Acceptability and feasibility of a screening protocol for antenatal depression (SPADe) in Blantyre District, Malawi.

BACKGROUND: Depression is one of the most common perinatal mental health problems that affect pregnant women. Antenatal depression can adversely affect the well-being of the pregnant woman and her foetus. Depression is rarely detected by midwives due to the unavailability of relevant screening instruments in Malawi. A Screening Protocol for Antenatal Depression (SPADe) was developed and recommended for possible use to screen for depression in antenatal clinics in the country. The acceptability and feasibility of using the SPADe protocol to screen for depression has not been established. The aim of this study was to assess the acceptability and feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre district. METHODS: This study used a quantitative survey design to collect data among 60 midwives in three antenatal clinics in primary care settings. All inclusive sampling of all 60 midwives were used. The Structured Assessment of FEasibility and Ottawa Acceptability of Decision Rules Instruments were used to collect the data. Descriptive statistics and Chi square tests were used to analyse the data. RESULTS: This study found that it was feasible to implement SPADe and the following enablers for screening depression had the highest ratings: the SPADe is applicable to pregnant women (M = 3.9, sd = 0.4); the intended goal of the SPADe matches the prioritised goals of Malawi Ministry of Health (M = 3.9, sd = 0.5); and the SPADe is likely to be effective (M = 3.8, sd = 0.6). On the other hand, barriers for implementing the SPADe were: the need for specific training to deliver the SPADe (M = 3.7, sd = 0.7); ongoing support and supervision (M = 3.5, sd = 0.8); and additional resources (M = 3.0, sd = 0.9). This study also found that the implementation of the SPADe was acceptable to respondents. The overall mean score for respondents on acceptability of screening antenatal depression using SPADe was found to be high (M = 4.6, sd = 0.6). However the differences in the respondents' mean scores on acceptability of screening for depression in antenatal clinics using SPADe in relation to their demographic characteristics were not significant (p > .05). CONCLUSION: This study suggests that midwives feel that it is feasible and acceptable for them to implement the SPADe in antenatal clinics with ongoing training, support and clinical supervision.

Professional quality of life amongst nurses in psychiatric observation units.

BACKGROUND: Professional quality of life amongst nurses in psychiatric observations units may be affected by working conditions such as an overflow of mental health care users (MHCUs), a shortage of nurses, lack of specialised staff and inadequate infrastructure to accommodate MHCUs amongst others. AIM: The aim of the study was to investigate the professional quality of life amongst nurses in psychiatric observation units. SETTING: The study was conducted in psychiatric observation units in eight hospitals in the Metropole District Health Services in the Western Cape. METHOD: A quantitative descriptive survey design using the Professional Quality of Life (ProQoL version 5) questionnaire was conducted with an all-inclusive sample of 175 nurses. The ProQoL has two scales, namely, the compassion satisfaction and the compassion fatigue. Compassion fatigue includes two subscales, burnout and secondary traumatic stress. Ethics to conduct the study was obtained from the Research Ethics Committee at the university and the Department of Health in the Western Cape. RESULTS: A response rate of 93% (n = 163) was obtained. Respondents reported moderate compassion satisfaction. Psychiatric nurse specialists and registered nurses reported lower compassion satisfaction than enrolled nurses and nursing assistants. This came with moderate levels of burnout and high levels of secondary traumatic stress, with enrolled nurses and enrolled nursing assistants reporting lower levels than the other professional groups. CONCLUSION: Psychiatric nurse specialists and registered nurses experienced higher burnout and secondary traumatic stress and lower compassion satisfaction than the lower categories of nurses.

A cross-sectional study of depression among women attending antenatal clinics in Blantyre district, Malawi.

BACKGROUND: Pregnancy is a period associated with major psychological and social changes in the life of a woman and can be associated with anxiety and depression. AIM: To describe demographic, clinical and risk profile of antenatal depression among pregnant women attending antenatal clinics in Blantyre district, Malawi. SETTING: The study was conducted in eight antenatal clinics in Blantyre district, Malawi. METHODS: A cross-sectional study of 480 randomly selected pregnant women attending antenatal clinics was conducted. Prevalence was determined using the Edinburgh Postnatal Depression Scale (EPDS) which was validated against a sub-sample using the Mini International Neuropsychiatric Interview. The risk factors of depression were assessed using the Pregnancy Risk Questionnaire. Data were analysed using descriptive statistics, Pearson chi-square test and binary logistic regression. RESULTS: Prevalence of antenatal depression using the EPDS was 19% (95% CI 15.5% - 22.5%, n = 91) and was comparable to the Mini International Neuropsychiatric Interview (25.8% [95% CI = 17.5-34], n = 25). The key risk factors that predicted antenatal depression were: 'being distressed by anxiety or depression for more than 2 weeks during this pregnancy' (OR = 4.1 [2.1-7.9], p ≤ 0.001); 'feeling that a relationship with partner is not an emotionally supportive one' (OR = 3.5 [1.4-8.4], p = 0.01); 'having major stresses, changes or losses in the course of this pregnancy' (OR = 3.2 [1.7-6.2], p = 0.01); 'feeling that father was critical of her when growing up' (OR = 3.2 [1.4-7.6], p = 0.01); and 'having history of feeling miserable or depressed for ≥2 weeks before this pregnancy' (OR = 2.4 [1.3-4.4], p = 0.01). CONCLUSION: This study confirmed the high-prevalence rate of depression in this group and illustrated that antenatal depression was associated with being distressed by anxiety or depression; support from partner; major stresses during pregnancy; and history of feeling miserable or depressed before pregnancy. This study also found a history of poor relationship between pregnant women and their fathers during childhood.

A systematic review of screening instruments for depression for use in antenatal services in low resource settings.

BACKGROUND: In low resource settings, short, valid and reliable instruments with good high sensitivity and specificity are essential for the screening of depression in antenatal care. A review of published evidence on screening instruments for depression for use in antenatal services in low resource settings was conducted. The aim of this review was to appraise the best available evidence on screening instruments suitable for detecting depression in antenatal care in low resource settings. METHODS: Searching, selection, quality assessment, and data abstraction was done by two reviewers. ScienceDirect, CINAHL, MEDLINE, PubMed, SABINET and PsychARTICLES databases were searched using relevant search terms. Retrieved studies were evaluated for relevancy (whether psychometric data were reported) and quality. Data were synthesised and sensitivity and specificity of instruments were pooled using forest plots. RESULTS: Eleven articles were included in the review. The methodological quality ranged from adequate to excellent. The review found 7 tools with varying levels of accuracy, sensitivity and specificity, including the Edinburgh Postnatal Depression Scale, Beck Depression Index, Centre for Epidemiologic Studies Depression Scale 20, Hamilton Rating Scale for Depression, Hopkins Symptoms Checklist-25, Kessler Psychological Distress Scale and Self-Reporting Questionnaire. The Edinburgh Postnatal Depression Scale was most common and had the highest level of accuracy (AUC = .965) and sensitivity. CONCLUSION: This review suggests that the Edinburgh Postnatal Depression Scale can be a suitable instrument of preference for screening antenatal depression in low resource settings because of the reported level of accuracy, sensitivity and specificity. PROSPERO REGISTRATION: CRD42015020316 .

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.

A survey of university students' perceptions of learning management systems in a low-resource setting using a technology acceptance model.

Learning management systems have been widely advocated for the support of distance learning. In low-resource settings, the uptake of these systems by students has been mixed. This study aimed to identify, through the use of the Technology Acceptance Model, the individual, organizational, and technological factors that could be influencing the use of learning management systems. A simple quantitative descriptive survey was conducted of nursing and health science students at a university in South Africa as part of their first exposure to a learning management system. A total of 274 respondents (56.7%) completed the survey questionnaire, made up of 213 nursing respondents (87.7%) and 61 health sciences respondents (25%). Overall, the respondents found the learning management system easy to use and useful for learning. There were significant differences between the two groups of respondents, with the respondents from health sciences being both younger and more computer literate. The nursing respondents, who received more support and orientations, reported finding the learning management system more useful. Recommendations are made for training and support to ensure uptake.

Blended learning: Assessing nursing students' perspectives.

BACKGROUND:  Blended learning combines face-to-face and online learning and has recently gained popularity, accelerated by the coronavirus disease 2019 (COVID-19) pandemic, often without active evaluation. OBJECTIVES:  This study aimed to assess university nursing students' perceptions of a blended learning approach during the COVID-19 pandemic. METHOD:  The population was 150 third-year nursing students from a university in the Western Cape, South Africa, using all-inclusive sampling. A one-group, pre-and post-evaluation study was conducted using a self-administered questionnaire (Student Perceptions of Blended Learning scale). Differences were assessed using Chi-squared and Mann-Whitney U tests with a significance level of p  0.05. RESULTS:  Before implementing blended learning, 128 students (85.3%) completed the questionnaire, while 95 (63.3%) did so after. Demographics and access showed no significant differences between the groups. Post-implementation showed a 10.1% increase in preference for blended learning (χ2 = 2.832, p = 0.092). Ease of use was rated significantly higher before implementation (3.07 ± 0.49), with no significant change post-implementation (2.99 ± 0.58). The blended learning process received lower ratings compared to content, with no significant differences before or after implementation for either (process: 2.55 ± 0.58 vs 2.54 ± 0.63; content: 2.75 ± 0.52 vs 2.79 ± 0.52). CONCLUSION:  Nursing students had a positive perception of blended learning, though the online learning component posed challenges with time and module comprehension.Contribution: The findings can help higher education institutions evaluate existing online management systems and guide nurse educators in meeting students' needs when developing module resources.

Eco-nursing competencies for nurses: A scoping review.

Background: Nurses are tasked with addressing the health impacts of climate change. Eco-nursing competencies, covering knowledge, attitudes, and skills related to climate change, equip nurses to actively mitigate and adapt to its effects on health and the environment. Objective: To synthesize existing literature on eco-nursing roles and competencies for nurses. Methods: A scoping review of published papers examined nurses' roles and eco-nursing competencies. Databases searched included Academic Search Complete, CINAHL Plus, MEDLINE (PubMed), and Google Scholar. Search terms encompassed climate change and nursing synonyms, limited to English articles up to April 15, 2023. Thematic analysis was used to synthesize findings, delineating roles, and eco-nursing competencies. Results were tabulated. Results: Out of 445 papers identified, 31 underwent data analysis. These papers highlighted nurses' roles in climate change (42%), along with climate change knowledge and skills (64.5%), and attitudes (13%). Roles encompassed research, education, advocacy, leadership, and clinical practice, with corresponding competencies embedded within existing core competencies for general nurses, nurse specialists, and nurse managers. Conclusion: The review demonstrates that nurses' roles in climate change necessitate relevant knowledge, attitudes, and skills. Future research should contextualize these roles and eco-nursing competencies based on geographical locations, considering the distinct disease burden in each area. Registration: The study protocol was registered in the Open Science Framework on 5 March 2023 before conducting the full study https://doi.org/10.17605/OSF.IO/9GC4N. Tweetable abstract: Amidst growing concerns about climate change, nurses are increasingly tasked with preparing to mitigate its health impacts through the delineation of eco-nursing competencies. These competencies will equip nurses to effectively tackle the health and environmental ramifications of climate change, building upon existing core competencies tailored to various geographic contexts.

A Survey of Nurse Informatics Competencies of Professional Nurses in Clinical Practice Public Hospitals in South Africa.

Competence in Nursing Informatics (NI), is vital for efficient nursing care in today's technologically-enabled healthcare environment. In South Africa, little is known on the competence of professional nurses in clinical practice in nursing informatics. METHODS: This study used a cross-sectional descriptive survey to examine self-rated competence in nursing informatics among 205 nurses in clinical practice across two hospitals in the Western Cape. The TANIC© scale was used to rate the skills of participants in computer literacy, clinical information management, and information literacy. RESULTS: The highest rating was received for computer literacy, approaching a 'comfortable' competency level. Lower scores were received for clinical information management and information literacy, indicating 'novice' to 'advanced beginner' levels. CONCLUSION: The study showed that practicing nurses have a limited level of nursing informatics competence, especially in the domains of clinical information management and information literacy. These findings support the need for educational programmes to extend beyond basic computer skills and prioritize continuous professional development in nursing informatics.

Cardiovascular risk among community members in three communities in the Cape Metropole of the Western Cape.

BACKGROUND:  Cardiovascular diseases pose a risk to population health in South Africa and are responsible for almost one in six deaths (17.3%). AIM:  To determine the cardiovascular risk among community members who attended a community outreach programme. SETTING:  Three communities in the Cape Metropole of the Western Cape. METHODS:  A health survey was conducted with 783 participants, 18 years and older, conveniently sampled. The survey included questions about cardiovascular risk factors, and biometric measurements of blood pressure (BP), height and weight were conducted. RESULTS:  A total of 777 participants were included in the study. Most participants were female (529, 68.1%), with an average age of 42.3 years (s.d. 14.2). Risk behaviours reported included smoking (216, 27.8%), consuming more than two drinks of alcohol daily (78, 10%), low physical activity (384, 49.4%), being stressed on most days (436, 56.1%) and unhealthy eating habits (253, 32.6%). More than half of the participants (402, 51.7%) had a body mass index (BMI) ≥ 30, 26.0% (202) had a systolic BP of ≥ 140 mm Hg and 22.4% (174) had a diastolic BP of ≥ 90 mm Hg; 16.6% (130) had a cardiovascular disease (CVD) risk of 10-20 and 19.3% (150) had a CVD risk of 20%. CONCLUSION:  Nearly a fifth of the participants had a significant probability of developing heart disease or experiencing a stroke over the next 10 years.Contribution: There is an urgent need for comprehensive health promotion and behaviour change interventions focused on reducing CVD risk factors at the community level.

Role analysis of the nurse/midwives in the health services in Sub-Saharan Africa.

AIM: To describe the tasks and the roles of nurses and midwives in Sub-Saharan African health services. BACKGROUND: The current roles of nurses and midwives in the African region of the World Health Organization have not been empirically established, with only studies from two countries found (South Africa and Mozambique). This makes it difficult to establish whether current nursing/midwifery education programmes and regulations adequately address the needs in the health services. DESIGN: A descriptive quantitative study. METHODS: A survey questionnaire was administered to ambulatory and hospital services. Data were collected between June-December 2010, with completed responses from 734 nurses from nine African countries (five Anglophone and four Francophone). RESULTS: The highest reported role functioning in both settings was for 'General Care and Treatment'. The lowest role functioning reported in both settings was in the role 'Maternal and Child Health' and in 'The Provision of Mental Health Care'. The reported role performance in Anglophone countries was significantly greater than in Francophone countries. CONCLUSION: The development of competency in nursing/midwifery roles other than medical surgical roles (general assessment and care) should receive more attention in curricula. Special attention needs to be given to Francophone countries, where the professions of nursing and midwifery are poorly developed.

COVID-19 fear among junior undergraduate nursing students during the pandemic in South Africa.

Background: During the COVID-19 pandemic, nursing students continued to work in facilities to complete clinical hours. Little was known about the impact of COVID-19 on nursing students during this time. Aim: To investigate fear of COVID-19 among junior undergraduate nursing students during the pandemic. Setting: A student nursing school at a university in the Western Cape, South Africa. Methods: A cross-sectional survey was conducted with 559 nursing students. A self-administered questionnaire with the validated COVID-19 fear scale (α= 0.84) was distributed. Scale reliability, factor analysis, means and 95% confidence intervals were calculated for items, overall scale and associations with demographic variables were tested using Kruskal-Wallis Independent Samples and Mann-Whitney U tests. Results: There were 370 respondents (68.51% response rate), predominantly female (294, 79.5%) and exhibited a mean age of 21.9 years (± 3.9). More than half, 192 respondents (51.9%) reported mild fear of COVID-19, 103 (27.8%) moderate fear and 57 (15.4%) severe fear. Apart from gender, no significant demographic associations with overall COVID-19 fear were found. Factor analysis identified two distinct factors, physiological and emotional expressions of fear (moderate significant positive correlation between factors [r = 0.541]). Conclusion: The study's findings reveal that junior undergraduate nursing students, during the pandemic, generally reported experiencing mild fear related to COVID-19. Contribution: This study contributes to the field of COVID-19 fear studies, provides insight into factors influencing fear levels and validates the scale's factor structure.

Out of Chaos Leaders Emerged.

COVID-19 had a major influence on nursing with the pandemic resulting in changes in the work environment while experiencing physical and emotional challenges such as moral distress, fear for self and family and dealing with the unknown. However, during this period, nurses demonstrated extraordinary resilience, crafted innovations in clinical practice, communication and support, providing leadership in the health service and in the nursing profession.

Professional Values of Undergraduate Students at a Nursing School in South Africa.

Background: Nursing schools play an important role in instilling nursing professional values in undergraduate nursing students and ensuring that they produce professional nurse graduates. Several studies in various countries have been conducted to describe the professional values held by nursing students, but this has not been explored in detail in South Africa. Aim: The purpose of this study was to describe the professional values held by undergraduate degree students at a nursing school in South Africa. Methods: A cross-sectional survey using a self-administered questionnaire was conducted. With a population of 1,233 undergraduate nursing students across four years in the degree programme at the nursing school, a sample of 294 was calculated as the representative (95% CI, 5% error, and 50% response distribution). The 26-item nurses professional values scale revision (NPVS-R) with five value dimensions was used to collect the data. Means, frequencies, and confidence intervals were used to describe the values and Mann-Whitney U tests and Kruskal-Wallis independent sample tests were used to compare the findings with the demographic characteristics. Results: A total number of 245 respondents completed the questionnaire (response rate of 83.3%). Overall, the nurse professional value score was high (113.1 ± 13.1). The values of trust (4.46 ± 0.61), justice (4.39 ± 0.57), and caring (4.38 ± 0.55) were rated significantly higher than those of professionalism (4.23 ± 0.64) and activism (4.22 ± 0.57). First- and final-year students had significantly higher professional value scores. Conclusion: The study results describe the professional values of undergraduate nursing students in the school and confirmed the importance of trust, justice, and caring as the key professional values in the South African setting. Clinical Relevance. Nursing education should embed and monitor nursing professional values in the curriculum. Instilling nursing professional values in undergraduate nurses during formal training programmes improves quality patient care and service delivery for clinical practice.

Training needs of professional nurses in primary health care in the Cape Metropole, South Africa.

BACKGROUND: In the fast-changing healthcare environment, it is important to ensure that primary health care (PHC) nurses are suitably qualified and have access to appropriate and relevant ongoing education. AIM: The aim of this study was to determine the training needs of professional nurses working in PHC facilities. SETTING: The research was conducted in PHC facilities in the Cape Metropole, Western Cape, South Africa. METHODS: A quantitative descriptive survey with all-inclusive sampling was used. All professional nurses (N = 303), employed for at least a minimum of 6 months in PHC facilities were included in the study. The Hennessy-Hicks Training Needs Analysis (TNA) questionnaire was used to collect the data on professional tasks training needs and open-ended questions for specific PHC contextual training needs. Importance and performance means for each of the TNA subsections and training needs were calculated. Open-ended questions were analysed using content analysis, identifying training domains and topics in terms of frequency and ranking. RESULTS: The TNA identified 'Research' as the highest training need. Research tasks were significantly rated as the least important and the lowest rated performance compared to other domains. Child mental health was rated as the most important specific training need. CONCLUSION: The results of this survey provide insight into the training needs of professional nurses employed in PHC facilities and highlight the need for child mental healthcare and research training in this setting.Contribution: The study contributes to the understanding of the training and education needs of professional nurses working in PHC facilities.

A systematic review of the effectiveness of videoconference-based tele-education for medical and nursing education.

BACKGROUND: Rural nurses and doctors typically have little opportunity to further their education and training. Studies have shown high participant satisfaction with the use of educational technology, such as videoconferencing, for education. A review of effectiveness of videoconference-based tele-education for medical and nursing education was conducted. AIMS: The aims of this study were to: (1) systematically review the literature and critique the research methods on studies addressing the review question: "How effective is videoconference-based education for the education of doctors and nurses?" (2) summarize the existing evidence on the effectiveness of videoconference education for medical and nursing staff; and (3) apply the findings to South Africa and other countries across the globe. METHODS: Research citations from 1990 to 2011 from cumulative index of nursing and allied health literature, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews, the Cochrane Controlled Trial Registry, Database of Abstracts of Reviews of Effectiveness, unpublished abstracts through NEXUS and Internet search engines (Google/Google scholar) were searched. Review methods included searching, sifting, abstraction, and quality assessment of relevant studies by two reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. No meta-analysis was conducted as the studies provided heterogeneous outcome data. RESULTS: Five studies were reviewed. Videoconference and face-to-face education is at least equivalent and one study reported an increase in knowledge and knowledge integration. RECOMMENDATIONS: Despite the methodological limitations and heterogeneity of the reviewed studies, there appears to be sufficient evidence of effectiveness to provide a rigorous Grade B evidence-based recommendation of moderate support. CONCLUSIONS: The use of videoconferencing for nursing and medical education should be encouraged along with guidelines for the use of videoconferencing. The paucity of studies and the lack of empirical precision in evaluating effectiveness of these interventions necessitate future rigorously designed experimental studies.

Perceived technology use, attitudes, and barriers among primary care nurses.

Background: In primary healthcare, health information technology has the potential to facilitate the delivery of healthcare services by improving quality of care, efficiency and patient safety. However, little is known about the uptake and technology acceptance among primary healthcare nurses. Aim: The aim of this study was to describe health information technology acceptance and use among primary healthcare nurses. Setting: Primary healthcare centres in the Western Cape. Methods: A quantitative descriptive survey was conducted with a sample of 160 nurses working in primary healthcare for more than 6 months, using a self-administered questionnaire based on the technology acceptance model constructs. Eighteen primary healthcare centres were randomly selected with a sample of 160 using nonprobability purposive sampling. Results: Ninety-three (58.1%) respondents completed the survey. Three-quarters of the respondents reported positive attitudes, positive perceptions of usefulness and ease of use towards the use of health information technology. Barriers of access and training were reported by 75%, with around half the respondents reporting poor computer and information accessing skills. Health information technology use was varied, with high ratings for seeking and using and low ratings of ability to use health information technology for patient administration and management. Health information technology use was predicted by perceptions of ease of use. Conclusion: This research presents a mixed picture of acceptance of technology among primary healthcare nurses and highlights the lack of access to computers and Internet in these settings. Contribution: This study contributes to the field of technology acceptance among primary healthcare nurses.

Public perceptions on Twitter of nurses during the COVID-19 pandemic.

BACKGROUND: The use of social media platforms to convey public opinions and attitudes has exponentially increased over the last decade on topics related to health. In all these social media postings related to the pandemic, specific attention has been focused on healthcare professionals, specifically nurses. OBJECTIVE: This study aimed to explore how the keyword 'nurse' is located in COVID-19 pandemic-related tweets during a selected period of the pandemic in order to assess public perception. METHODS: Tweets related to COVID-19 were downloaded from Twitter for the period January 1st, 2020, to November 11th, 2021. Sentiment analysis was used to identify opinions, emotions, and approaches expressed in tweet which included 'nurse', 'COVID-19', and 'pandemic' as either keyword or hashtags. RESULTS: A total of 2,440,696 most used unique words in the downloaded 582,399 tweets were included and the sentiment analysis indicated that 24.4% (n = 595,530) of the tweets demonstrated positive sentiment while 14.1% (n = 343,433) of the tweets demonstrated negative sentiment during COVID-19. Within these results, 17% (n = 416,366) of the tweets included positive basic emotion words of trust and 4.9% (n = 120,654) of joy. In terms of negative basic emotion words, 9.9% (n = 241,758) of the tweets included the word fear, 8.3% (n = 202,179) anticipation, 7.9% (n = 193,145) sadness, 5.7% (n = 139,791) anger, 4.2% (n = 103,936) disgust, and 3.6% (n = 88,338) of the tweets included the word surprised. CONCLUSIONS: It is encouraging to note that with the advent of major health crises, public perceptions on social media, appears to portray an image of nurses which reflects the professionalism and values of the profession.