Experiences of families with children diagnosed with Autism Spectrum Disorder in World Health Organization Afro-Regions: A scoping review.

A scoping review on Autism Spectrum Disorder (ASD) and its impact on the families of affected children was undertaken due to insufficient information available on the diverse experiences impacting their lives. Using the Joanna Briggs Institute methodology, eligibility criteria were guided by Population (families), Concept (family experiences), and Context (African region). English-language articles were sought from a variety of databases and search engines. The publication date of the identified articles ranged from 2003 to 2021 with most published in 2020 (n = 10), and the majority using qualitative methodologies (n = 51). Most family members involved were parents (n = 51) and their ages ranged from 18 to 75 years. The families experienced various challenges related to their child with regard to education, healthcare, and the broader community including lack of support. Family coping strategies included believing in God, attending counseling sessions, adapting, and accepting the situation. Healthcare professionals should be prepared and positioned to educate families and siblings on various aspects of ASD. There is a need for active, continued research on families within most countries of World Health Organization Afro-region.

Family-Focused Nursing Research in WHO Afro-Region Member States: A Scoping Review.

Although family nursing research has become an important focus for over the past 20 years, the evolution and extent of family nursing research in the World Health Organization (WHO) Afro-regions is less explored. The purpose of this scoping review was to map the evidence of family-focused nursing research using the Joanna Briggs Institute Scoping Review methodology. A systematic electronic search of articles was carried out for the period January 1, 2000 to December 31, 2020. The review process culminated in 85 articles, evidencing an increase in publications particularly in 2019 (n = 12). Eighteen countries were involved, with the Southern African region contributing 52% of the studies. Family members were predominantly described as parents, siblings, and children, with the most focused area of study being family experiences (n = 52). The majority of studies (n = 59) used qualitative methodologies. Despite the recent increase in family-focused nursing research in the WHO Afro-regions, further qualitative research, including more complex methodologies and interventions are still required to build contextualized evidence-based family-focused nursing.

Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions.

The Covid-19 pandemic lockdown regulations caused retirement homes to temporarily ban in-person visitation potentially increasing the mental health risks of older people. An opportunity arose for a multistakeholder community collaboration to design a mental health program for older people. To evaluate the process of delivering a 12-week psychosocial program aimed at preventing loneliness, countering boredom, and providing older people in restricted settings with education about Covid-19 during the lockdown, in Durban, South Africa. A qualitative retrospective design was used. Data from two focus groups and six semistructured individual interviews conducted with stakeholders (volunteers, social workers, and residents) postproject were analyzed using reflexive thematic analysis. Stakeholders had varied experiences of the project, in terms of content, processes of engagement, and implementation, resulting in five themes. The study concluded with recommendations. A strong need exists for multistakeholder community collaborations when implementing a program where the context restricts physical access.

Evaluation of a digital programme for final year nursing students during COVID-19.

Aim: The aim of this study was to evaluate a digital programme aimed to address COVID-19 related anxiety of final year undergraduate nursing students on returning to the clinical practice during the pandemic in South Africa. Background: In South Africa, concern about the physical and psychological safety of nursing students resulted in the planning of a psychological first aid program to facilitate nursing students return to clinical practice. Design: A survey was conducted in September 2020 following the August 2020 return of final year nursing students to clinical facilities. Methods: All final year nursing students were invited to participate in the study (N = 196). An online survey was circulated via WhatsApp asking respondents to rate their anxiety and fear of COVID-19 before and after return to practice following an intervention (eCOVID). Related pair analysis was done on the main outcome measures of anxiety, COVID-19 fears and concerns using Related Samples Wilcoxon Signed Rank tests. Results: After the programme, the respondents reported a significant reduction in anxiety (W = 2.92, p =.004) and COVID fear (W=0.3.1, p =.001), specifically related to infecting family, being exposed to COVID-19 at work, propagating infection at work and lacking access to COVID-19 information and communication. Conclusion: The implementation of a dedicated digital programme, underpinned by a sound theory base of psychological first aid, may have decreased anxiety and fear in nursing students during clinical practice in the pandemic.Contribution: The study contributes to evidence on psychological first aid support of nursing students during the COVID-19 pandemic.

A road less travelled: Undergraduate midwifery students' experiences of a decentralised clinical training platform.

BACKGROUND: In South Africa, the critical skill base shortage of healthcare workers, the underperforming global health indicators and the planned roll out of the National Health Insurance have burdened South African higher education authorities to rapidly expand nursing student enrolments. The expansion in student numbers has placed increased demands on overstretched educational institutions, and students are confronted with challenges of congestion in classrooms and clinical facilities, while lecturers encounter difficulties in the process of clinical allocation. A solution is to utilise decentralised clinical training platforms (DCTPs) and allocate students in rural hospitals. AIM: To explore and describe undergraduate midwifery students' reflections of their DCTP experiences, in order to inform future practice of decentralisation in student training. SETTING: The study was conducted in the nursing discipline of an urban-based university in KwaZulu-Natal, South Africa, involving undergraduate midwifery students. The university had commenced a programme of allocating students to decentralised clinical sites. METHOD: Elo and Kyngäs' content analysis was used to analyse the experiences of DCTP by undergraduate midwifery students (n = 14) as expressed in a focus group (n = 11) and three individual interviews (n = 3). RESULTS: The following four categories emerged: Recognition as a team member, engaging support, win-win platform and juxtaposed challenges. CONCLUSION: In the presence of support and teamwork, rural settings can develop undergraduate student midwives, not only in the areas of midwifery competency but also in their personal capacity, and strengthen the responsiveness, preparedness and relevance of midwifery graduates.

Continuing Professional Development status in the World Health Organisation, Afro-region member states.

There is evidence of underperformance of the Global Health Indicators, particularly in the WHO Afro-region. Yet, quality, effective healthcare delivery, and access to information about best practice remains a challenge to nurses and midwives in the WHO Afro-region. For nurses and midwives to have the capacity to practice safely and competently they need to engage in mandatory Continuing Professional Development (CPD). However a composite picture is not available for future project planners, researchers, and policy developers. Published literature from the past five years and professional body webpages were searched. The results of shining a light on the WHO Afro-region member states' CPD status revealed strengths, weaknesses, opportunities, and threats. The strengths lay in the beginnings of mandatory CPD and annual licensure renewal, while the weaknesses revealed inequity of CPD distribution across the region. The opportunities showed international academic partnership with possibilities for further engagement, and the threats were evident in the health context of the Afro-region, the shortage of nurses and the lesser participation of nurses in CPD programs. The illumination of the CPD status in the Afro-region suggests that a revised CPD landscape is necessary to strengthen the relevance and response capacity of nurses and midwives, as key contributors towards the Global Health Indicators.

Evidence of nonverbal communication between nurses and older adults: a scoping review.

BACKGROUND: Communication is an integral part of life and of nurse-patient relationships. Effective communication with patients can improve the quality of care. However, the specific communication needs of older adults can render communication between them and nurses as less effective with negative outcomes. METHODS: This scoping review aims at describing the type of nonverbal communication used by nurses to communicate with older adults. It also describes the older adults' perceptions of nurses' nonverbal communication behaviors. It followed (Int J Soc Res 8: 19-32, 2005) framework. Grey literature and 11 databases were systematically searched for studies published in English and French, using search terms synonymous with nonverbal communication between nurses and older adults for the period 2000 to 2019. RESULTS: The search revealed limited published research addressing nonverbal communication between older adults and nurses. The studies eligible for quality assessment were found to be of high quality. Twenty-two studies were included and highlighted haptics, kinesics, proxemics, and vocalics as most frequently used by nurses when communicating with older adults; while studies showed limited use of artefacts and chronemics. There was no mention of nurses' use of silence as a nonverbal communication strategy. Additionally, there were both older adults' positive and negative responses to nurses' nonverbal communication behaviors. CONCLUSION: Nurses should be self-aware of their nonverbal communication behaviors with older adults as well as the way in which the meanings of the messages might be misinterpreted. In addition, nurses should identify their own style of nonverbal communication and understand its modification as necessary in accordance with patient's needs.

An Evaluation of a Low-Intensity Cognitive Behavioral Therapy mHealth-Supported Intervention to Reduce Loneliness in Older People.

There is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can affect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which targeted maladaptive cognitions in older people (≥60 years) experiencing loneliness. The three-month intervention using WhatsApp was implemented with older people in four inner-city residential care facilities. The intervention included three components: technology acceptance, psycho-education, and individualized positively worded messages addressing maladaptive cognitions. The intervention was evaluated using a randomized control design. Key outcomes were measured pre-, post-, and one month after the intervention. There were significant changes in social cognition (YSQ-SF T0-T1-T2, X² = 9.69, p = 0.008) and loneliness levels (total loneliness T0-T1-T2, X² = 14.62, p = 0.001), and an increase in WhatsApp usage (T0 = 26% vs. T1 = 60%, X²=15.22, p = 0.019). At 1-month follow-up, even with a significant reduction in WhatsApp usage, a significant reduction in loneliness was maintained. LI-CBT delivered via instant messaging may be effective in reducing loneliness experienced by older people.

Northern Ghana final-year nurses' attitudes towards nursing and remaining post qualification.

BACKGROUND:  Recruitment and retention concerns nursing globally, including Ghana, as the country attempts to meet health demands. A link exists between nursing students' attitudes towards nursing and decisions to enter, remain in or withdraw from the profession. OBJECTIVES:  To describe northern Ghana final-year student nurses' current attitudes towards nursing and remaining in nursing post qualification. METHOD:  Non-experimental quantitative descriptive design used convenient sampling targeting final third-year student nurses (n = 80) studying towards a Diploma in Registered General Nursing in a northern Ghana college (N = 220). Data were gathered using the attitude dimension of a self-administered questionnaire, developed by Al-Omar. RESULTS:  The response rate was 87.5% (n = 70). Respondents were 20-30 years of age, more men and predominantly from urban areas. The mean attitude dimension score (range 10-50) was 35.41 (SD 4.03) with no skewness (0.37); mean of single-item question about intention to stay in nursing was 3.68 (SD 1.14) with negative skewness (-0.92). Male and urban respondents' attitudes were more positive than those of female respondents. No association was found between attitude score and demographics or intention to stay in nursing, but significant association was found between gender and habitation and attitude categories. Medium positive correlation existed between intent to stay in nursing and attitude score. Pay, travel opportunities and nursing being a challenging career attracted unfavourable attitudes. CONCLUSION:  Ghanaian male student nurses' attitudes are non-typical of general stereotypes held of nurses and gender, suggesting increased recruitment of male nurses. Demographic variables hold a small amount of value in the development of attitudes in Ghanaian nurses.

The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews.

As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of e-Interventions for older people and specifically in having a role in increasing social networks and decreasing loneliness. A systematic review of e-Interventions to reduce loneliness in older people was conducted with the aim to synthesize high quality evidence on the effectiveness of e-Interventions to decrease social isolation/loneliness for older people living in community/residential care. A systematic search of 12 databases for reviews published between 2000-2017 was conducted using search term synonyms for older people, social isolation and interventions. Three independent researchers screened articles and two reviewers extracted data. The Revised-Assessment of Multiple Systematic Reviews was used to assess the quality of reviews. The final search identified 12 reviews, which included 22 unique primary research studies evaluating e-Interventions for social isolation or loneliness. The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.

Social capital and mental well-being of older people residing in a residential care facility in Durban, South Africa.

INTRODUCTION: Global increases in life expectancy are expected to continue, with accompanying physical and mental well-being challenges specifically for older people living in residential care settings. OBJECTIVE: The aim of the study was to investigate the association between mental well-being and social capital of older residents (60+ years) in an urban residential care facility in South Africa. METHOD: A descriptive survey was conducted with 103 residents living in a residential care facility in an urban environment in South Africa. The social capital framework from the Canadian Policy Research Initiative, the WHO-5 well-being index, the Kessler-6 measure of psychosocial distress, the OSLO-3 Social Support Scale and the Australian Bureau of Statistics Indigenous Health Questionnaire were used to develop the questionnaire. RESULTS: The WHO-5 showed moderate ratings of mental well-being for the standard scoring (>13) (62, 82.7%), but lower levels when using 'no negative ratings' (36; 50.6%). Significant differences in the primary network size, average closeness, self-efficacy and social support as well as the ability to confide in primary network was shown between residents with mentally well and unwell ratings. Logistic regression showed that the strongest predictor for mental well-being was participation in activities outside of the residence and having a primary network. CONCLUSION: The study confirms the association between social capital and mental well-being.