Psychological impact of COVID-19 on nurses caring for patients during COVID-19 pandemic in Gaborone.

AIM: Nurses as front liners have direct contact with COVID-19 patients during the pandemic. Carrying the heavy burden during the pandemic has a mental health toll on healthcare professionals. The study explored nurses' experiences of psychological distress during the COVID-19 pandemic in Botswana's two COVID-19 special care centres. DESIGN: The study used qualitative case study research to solicit nurses' experiences caring for patients with COVID-19 in selected COVID-19 centres in Gaborone. METHOD: Researchers purposively recruited nurses from two COVID-19 centres in Botswana. Data were collected using semi-structured telephone interviews and analysed through inductive thematic analysis. Various institutional review boards ethically cleared the study. RESULTS: Six themes emerged from the thematic analysis: feelings of fear and anxiety, hopelessness and helplessness, loneliness, physical distress, support mechanism and commitment to care. PUBLIC CONTRIBUTION: The results offer important insights into the nurses' experiences during the COVI-19 pandemic.

Implementation Planning for Integrating Depression Screening in Diabetes Mellitus and HIV Clinics in Botswana.

Depression is highly prevalent and, when comorbid with other medical conditions, can worsen health outcomes. Implementing routine depression screening within medical clinics can ensure that patients receive suitable treatment and improve overall health outcomes. Unfortunately, depression screening within medical settings is rare, particularly in low- and middle-income countries. This qualitative study evaluated patient and clinician perspectives on implementing depression screening within HIV and diabetes clinics in Botswana. Seven clinicians and 23 patients within these clinics were purposively selected and interviewed using a guide informed by the Consolidated Framework for Implementation Research (CFIR) to understand barriers and facilitators to depression screening in medical clinics in Botswana. Interviews were recorded, transcribed, and analyzed using NVivo. Three general themes emerged: (1) Appropriateness and Acceptability: attitudes and beliefs from clinicians and patients about whether depression screening should occur in this setting; (2) Stigma as an important barrier: the need to address the negative associations with depression to facilitate screening; and (3) Recommendations to facilitate screening including improving knowledge and awareness about depression, offering incentives to complete the screening, providing staff training, ensuring resources for treatment, the need to preserve confidentiality, and utilizing leadership endorsement. These results offer insights into how to implement depression screening within medical clinics in Botswana. These results can help design implementation strategies to increase depression screening in these clinics, which can be tested in future studies. Supplementary Information: The online version contains supplementary material available at 10.1007/s43477-022-00062-3.

Experiences of family caregivers of persons living with mental illness: A meta-synthesis.

BACKGROUND: Meta-synthesis is used to generate and understand new insights from a qualitative perspective. Caregiving is associated with a range of physical and psychological symptoms. Caregivers bear the brunt of caregiving and this has become worse since the inception of de-institutionalisation, as more patients are discharged into the community under the care of their families. OBJECTIVES: The purpose of this study was to synthesise phenomenological qualitative studies and create a comprehensive chronicle of phenomena of family caregivers' experiences of caring for relatives living with mental illness. METHOD: Google Scholar and different electronic databases, which included CINAHL, MEDLINE, EBSCO and PubMed, were searched using keywords for relevant studies published from 1994 to 2014. To obtain an in-depth view of caregivers' lived experiences, a qualitative meta-synthesis was employed to review the findings of 10 studies. RESULTS: A total of 10 studies were included in the meta-synthesis. The family caregivers described their caregiving experiences under four themes: perceived responsibility of caregiving, experiences of emotional effect, experiences of support needs and experiences of changed perspective. CONCLUSION: The meta-synthesis revealed a lack of emotional coping among the family caregivers. This calls for robust family caregiver interventions to facilitate their mental health.

A qualitative description of service providers' experiences of ethical issues in HIV care.

BACKGROUND: Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. PURPOSE: This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. RESEARCH DESIGN: A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. PARTICIPANTS AND CONTEXT: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. ETHICAL CONSIDERATIONS: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. FINDINGS: HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. DISCUSSION: The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. CONCLUSION: Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

Experiences of family caregivers of persons living with mental illness: A meta-synthesis

Background: Meta-synthesis is used to generate and understand new insights from a qualitative perspective. Caregiving is associated with a range of physical and psychological symptoms. Caregivers bear the brunt of caregiving and this has become worse since the inception of de-institutionalisation, as more patients are discharged into the community under the care of their families.Objectives: The purpose of this study was to synthesise phenomenological qualitative studies and create a comprehensive chronicle of phenomena of family caregivers' experiences of caring for relatives living with mental illness.Method: Google Scholar and different electronic databases, which included CINAHL, MEDLINE, EBSCO and PubMed, were searched using keywords for relevant studies published from 1994 to 2014. To obtain an in-depth view of caregivers' lived experiences, a qualitative meta-synthesis was employed to review the findings of 10 studies.Results: A total of 10 studies were included in the meta-synthesis. The family caregivers described their caregiving experiences under four themes: perceived responsibility of caregiving, experiences of emotional effect, experiences of support needs and experiences of changed perspective.Conclusion: The meta-synthesis revealed a lack of emotional coping among the family caregivers. This calls for robust family caregiver interventions to facilitate their mental health

Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members.

Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs), and 39 HIV professional care team members (PCTMs). SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.

Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.

Exploring the HIV/AIDS-related knowledge, attitudes, and behaviors of university students in Botswana.

PURPOSE: Because of the serious threat of HIV/AIDS to students at a university in Botswana, faculty instituted two interventions to change students' HIV/AIDS-related knowledge, attitudes, and behavior: (a) an HIV/AIDS course and (b) the Health and Wellness Centre. The purpose of this study is to evaluate the success of these interventions. METHOD: A four-group comparison design was created for this study as a method for the qualitative formative evaluation. Data collection was done using the rapid assessment method, in which team interviews of 105 students at the university were conducted. The teams used descriptive, interpretive, and explanatory codes to create themes, which were compared to findings in the literature. RESULTS: Although students indicated significant learning and attitude changes, no major changes in sexually risky behavior were reported. DISCUSSION: Substantive, methodological, and theoretical implications are discussed.

Cultural considerations in theories of adolescent development: a case study from Botswana.

Western studies of adolescent development are beginning to corporate not only the traditional ideas of nature and nurture, but also contextual factors such as culture, ecology and historical time. This article explores how adolescent development is influenced by both a specific culture (Botswana) and a specific ecological situation (the rampant HIV pandemic in that country). A case study of late adolescents living in this pandemic in Botswana helps broaden our traditional views of adolescent development.

HIV/AIDS education, prevention and control course (BNS101): the way forward.

Botswana currently has one of the highest HIV-positive prevalence rates in the world. University students are an important group seriously affected by this pandemic. They represent one of the country's richest resources for the future, and faculty at University of Botswana believe there is a responsibility to educate them in a way that helps them preserve their health and vitality. This article represents a case study of one university faculty's efforts to fight the threat of HIV/AIDS to their student body. This case study reviews the early stages of faculty endeavors beginning with the development of an HIV/AIDS course and continuing through evaluation of the success and failures of the course, as well as current refinements now being made. Because the problem of HIV/AIDS on campus is a common one throughout sub-Saharan Africa, the authors hope that this case study of one faculty's approach may be helpful to those facing the same challenge.

Using qualitative methods for course evaluation: a case study from Botswana.

This article is a report of a qualitative evaluation of a course on human immunodeficiency virus/acquired immunodeficiency syndrome carried out jointly by faculty from Botswana and the United States at a university in Botswana. It demonstrates the importance of both international nurse educator expertise in impacting a major pandemic and the use of qualitative methods for course evaluation.