Effectiveness of Community-based Obesity Intervention for Body Weight, Body Mass Index, and Waist Circumference: Meta-analysis.

Background: Obesity is a significant health problem worldwide and an alarming problem in the developed world including the United States of America and European populations. Subsequently, obesity can lead to different health problems, such as non-communicable diseases. However, it can be prevented through a healthy diet, exercise, and lifestyle modification. The study's purpose was to analyze the published literature on community-based obesity interventions and to present a comprehensive summary of how to reduce the body weight, Body Mass Index (BMI), and Waist Circumference (WC) among overweight and obese individuals in the community through health education and behavior interventions. Material and Methods: The meta-analysis was conducted in February-July 2021, searching CINAHL, Cochrane Library, Google Scholar, PubMed, and Science Direct databases. Studies published during the prior 12 years on community-based obesity intervention for weight, BMI, and WC were included in this review. Cochrane Revman software was used for meta-analysis. Results: Seventeen studies met the selection criteria for the review. A meta-analysis of the studies on health education and behavioral intervention studies resulted in a statistically significant reduction at 95% confidence intervals in the mean differences of BMI -1.19 (-1.77, -0.62) and WC -1.11 (-1.54, -0.68). Conclusions: Community-based obesity interventions through health education and behavior interventions effectively reduce the body weight, BMI, and WC. Implementing community-based health education and behavioral interventions effectively prevents and treats obesity in communities.

Effectiveness of a resilience-focused educational program for promoting resilience in nursing students: A systematic review and meta-analysis.

AIM: To evaluate the effectiveness of a resilience-focused educational program to promote resilience among the forming year's BSN students. BACKGROUND: Resilience is a resource for the well-being and growth of nursing students. Lack of resilience is a high-risk condition for psychosocial health problems that hinder students' academic and professional growth during the BSN program. DESIGN: A systematic review and meta-analysis are reported using PRISMA guidelines. The review was registered at the PROSPERO with the ID number: CRD42023475098. METHODS: A primary search was done on the most relevant databases: PubMed, CINAHL, and PsycINFO while a secondary search was done on the Wiley Online Library, HEC Digital Library, and Science Direct for studies in the English language that assessed resilience-building interventions in forming years (1st and 2nd year) undergraduate nursing students till Oct 2023. Both quasi-experimental studies (QESs) and randomized control trial studies (RCTs) were included in this review. The meta-analysis was performed on three QESs and two RCTs that provided information about a pooled estimate of resilience promotion. RESULTS: Of 596 identified records, six were found eligible comprising four QESs and two RCTs with a total of 472 participants. Studies were found with variability in sample size, intervention strategy, teaching-learning activities, intervention content and duration, measurement scales, and statistical analysis of the main outcome. Meta-analysis of QESs showed no effects between pre-and post-intervention resilience scores, the standardized mean difference (SMD) of 0.04 [95 % CI -0.22, 0.30]. The RCTs immediately after intervention showed a non-significant effect, SMD 0.35 [95 % CI -0.06, 0.75]; however, at follow-up of one month, it showed a statistically significant effect in favor of the experimental group, SMD 0.54 [95 % CI 0.12, 0.95]. CONCLUSION: This review has provided evidence of a delayed effect of educational intervention to improve resilience among nursing students. The resilience-focused educational intervention has the potential to improve the resilience of nursing students. However, because of the time-bound and multi-faceted nature of resilience, a need to develop an inclusive multi-dimensional approach for resilience building is recommended for future studies. REPORTING METHOD: The manuscript has been written in adherence with PRISMA guidelines for the systematic review and meta-analysis.

Lived experiences of village-based patients with chronic kidney disease receiving haemodialysis at Mirpur, Azad Kashmir, Pakistan: a transcendental phenomenology study protocol.

BACKGROUND: Chronic kidney disease (CKD) is one of the major health issues in Pakistan, exerting notable effects on both the physical and mental well-being of individuals undergoing haemodialysis. Of particular concern to healthcare professionals is the potential adverse influence of haemodialysis on the lives of patients with CKD residing in rural areas of the country. This study will explore and describe the lived experiences and needs of patients with CKD receiving haemodialysis from the perspectives of patients and their family caregivers. METHODS AND ANALYSIS: Transcendental phenomenological research design will be used. Participants will be recruited from the dialysis centre of a tertiary hospital through purposive sampling based on specific inclusion criteria. In-depth unstructured interviews, observation and document analysis will be the methods for data collection. Data will be analysed using Colaizzi's approach following the transcription of the interviews. ETHICS AND DISSEMINATION: The study has been approved by the Institutional Review Board (IRB) of Shifa Tameer-e-Millat University, Pakistan (IRB # 0307-23) and written permission was obtained from the administration of the study hospital. Before giving written and verbal consent, all participants will receive detailed information about the study. Participants will maintain the freedom to withdraw from the study at any point. Confidentiality of the participants will be ensured. The study findings will be disseminated to important stakeholders and published in scientific papers and conference proceedings.

Indigenous practitioners' views on causes of female infertility.

Background: The use of indigenous practices has increased remarkably throughout the world. Subsequently, society uses this practice for the treatment of various health problems, including infertility. This research focussed on the role of indigenous practitioners (IPs) using a holistic approach to explore the causes of infertility in women. Aim: This study aimed to explore and describe the views of IPs on the causes of female infertility in Ngaka Modiri Molema health district. Setting: The study was conducted in Ngaka Modiri Molema, North West Province, one of the most rural provinces in South Africa. Methods: The study followed a qualitative explorative design. A purposive sampling technique identified five IPs who were experts in managing infertility. Individual semi-structured interviews were conducted, and data analysis used Creswell's method of qualitative data analysis. Results: Findings revealed that IPs offered a wide range of services in the treatment and management of infertility among rural women. Hence, the following themes emerged, namely, history taking regarding infertility, treatment of infertility and holistic care on infertility. Conclusion: The IPs are important providers of healthcare in the management of infertility in indigenous communities. The findings revealed that there are various causes of female infertility according to the indigenous healthcare system. Contribution: In contribution, the study described the unique practices found in the community as executed by the IPs. This care focusses on holistic care, including treatment and continuous care for the healthcare user and the family. Noteworthy to mention, this holistic care extends to subsequent pregnancies. However, there is a need for further research to valorise the indigenous knowledge unearthed in this study.

Knowledge attitudes and readiness of nursing students in assessing peoples' sexual health problems.

BACKGROUND: Sexual health is an important part of human physical health. Sexual wellbeing is a condition of physical, emotional, mental, and social ease concerning sexuality. Therefore, all health care professionals should respect, protect, and fulfil the sexual-health needs of a person. PURPOSE: This research aims to assess the knowledge, attitudes, and readiness of nursing students in assessing people's sexuality. METHODOLOGY: Cross-sectional descriptive research design was used to conduct this research. A stratified random sampling technique was used to recruit 195 nursing students from BSN (semester VI & VIII), Post RN (semester II & IV). Three self-administered tools Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ), Self-Addressing Sexual-Health (SA-SH), and Self-Addressing Sexual-Health History Taking was used to collect data from the participants. Data analysis was conducted on SPSS V-23. RESULT: Majority (111, 56.9%) of participants belong to the public sector as compared to the private. The majority of the students were female (n = 117, 60%). Most (153, 78.5%) of the participants were interested in people's sexual-health history taking; they had positive attitudes toward people's sexuality. Most (139, 71.3%) of the study participants were comfortable and ready to some extent to deal with sexual health issues. Religion, culture, and people's opposite-gender were identified barriers in assessing people's sexuality. CONCLUSION: This study identified that nursing students had insufficient knowledge regarding STDs, but they had positive attitudes toward addressing peoples' sexual-health concerns. Students are comfortable and ready to some extent to deal with sexual problems.

Validation of a clinical competence evaluation tool for community service nurses in North West province, South Africa.

BACKGROUND: Little has been done to evaluate clinical competence of community service nurses (CSNs) during the 12-month compulsory community service in South Africa. Evaluating clinical competence of CSNs would be of benefit as it might improve quality patient care and promote patient satisfaction. It therefore became of paramount importance for the researcher to establish some method of evaluating the CSNs' clinical competence during their compulsory service in the North West province (NWP), South Africa. AIM: To evaluate the clinical competence evaluation tool (CCET) for CSNs for reliability and validity. SETTING: A selected regional level 2 hospital. METHODS: Ten experts participated in the validation process. The tool was tested at one of the public hospitals in the NWP and 11 out of 13 CSNs participated in this process. Statistical Package for the Social Sciences version 25 was employed and the reliability of the tool was measured using Cronbach's alpha. RESULTS: This tool's content validity index has exceeded 0.80 and is indicated at 0.98, which reflects excellent content validity. The higher the content validity ratio score the greater the agreement amongst the experts. The Cronbach's alpha coefficients in the six competencies are all greater than 0.7 implying that the tool developed in this study is reliable. All the experts indicated that the tool is clear, simple, general, accessible and important. CONCLUSION: From the above-mentioned results, a CCET for CSNs was proven to be valid and reliable. CONTRIBUTION: This was the first tool to be developed in NWP of South Africa.

Professional nurses' perceptions regarding clinical competence of community service nurses in North West province, South Africa.

BACKGROUND: South African Nursing Council requires nurses who successfully complete their training to perform a year of community service before obtaining registration as professional nurses (Regulation 425). Community service for health professionals was introduced as a strategy to retain newly qualified professionals within the country. The premise is that community service for newly graduated nurses gives them the opportunity to develop skills and acquire knowledge critical in their professional development. AIM: To explore and describe the perceptions of professional nurses as the supervisors of community service nurses (CSNs) during their 12 months of community service. SETTING: Selected hospitals of the North West province, South Africa. METHODS: A qualitative, exploratory and descriptive design was used. The study was conducted between September and November 2018 at three public hospitals in the North West province. Through purposive sampling, 15 professional nurses who supervise CSNs participated in the study. Data were collected in three focus group discussions using semi-structured questions. All focus group discussions were recorded and transcribed for analysis. Data were analysed using Pienaar's four steps of thematic analysis. RESULTS: Three themes emerged: perceptions of clinical competence, challenges impacting clinical competence and suggestions to improve clinical competence. CONCLUSION: It is suggested that even though the majority of CSNs were perceived to be competent and capable of working independently, they still required supervision and mentorship to refine their competency. Furthermore, the study reported similar challenges noted from previous studies that were perceived to be affecting CSNs' ability to deliver quality health care, and therefore recommendations for improvement were made. CONTRIBUTION: The study contributed to the developed the clinical competence evaluation tool which will be of benefit to the future community service nurses in the province.

A conceptual framework for psychosocial health management grounded in the therapeutic merits of indigenous KhoiSan health dialogues.

BACKGROUND: The researchers established that an indigenous KhoiSan community functions healthily without western mental health services. This community relies on indigenous healthcare with positive health outcomes over centuries. Despite this positive evidence, the community's therapeutic achievements have not been explored previously. AIM: To explore the therapeutic merits embedded in dialogues of healing to formulate a generic approach to managing psychosocial challenges. SETTING: The study was conducted in an indigenous KhoiSan community, Northern Cape province, South Africa. METHODS: A qualitative approach, by using an indigenous African research design, was followed. An African Indigenous Health Research Framework (AIHRF) was employed, particularly applying a classical African indigenous method of data-collection, namely orature. Theoretical sampling was used for the purpose that the emerging data guide the researcher to the next participants. The four-step analysis of the mentioned framework was deployed for data analysis. RESULTS: It was deduced that the therapeutic merits of dialogues go beyond the word of mouth, leading to the emergence of themes related to the successful management of psychosocial health challenges in the KhoiSan community. CONCLUSION: These findings were used to generate a baseline conceptual framework for the management of psychosocial challenges in the KhoiSan community. CONTRIBUTION: Revitalisation of communal indigenous practices for the management of psychosocial health challenges within the KhoiSan community. The latter will sensitise research, teaching and learning to foster culturally informed counseling approaches. Moreover, these will inform policy formations to posses a culturally competent approach towards indigenous communities such as the KhoiSan community in the Northern Cape, South Africa.

Peer-mentees' challenges in an undergraduate peer-group clinical mentoring programme in a nursing education institution.

BACKGROUND: Clinical competency and professional growth amongst nursing students is the cornerstone of a nursing education programme. The demanding and complex training of nursing students requires various clinical teaching and learning strategies such as peer-group clinical mentoring. AIM: The objective of this research was to explore and describe the challenges that peer-mentees experience in an undergraduate peer-group clinical mentoring programme in one-specific nursing education institution in the North West Province. SETTING: The study was conducted at a nursing education institution in North West Province. METHODS: A qualitative, retrospective case study research design was used. Two separate World Café sessions following a semi-structured schedule based on Gibbs Reflective Cycle were conducted with 51 peer-mentees who were mentored in clinical practice. Four levels of qualitative thematic data analyses were employed to analyse the data. RESULTS: Five themes emerged from the findings of the study, namely, poor implementation of the peer-group clinical mentoring programme, ineffective undergraduate peer-group clinical mentoring programme, undesirable attitudes of the mentors, mentors unprofessional conduct as well as communication challenges. Ten sub-themes emerged from the findings. Literature control was done to support the findings. CONCLUSION: The findings showed that undergraduate nursing students faced a diversity of challenges in the effective learning and teaching of peer-mentees in a clinical context. Limitations and recommendations of the study were given. Recommendations were given for nursing practice, education and research.

Community service nurses' experiences regarding their clinical competence.

BACKGROUND: In South Africa, it is mandatory for nurses who have qualified as a nurse (general, psychiatric and community) and midwifery, leading to registration in Government Gazette Notice No. R425 of 22 February 1985, to perform 12 months' compulsory community service after completion of training at a College of Nursing. Community service affords new graduate nurses the opportunity to improve their clinical skills and knowledge while nurturing professional behavioural patterns and critical thinking consistent with the profession. AIM: To explore and describe the experiences of community service nurses (CSNs) regarding clinical competence during their placement in three selected hospitals. SETTING: The study setting was North West Province (NWP), South Africa. METHOD: This study followed a qualitative, exploratory, descriptive and contextual research design. A cluster sampling technique was used and 17 CSNs participated in the study. Three focus group discussions framed by semi-structured questions were conducted with five to six participants per group. All discussions were recorded using a digital voice recorder and transcribed. Data were analysed using Pienaar's four steps of qualitative thematic analysis. RESULTS: Four themes emerged from this study: facilitative experiences, defacilitative experiences, challenges confronted during placement and suggestions to improve clinical competence. CONCLUSION: Clinical competence of CSNs could be improved if all the stakeholders, including professional nurses and CSNs themselves, hospital management and the regulatory body, the South African Nursing Council, collaborate. More importantly, this study's results were used to develop a clinical competence evaluation tool in the NWP, South Africa.

Conceptualisation of African primal health care within mental health care.

BACKGROUND:  It is believed by western education systems that the first contact should be with the nurse in primary health care. However, it is not the case. Therefore, the researcher attempts to correct this misconception by conceptualising the correct beginning of health seeking behaviour in an indigenous African community, namely African Primal Health Care (APHC). 'Primal' was coined during a colloquium by Dr Mbulawa and Seboka team members; however no formal conceptualisation took place, only operational definition. Due to the study scope, conceptualisation is narrowed to mental health, but this concept is applicable in the broader health context. The research purpose was to contribute to the body of indigenous knowledge systems to advocate towards co-existence of primal health care and mental health care. AIM:  Formulate APHC within a mental health care context. OBJECTIVES:  To explore philosophical grounding of APHC and describe epistemology of APHC. To analyse and crystallise the exploration to establish understanding within mental health and conceptualise APHC within mental health care to enhance co-existence. METHODOLOGY:  Narrative synthesis, concept analysis (qualitative design). Lekgotla was used as a method of data collection and data were analysed using Leedy and Ormrod's five steps of data analysis. RESULTS:  APHC is a health care system that existed in Africa prior to the introduction of the western health care system. It is based on the African belief system and practices. The practices come from the community, for the community and are authenticated by the community. APHC uses a holistic approach and the family and community are involved in the healing process.

Experiences and support needs of poverty-stricken people living with HIV in the Potchefstroom district in South Africa.

This study was undertaken to address the lack of support for poverty-stricken people living with HIV that was identified in the Potchefstroom district in the North-West Province in South Africa. A qualitative phenomenological design was used to explore the experience, identify the support needs, and formulate guidelines for effective support for poverty-stricken people living with HIV. A total of 25 in-depth interviews guided by two central questions resulted in the following themes: facilitative and impeding experiences of poverty-stricken people living with HIV, basic needs, psychosocial needs, cultural-spiritual needs, and self-actualization needs. The experience of poverty-stricken people living with HIV in the Potchefstroom district is closely related to their support needs. To address these needs holistically and to enhance the quality of life of poverty-stricken people living with HIV, the needs should first be addressed individually. Following that, the collective needs can be addressed by a support system.

Black South African farm workers' beliefs about HIV.

Black South African farm workers' context of an isolated lifestyle and lack of education and resources might lead to unique beliefs that influence their understanding and behavior regarding HIV infection. An exploration and description of these beliefs can inform suggestions for a belief-sensitive approach for HIV-prevention programs. A participative rural appraisal research method was implemented, following a qualitative, explorative, and descriptive approach. A culturally sensitive mode of interviewing, namely lekgotla, was used as a strategy to collect data. The results indicated that Black South African farm workers have specific beliefs about HIV. Most of the beliefs protect them from being infected, but some marginal beliefs can put them at risk of being infected. Clinical considerations, which health care professionals can incorporate in HIV-prevention programs, were formulated based on the results, relevant literature, and conclusions.

Intrapartum practices to limit vertical transmission of HIV.

The need to improve health services to HIV-positive women requires a specific focus on limiting mother-to-child transmission. Vertical transmission most often takes place during the intrapartum period; hence, it is essential to alert midwives to what constitutes safe or risky intrapartum practices. Midwives in the southern region of the North West Province of South Africa were surveyed for their knowledge of safe intrapartum practices that can limit vertical transmission of HIV, consequently indicating which intrapartum practices prevail in the region. We used a quantitative survey design and collected data by means of a questionnaire and checklist. A purposeful availability sample of 31 midwives who work in all four hospitals in the province was used and a random sample of 401 obstetric records was audited. Data were analysed by means of frequency analysis, effect sizes and cross-reference. A slight majority of the midwives had sufficient knowledge to distinguish between risky and safe practices. However, safe intrapartum practices are not always carried out and this raises concerns. Accordingly, we formulate general recommendations for nursing education, future research, and midwifery practice. In particular we suggest ways the national Guidelines for Maternity Care in South Africa may be adapted and better implemented to enhance safe intrapartum practices to limit vertical transmission of HIV.