Lived experiences of student nurses caring for intellectually disabled people in a public psychiatric institution.

BACKGROUND: Caring for intellectually disabled people can be demanding for student nurses who are novices in the nursing profession. To ensure that quality nursing care is provided, student nurses should have an understanding of and a positive attitude towards intellectually disabled people. Nursing intellectually disabled people can be a challenge for the student nurses. Therefore, student nurses need to be able to deal with challenges of caring for intellectually disabled people. OBJECTIVE: This article aims to explore and describe experiences of student nurses caring for intellectually disabled people in a public psychiatric institution. DESIGN AND METHOD: A qualitative, exploratory, descriptive and contextual research design was used. Data were collected through individual in-depth phenomenological interviews, naïve sketches and field notes. Thematic analysis was utilised to analyse the collected data. Results were contextualised within the literature and measures to ensure trustworthiness were adhered to. Ethical principals were also applied throughout the research process. RESULTS: Five themes emerged from the data. Student nurses experienced a profoundly unsettling impact on their whole being when caring for intellectually disabled people; they developed a sense of compassion and a new way of looking at life, and experienced a need for certain physical, mental and spiritual needs to be met. CONCLUSION: From the results, it is evident that student nurses were challenged in caring for intellectually disabled people. However, they developed a sense of awareness that intellectually disabled people have a need to be cared for like any other person.

Defining and Measuring Spirituality in South African Specialist Psychiatry.

To define the meaning of "spirituality" in a South African phenomenological, theory-generating qualitative inquiry, theory construction methodology was used. This refers to the tradition of nursing theory development, where a central core concept identified from the integrated data-in this case, interviews and the literature content-had to be defined. A major focus of the study was to distinguish spirituality from religion. The denotative and connotative meanings of "spirituality" were explored to establish the components for a definition. The attributes of this definition included that spirituality constitutes a "quality", a "journey", a "relationship" as well as a "capacity". While these items derived from this local definition of spirituality can be proposed for inclusion in a questionnaire for measuring spirituality in a South African context, the limits of the scope of the explorative qualitative inquiry from which it was derived must be considered.

Student nurses' experience working with mentally challenged individuals in South Africa.

South African student nurses experience emotional discomfort that might influence their adjustment and coping while working with mentally challenged individuals. Adjustment and coping might impact on their mental health and support needed while working in this challenging context. Student nurses working with mentally challenged individuals experience emotional discomfort that may result in work-related stress. The experiences of student nurses working with mentally challenged individuals were explored and described as it may influence their adjustment, coping and result in work-related stress, impacting on their mental health. The study used a qualitative, explorative, descriptive, contextual research design with a case study as strategy. Thirteen student nurses from a specific higher educational institution in Gauteng, South Africa, participated in the focus group interviews. The researcher utilized reflective journals, a reflective letter, naïve sketches, drawings and field notes to collect data. Data analysis was done according to Tesch's descriptive method of open coding and theme analysis. A central storyline emerged where student nurses described working with mentally challenged individuals as a process of personal transformation that was initiated by an engagement on a deeper emotional level with these individuals. The process of personal transformation started a journey towards the discovery of meaning for the self, as student nurses. Student nurses working in challenging environments during their training may experience emotional discomfort and need additional support in coping and adjustment within this context. The nurse educator plays an important role in providing this support to manage work-related stress as well as in creating learning opportunities for the student nurses working in challenging contexts.

Experiences of psychiatric nurses exposed to hostility from patients in a forensic ward.

BACKGROUND: Hostile behaviour is becoming a way of life in South Africa. Hostility prevails at all settings, including in the health sector. In a forensic ward psychiatric nurses are subjected to hostile behaviour by the patients. AIM: The aim of the present study was to explore and describe the psychiatric nurses' experiences of hostile behaviour by patients in a forensic ward and make recommendations for nurse managers to empower these psychiatric nurses to cope with the patients' aggression. METHOD: Qualitative, in-depth, phenomenological interviews were conducted with nine psychiatric nurses exposed to hostility from patients in a forensic ward. Recommendations were derived from the results from nurse managers to assist psychiatric nurses. RESULTS: It became apparent from the findings that psychiatric nurses in a forensic ward work in a stressful environment. Hostile behaviour in the forensic ward is consistently experienced by the psychiatric nurses as hindering therapeutic relationships. The psychiatric nurses experienced being disempowered. CONCLUSION: Psychiatric nurses experience hostile behaviour by patients in a forensic ward as disempowering. IMPLICATIONS FOR NURSE MANAGEMENT: Nurse managers can facilitate psychiatric nurses' empowerment by providing them access to: information, support, resources, opportunity and growth.

Registered nurses' experiences of interaction with patients with mental health challenges in medical wards in Johannesburg.

AIM: The aims of this research were to explore and describe registered nurses' experiences of interacting with patients with mental health challenges in the medical wards of a public hospital in Johannesburg. BACKGROUND: Nurses are the major providers of hospital care and have become an important resource in the delivery of mental health care to patients with mental health challenges. However, the attitude and ability of many nurses in providing this care have been shown to be poor. METHOD: In-depth phenomenological interviews were conducted with eight female registered nurses working in four medical wards where they interact with patients with mental health challenges. RESULTS: From the findings it is clear that registered nurses experienced frustration, unhappiness, fear and perception of danger when interacting with patients with mental health challenges in their wards. This could be attributed to a lack of knowledge and skills in mental health. CONCLUSION: Registered nurses have negative experiences with interaction with patients with mental health challenges in medical wards because of a lack of knowledge and skills in mental health. IMPLICATIONS FOR NURSING MANAGEMENT: Ward managers can facilitate the psychological empowerment of registered nurses.

Exploration of the views of traditional healers regarding the termination of pregnancy (TOP) law.

The North-West Province is predominantly a rural area, and traditional healers remain the most important and influential members of the rural communities. A qualitative, explorative, descriptive and contextual research design was used. In-depth, individual focused and interactive interviews were held with eight traditional healers from the rural areas of Mmabatho-Mafikeng. In addition, field notes and observations were utilised. The objective of this article is to explore the views of the traditional healers regarding termination of pregnancy (TOP) law. The results reflected the following themes: termination of pregnancy is killing; a child is a precious gift from God and the ancestors; there are alternatives to TOP; people who had any type of abortion should be cleansed with "dipitsa" or herbs; TOP may be allowed only in case of rape and incest, rape and incest offenders should be severely punished; and the traditional healers were not consulted during formulation of the TOP Law. It is therefore recommended that traditional should be involved in TOP workshops and educational programmes to enable them to provide counselling before and after abortion.

Life stories of depressed adult women in peri-urban Namibia.

The problems women in peri-urban Namibia are faced with are multi-dimensional. Like women in other communities they face the pressure of having a number of responsibilities, namely working, being a wife and mother, taking care of their families and perhaps caring for aging parents. Sometimes the pressure can be too overwhelming to manage. As a result, many women become depressed. Studies on depression among black African women in Namibia could not be traced. It was therefore considered to find out how women suffering from depression from this part of the world tell their life stories. The purpose of the study was two-fold: Firstly, to explore and describe the life stories of depressed adult women in peri-urban Namibia, and secondly to use the information obtained to describe guidelines for psychiatric nurses working with these patients at psychiatric outpatient clinics as well as in the community. A qualitative phenomenological research design of an explorative, descriptive and contextual nature was used. The researcher approached the subjects and their experiences with an open mind. Ten depressed adult women between 21-55 years were involved in the research. The researcher strived to adhere to the principles of trustworthiness. To ensure this Guba's model (in Krefting, 1991: 217) of trustworthiness was adopted. All the interviews were analysed following Tesch's method (Creswell, 1994: 154-55). The services of an independent coder were obtained. The results indicated that impaired interpersonal interactions and stressful life events have a negative influence on the daily life of women leading to the development of depressive symptoms. Guidelines to support psychiatric nurses working with depressed women were drawn up.

Women's experience of termination of a pregnancy.

In November 1996 the Act on the Termination of Pregnancies (no 92 of 1996) was promulgated. This Act enabled women from the age of twelve years old to decide to terminate their pregnancies before twelve weeks gestation without permission of anybody else. Since February 1997 almost 160 000 terminations of pregnancy have been carried out in South Africa. Little research has been conducted to explore and describe the effect of the termination of pregnancies on women Two aims were formulated for the research project described in this article: (1) the exploration and description of the women's experience of terminating a pregnancy, and (2) the description of counselling guidelines for caring professionals to assist these women. Participants were included in the sample through purposive sampling. Phenomenological interviews were conducted individually. Data were analysed by means of Tesch's descriptive approach. Counselling guidelines for educational psychologists and other caring professionals to empower the involved were being logically inferred from the results of the interviews. Measures to ensure trustworthiness have been applied in the research and ethical measures have been strictly adhered to during the research. One central theme was identified from the results of the interviews and naïve sketches, namely women's experiences of a negative relationship with themselves and other persons as well as their focus on their terminated pregnancies.

The lived experience of women subjected to domestic violence and abuse.

The number of incidents of domestic violence appears to be continually on the increase. Domestic violence and repeated victimisation and offending can even give rise to fatality. Evaluation of the quality of service delivery and understanding of domestic violence by community members and health care workers show poor results with some people still clinging to myths coming from cultural beliefs. The goal of this article is to explore and describe the lived experience of women subjected to domestic violence and abuse; and to make recommendations for nursing practice, nursing education and nursing research to support women who were subjected to domestic violence and abuse, in facilitating their mental health and optimising their ability to terminate the abusive situation. The framework of the Theory for Health Promotion in Nursing (Rand Afrikaans University, 2000) was used. A qualitative, explorative, descriptive and contextual research design and in-depth, semi-structured, qualitative research interviews were used. Guba's model of trustworthiness (Poggenpoel, 1998: 348-350) was applied. Guba's model for trustworthiness was used (Poggenpoel, 1998: 348-350) Data analysis was done according to Tesch's method (Poggenpoel, 1998: 343-352). The target population of this study was white women in Middelburg, Mpumalanga Province, that experienced abuse for at least the last year and were still married to or in the process of divorcing the abuser. The researcher used a sample of nine participants of which one was involved in the pilot study.