Research Articles (Nursing and Midwifery)


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    A global bibliometric analysis of research productivity on vaccine hesitancy from 1974 to 2019
    (Taylor & Francis, 2021-05) Jaca, Anelisa; Iwu-Jaja, Chinwe J.; Balakrishna, Yusentha; Pienaar, Elizabeth; Wiysonge, Charles S.
    Vaccine hesitancy is a phenomenon where individuals delay or refuse to take some or all vaccines. The objective of this study was to conduct a global bibliometric analysis of research productivity and identify country level indicators that could be associated with publications on vaccine hesitancy. We searched PubMed and Web of Science for publications from 1974 to 2019, and selected articles focused on behavioral and social aspects of vaccination. Data on country-level indicators were obtained from the World Bank. We used Spearman’s correlation and zero-inflated negative-binomial regression models to ascertain the association between country level indicators and the number of publications. We identified 4314 articles, with 1099 eligible for inclusion. The United States of America (461 publications, 41.9%), Canada (84 publications, 7.6%) and the United Kingdom (68 publications, 6.2%) had the highest number of publications. Although various country indicators had significant correlations with vaccine hesitancy publications, only gross domestic product (GDP) and gross national income (GNI) per capita were independent positive predictors of the number of publications. When the number of publications were standardized by GDP, the Gambia, Somalia and Malawi ranked highest in decreasing order. The United States, Canada and United Kingdom ranked highest (in that order) when standardized by current health expenditure. Overall, high-income countries were more productive in vaccine hesitancy research than low-and-middle-income countries. There is a need for more investment in research on vaccine hesitancy in low-and-middle-income countries.
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    Reorganisation of primary care services during COVID-19 in the Western Cape, South Africa : perspectives of primary care nurses
    (AOSIS, 2021-11) Crowley, Talitha; Kitshoff, Danine; De Lange-Cloete, Frances; Baron, Justine; De Lange, Santel; Young, Cornelle; Esterhuizen, Tonya; Couper, Ian
    Background: Primary care nurses play a pivotal role in the response to disasters and pandemics. The coronavirus diseases 2019 (COVID-19) pandemic required preventative, diagnostic, and curative measures for persons presenting with symptoms of COVID-19 by healthcare providers, whilst continuing other essential services. We aimed to investigate the reorganisation of primary care services during COVID-19 from the perspectives of primary care nurses in the Western Cape province of South Africa. Methods: We administered an online survey with closed and open-ended questions to professional nurses enrolled for a Postgraduate Diploma in Primary Care Nursing at Stellenbosch University (2020) and alumni (2017–2019) working in the Western Cape. Eighty-three participants completed the questionnaire. Results: The majority of the participants (74.4%) reported that they were reorganising services using a multitude of initiatives in response to the diverse infrastructure, logistics and services of the various healthcare facilities. Despite this, 48.2% of the participants expressed concerns, which mainly related to possible non-adherence of patients with chronic conditions, the lack of promotive and preventative services, challenges with facility infrastructure, and staff time devoted to triage and screening. More than half of the participants (57.8%) indicated that other services were affected by COVID-19, whilst 44.6% indicated that these services were worse than before. Conclusion: Our findings suggest that the very necessary reorganisation of services that took place at the start of the COVID-19 pandemic in South Africa enabled effective management of patients infected with COVID-19. However, the reorganisation of services may have longer-term consequences for primary care services in terms of lack of care for patients with other conditions, as well as preventive and promotive care.
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    Factors influencing patient falls in a private hospital group in the Cape Metropole of the Western Cape
    (AOSIS, 2020-06) Janse van Rensburg, Renee; van der Merwe, Anita; Crowley, Talitha
    BACKGROUND: The fall rate of patients in hospitals is a worldwide concern due to the impact falls have on patients, the family or relatives, as well as the healthcare setting. Factors influencing patient falls are categorised as intrinsic and extrinsic. Intrinsic factors refers to physical conditions and the extrinsic factors include the environment of the patient, nursing staffing levels and skill mix. AIM: The study aimed to determine the factors that influence patient falls. SETTING: A private hospital group in the Cape Metropole of the Western Cape. METHODS: A quantitative retrospective descriptive research approach was used by analysing 134 records of patients that have fallen from October 2016 to February 2018. Data was collected using a data extraction sheet and analysed using the Statistical Package for the Social Sciences (SPSS). RESULTS: Intrinsic factors contributing to patient falls includedthe patient's age, hypertension, co-morbidities and the use of benzodiazepines as a sedative. Extrinsic factors were the incorrect use of bed rails and the skill mix of the staff. In over half of the cases (n = 68; 50.7%), risk assessments were not performed according to the protocol. Only 5 (3.7%) patients sustained major injuries due to the falls. However, the risk of more severe falls increased 2.4 times with the lack of risk assessment. CONCLUSION: The lack of accurate and consistent patient fall risk assessments, use of benzodiazepines as a sedative and the staff skill mix were contributors to the fall rate in these hospitals.
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    Effort and reward imbalance factors motivating Namibian professional nurses to participate in continuous professional development : a confirmatory factor analysis
    (Publishers version, 2021-11) Mbidi, Tekla S. N.; Damons, Anneleen
    Background: To improve professional development, it is important to understand the motivational factors behind nurses’ participation in specific types of continuous professional development activities. Effort–rewards imbalance (ERI) posits an imbalance between high efforts spent at work and low rewards sometimes received in turn. However, professional nurses have various ERIs that can influence their reasons to participate in continuous professional development activities. Aim: The purpose of this article was to propose a model for selected ERI factors, which motivate professional nurses to participate in continuous professional development activities. Setting: Two hundred and forty-one professional nurses working in a public national referral hospital in Namibia participated in the study. Methods: Survey data on professional nurses’ reasons and motivations to participate in the professional development activities were analysed using a literature-based framework on ERI and reasons for participation in continuous professional development. The survey data were analysed for reflective relationships of ERI and reasons for participation in continuous professional development activities. A confirmatory factor analysis method using IBM SPSS AMOS version 23 was used to develop and validate the effort–reward motives for a continuous professional development model. Results: Four effort-reward imbalance factors were derived from sixteen CPD motives. The reflective factors were (1) extrinsic efforts, (2) intrinsic efforts, (3) reward motives, and (4) over-commitment motives. The four conceptual factors made up a second-order effort-reward motives factor for the nurses’ reasons to take part in continuous professional development activities. Conclusions: The results of this study show that professional nurses consider taking part in continuous professional development activities in order to carry out their work better but not as a way to increase chances of promotion. The study also concluded that the older professional nurses tend to have higher intrinsic effrot motivation than their younger counterparts. Thus, nurses could use these findings to understand the reasons which motivate them to develop professionally.
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    Improving nurses knowledge of managing endotracheal tube cuff pressure in intensive care units : a quasi-experimental study
    (AOSIS, 2020-12) Mpasa, Ferestas; van Rooyen, Dalena R. M.; Venter, Danie; Jordan, Portia; ten Ham-Baloyi, Wilma
    Background: Previous studies conducted on nurses’ knowledge regarding endotracheal tube cuff pressure revealed that there were differences in intensive care nurses’ knowledge, leading to varying practices. Aim: This study aimed to evaluate how an educational intervention based on the existing evidence-based guidelines, using both passive and active implementation strategies, could improve the knowledge of nurses regarding managing endotracheal tube cuff pressures in Malawian intensive care units. Setting: Six functional ICUs (four public and two private) in Malawi. Methods: The study followed a quasi-experimental, pre- and post-test design using an educational intervention. Intensive care nurses of six functional intensive care units in Malawi were randomly assigned to two intervention groups. Both groups received a half-day educational session, a printed version of the evidence-based guidelines, a printed and laminated summary of the guidelines and a related algorithm. Additionally, Intervention 2 group received four monitoring visits. Pre- and post-test questionnaires were conducted between February and August 2016. Descriptive and inferential data analyses (a chi-square test and t-test) were utilised. Results: An improvement in knowledge was observed on the nursing care practices for the management of endotracheal tube cuff pressure for both groups following the educational intervention, although only the results comparing Intervention 2 group participants indicate that the level of knowledge was significant (t[df = 48] = 2.08, p = 0.043, d = 0.59). Conclusion: Implementation of a formal training and mentorship programme for Malawian intensive care nurses would be of great benefit to enhance the knowledge and skills managing endotracheal tube cuff pressure. Follow-up studies would also assist in understanding how guidelines could be implemented most effectively to achieve better knowledge outcomes.