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Background:  The psychometric properties of a clinical assessment tool used in the postgraduate midwifery programme in Botswana have not been evaluated. A lack of reliable and valid clinical assessment tools contributes to inconsistencies in clinical assessment in midwifery programmes.

Objectives:  This study aimed to evaluate the internal consistency and content validity of a clinical assessment tool used in the postgraduate midwifery programme in Botswana.

Method:  For internal consistency, we calculated the total-item correlation and Cronbach's alpha coefficient. For content validity, subject matter experts completed a checklist to evaluate the relevance and clarity of each competency in the clinical assessment tool. The checklist included questions with Likert-scale responses, indicating the level of agreement.

Results:  The clinical assessment tool had a good reliability, with a Cronbach's alpha of 0.837. The corrected item total correlation values ranged from -0.043 to 0.880 and the Cronbach's alpha (if item deleted) ranged from 0.079 to 0.865. Overall content validity ratio was 0.95, and content validity index was 0.97. Item content validity indices ranged from 0.8 to 1.0. The overall scale content validity index was 0.97 and the scale content validity index using universal agreement was 0.75.

Conclusion:  The clinical assessment tool used in the postgraduate midwifery programme in Botswana has acceptable reliability. Most of the competencies included in the clinical assessment tool were relevant and clear. Certain competencies need to be reviewed to improve the reliability and validity of the clinical assessment tool.Contribution: The clinical assessment tool currently used in the postgraduate midwifery programme in Botswana had acceptable internal consistency reliability and validity.

Background:  The results of the study conducted at Alfred Nzo Municipality revealed that newly qualified nurses were overwhelmed with the challenges surrounding the execution of their duties in healthcare facilities. The experienced staff largely ignored the newly appointed personnel, which led to emotional distress among the newly qualified nurses.

Objectives:  This study aimed to explore and describe the effects of bullying and the shortage of staff and resources in the workplace on newly qualified nurses and to evaluate the support offered to these nurses in the workplace.

Method:  A qualitative, explorative, descriptive and contextual design was used with semi-structured interviews to gather data that were analysed using Tesch's thematic analysis.

Results:  The themes that emerged revealed that the participants felt bullied in the workplace, the shortage of staff and resources made the participants feel ineffective in their work environment, and the clinical exposure to different units and procedures added value to the participants' development in the workplace.

Conclusion:  The study revealed that bullying has adverse implications for newly qualified staff. The shortage of staff and resources made the newly qualified nurses feel ineffective and useless but their rotation through the wards added value to their development and confidence in their expertise.Contribution: A conceptual framework serves as a guide to newly qualified professional nurses in guiding, protection and coaching in the workplace.

Background:  The Objective Structured Clinical Examination (OSCE) is widely accepted as an effective means of assessing clinical competence and nursing skills. There is, however, little existing knowledge on how first-year nursing students perceived stress during their first OSCE.

Objectives:  To determine the perception of stress; to identify the perceived factors causing stress; and to determine the perceived incidence of stress.

Method:  A descriptive, survey was conducted on a sample of 82 first-year nursing students using the Perceived Stress Scale (PPS).

Results:  The results showed that more than half (n = 54) of students perceived stress at moderate levels. Students not having sufficient time to complete the OSCE was perceived as the main factor causing stress (mean = 22.04; standard deviation [s.d.] = 6.21). The correlation between perception of stress and perceived factors causing stress showed a significant weak positive linear correlation among the variables (r = 0.45; p  0.05).

Conclusion:  The study findings are important as the data determining the first-year nursing students' perception of stress were collected immediately after their first OSCE, which may indicate that perception of stress was related to the actual event rather than the preparation for the OSCE. A follow-up qualitative research study should be conducted, preferably in the same setting, so that the students' experiences of stress during the first OSCE can be explored in depth.

Background:  Quality has increasingly become a critical part of life in every aspect. Patients are today continuously looking for good quality services from health professionals. Professional nurses are expected to render quality care to fulfil the patients' healthcare needs. Poor nursing care has led to several litigations and the loss of patients' lives. It is essential to explore professional nurses' viewpoints regarding quality nursing care.

Objectives:  To explore and describe the understanding of professional nurses regarding quality care rendered to patients in the selected hospitals of Limpopo Province.

Method:  This study utilised a qualitative, exploratory-descriptive design. Individual semi-structured interviews were conducted for data collection. Participants comprised 35 professional nurses who were purposely selected. Data collected were audio-recorded and transcribed verbatim. Data were analysed using Tech's eight-step data coding process, which led to the emergence of themes and sub-themes. Trustworthiness was ensured through credibility, confirmability, dependability, and transferability.

Results:  Three themes emerged: professional nurses' descriptions, meanings, and expectations of quality nursing care. The findings highlight that quality nursing care means meeting patients' needs through advocacy, empathy, fulfilment of patients' needs, good interpersonal relationships and teamwork. Challenges experienced included the lack of resources and staff shortage.

Conclusion:  Hospital management needs to develop effective ways to support professional nurses in delivering quality nursing care. In discussion with the Department of Health (DoH), hospitals should be fully equipped with resources to render quality care to patients. Evaluation of service quality and patient satisfaction should be ongoing for improving the quality of patient care.Contribution: The study reveals that professional nurses perceive quality nursing care differently. Moreover, it emphasises the importance of maintaining and promoting quality nursing care as the cornerstone of healthcare.

Background:  Substance abuse negatively affects the youth who use substances, their families and especially their parents. The use of substances impairs the health of the youth and is linked to an increase in noncommunicable diseases. Parents become stressed and they need help. Parents fail to carry out daily plans and routines because they are not sure what the substance abuser can do or what can happen to the substance abuser. When the parents' well-being is taken care of, they will be able to take care of their youth when they need help. Unfortunately, little is known about the psychosocial needs of the parents, especially when their child abuses substances.

Objectives:  This article aims to review the literature to explore the need for support for parents of youth abusing substances.

Method:  The study adopted the narrative literature review (NLR) methodology. Literature was retrieved from the following databases and search engines: electronic databases, search engines and hand searches.

Results:  Substance abuse has been found to affect the youth abusing substances and their families negatively. The parents, being the most affected, need support. The involvement of health professionals can assist the parents in feeling supported.

Conclusion:  Parents need support programmes that will give support and strength to their existing abilities.Contribution: Focusing on the support needs of the parents of youth abusing substances will help to ensure parents are supported and mentally healthy.

Background:  Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse.

Objectives:  To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa.

Method:  A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process.

Results:  Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse.

Conclusion:  The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province.Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Background:  The worldwide phenomenon of teenage pregnancy among 13-9-year-olds is complicated by obstetric conditions. Among the top three causes of maternal mortality, hypertension is the third in South Africa. Quality maternal care is assured by obstetric practitioners (OPs) implementing guidelines specific for management of hypertension in pregnancy.

Objective:  The objective of this study was to investigate implementation of maternal guidelines for hypertension in pregnancy among teenagers.

Methods:  As a retrospective quantitative research design was used, 173 maternal records of pregnant teenagers from 13 to 19 years were sampled from six district hospitals and Community Health Centres (CHCs) between 01 January 2017 and 31 December 2019 to undergo systematic random sampling. A pretested structured checklist was used to record data from sampled maternal records. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis, and results were presented using simple descriptive statistics.

Results:  Research results indicated that teenagers who suffered from hypertension intrapartum and postpartum did not receive maternal care according to the guidelines for maternity care in South Africa. Blood pressure was not measured of six (3.47%) intrapartum and five (2.9%) postpartum teenagers. Seventeen (9.8%) hypertensive postpartum teenagers received their antihypertensives.

Conclusion:  Public health institutions (PHIs) compromised provision of quality maternal care among teenagers, evidenced by incomplete intrapartum and postpartum assessment, diagnosis and management of hypertensive disorders in pregnancy (HDP).Contribution: This study contributed to facilitating adherence to guidelines improving healthcare of teenagers in government facilities.

Background:  E-learning is becoming an important approach to teaching and learning in higher education institutions, including nursing training. Despite that, there are students who were never introduced to e-learning prior to the coronavirus disease 2019 (COVID-19) pandemic. Their challenges in relation to e-learning could differ from those of other students who had experienced the platform before, especially against the backdrop of the COVID-19 pandemic that brought an abrupt change in the approach to teaching, learning and assessment.

Objectives:  This study explored and described university nursing students' challenges in relation to e-learning during the early stages of the COVID-19 pandemic in a resource-constrained setting.

Method:  Qualitative exploratory and contextual design was used. The sample consisted of 17 participants who were conveniently selected, and data were collected by means of two focus groups and five individual interviews. Data analysis followed a qualitative content analysis process.

Results:  The five categories emanated from analysis are e-learning mode not suitable for practical components, challenges related to assessment of learning, connectivity issues, e-learning is a lonely journey and computer illiteracy and limited skills for the use of e-learning.

Conclusion:  Nursing students' challenges regarding e-learning during the early stages of the COVID-19 pandemic related to the learning of practical components, assessment, connectivity, a lack of interaction with peers and a lack of the skills required to operate e-learning tools.Contribution: The findings have implications for international, regional and local contexts in helping to develop support systems and preparing students to use e-learning when it is introduced abruptly.

No abstract available.

Background:  Caring for mental healthcare users (MHCUs) with a comorbid disorder of human immunodeficiency virus (HIV) and schizophrenia has always been challenging and requires expertise, skill, intuition and empathy.

Objectives:  The objective of this study was to explore and describe the experiences of psychiatric nurses caring for MHCUs with a comorbid disorder of HIV and schizophrenia.

Method:  A qualitative, exploratory, descriptive and contextual research design was used. Eight participants were selected through purposive sampling for individual in-depth interviews to collect data. Thematic analysis was used to analyse data.

Results:  Three themes emerged from this study. The first theme is that the psychiatric nurses experienced deep frustration because they were capable but unable to manage MHCUs with HIV and schizophrenia because of poor infrastructure and other contributing barriers. The second theme identified that the psychiatric nurses experienced discrimination against MHCUs compromising their holistic recovery. Lastly, the psychiatric nurses identified the need for health care workers in general hospitals and communities and families of MHCUs with a comorbid disorder to be educated in mental health issues to ensure continuous medical care.

Conclusion:  The results of this study showed that psychiatric nurses became exhausted when trying to cope with difficult nursing situations. The challenges they faced had negative consequences for the mental health of the psychiatric nurses and compromised patient care.Contribution: This study adds knowledge to nursing practice, nursing education and nursing research by implementing recommendations to mitigate the challenges of psychiatric nurses caring for MHCUs with HIV and schizophrenia.