used to analyse the data collected for the study. Two themes that emerged are experiences of factors related to unfair labour practices in the PHC facilities and the perceptions regarding how to improve their working conditions. The categories that were found in the first themes were favouritism and discrimination. In the second theme, in-service training and transparency regarding staff training and development emerged. Recommendations comprised, among others, training on the concepts of equality in the workplace, and reinforcement of transparency regarding granting of study leave and attending workshops. CONCLUSION:  Operational managers in the PHC facilities experienced unfair labour practices as evidenced by favouritism and discrimination.

Psychoactive substances: Position statement on harm reduction.

Psychoactive substances are subject to several international and national conventions and laws that have emphasised the importance of the 'war on drugs' and supply reduction. At the same time, it is increasingly clear that evidence-based, balanced policies are needed, which address the important differences between alcohol, tobacco, marijuana and other psychoactive substances or drugs. The Prevention of and Treatment for Substance Abuse Act 70 of 2008 speaks to the National Drug Master Plan, which emphasises a range of strategies for addressing the excessive use of alcohol, tobacco, marijuana and other psychoactive substances.

Experiences of women who reported sexual assault at a provincial hospital, South Africa.

BACKGROUND: Sexual assault poses a serious health problem to both the survivor and the health system. Experiencing sexual assault requires women to seek medical and psychological assistance as part of their journey towards recovery. This study examined the experiences of women who received post-sexual assault services from a specialised care centre within a provincial hospital. METHODS: A qualitative, exploratory and contextual design was used to explore and describe experiences of women. Data were obtained through individual in-depth interviews from a total of 18 women aged between 18 and 55 years. Interviews were supplemented by the researcher's field notes and audiotape recordings. RESULTS: Findings yielded two main themes: Women expressed their lived experiences of sexual assault characterised by different forms of trauma. The second theme was an expression of a need for safety and support. CONCLUSION: Women who experience sexual assault are left with devastating effects such as physical and psychological harm and social victimisation. There is also a need for safety and support towards the recovery of these women. This study recommends that professional practitioners involved in the management of sexual assault be sensitised regarding the ordeal experienced by women and stop perceiving survivors as crime scene 'clients' from whom only medico-legal evidence has to be collected. Professional practitioners and family members must be supportive, non-judgemental and considerate of the dignity of survivors. The establishment of sexual assault response teams (SART) is also recommended. There should also be inter-professional education for better coordination of services rendered to sexually assaulted women.

Using an innovative mixed method methodology to investigate the appropriateness of a quantitative instrument in an African context: Antiretroviral treatment and quality of life.

The relationship between quality of life (QoL) and antiretroviral treatment (ART) has mainly been studied using quantitative scales often not appropriate for use in other contexts and without taking peoples' lived experiences into consideration. Sub-Saharan Africa has the highest incidence of HIV and AIDS yet there is paucity in research done on QoL. This research report is intended to give an account of the use of a mixed method convergent parallel design as a novice approach to evaluate an instrument's context specificity, appropriateness and usefulness in another context for which it was designed. Data were collected through a qualitative exploration of the experiences of QoL of people living with HIV or AIDS (PLHA) in Africa since being on ART, as well as the quantitative measurements obtained from the HIV/AIDS-targeted quality of life (HAT-QoL) instrument. This study was conducted in three African countries. Permission and ethical approval to conduct the study were obtained. Purposive voluntary sampling was used to recruit PLHA through mediators working in community-based HIV/AIDS organisations and health clinics. Interviews were analysed through open coding and the quantitative data through descriptive statistics and the Cronbach's alpha coefficient. A much wider range and richness of experiences were expressed than measured by the HAT-QoL instrument. Although an effective instrument for use in the USA, it was found not to be sensitive, appropriate and useful in an African context in its present form. The recommendations focus on adapting the instrument using the data from the in-depth interviews or to develop a context-sensitive instrument that could measure QoL of PLHA in Africa.