Oluyinka Adejumo

An Ethnographic Exploration of Postoperative Pain Experiences Among Ghanaian Surgical Patients

Background: The experience of pain associated with surgery has been a challenge for health care professionals for many years, and culture is said to influence pain. Purpose: This study focused on patients’ experiences of postoperative pain (POP) and factors that affect POP. Design: The study employed qualitative ethnographic principles. Method: Data were collected through individual face-to-face interviews. Data were saturated after analyzing data from 13 patients from two hospitals in Ghana. Findings: Themes that emerged were the subjective nature of pain, which described pain dimensions and communication; psycho-sociocultural factors, such as personal inclinations and sociocultural background; and health system factors, such as personnel attitudes and health financing. Implications for Future Research and Practice: Health professionals need to understand the sociocultural effects of pain in order to give effective care. Conclusion: The study highlighted the need for patient education and the importance that health care professionals understand context-specific factors that influence POP management.

A 2-Decade Appraisal of African Nursing Scholarship: 1986-2006

PURPOSE This paper is a description of a study about articles published about nursing in Africa from 1986 to 2006. METHODS An exhaustive database search of articles written by nurses or articles related to nursing in Africa was done. Access to the database was mainly via EBSCO (http://www.ebsco.com), which allowed searching seven electronic databases. These are major databases useful for finding and accessing articles in academic journals, repositories, and archives. Data were recorded on computer spreadsheets and analyzed using frequencies and percentages. FINDINGS A total of 1,860 indexed research studies were categorized and analysed for themes, content, source of publication, location, subject, scientific or nonscientific methods, nursing or non-nursing research, clinical or nonclinical nursing. A progressive increase of publications was noted. Regional variations were observed in the number of publications over the years with most from Southern Africa (67.3%) compared to West Africa (5.2%) and East Africa (3.3%). Common themes were nursing education (11.9%) HIV/AIDS (11.9%), community health care (16.1%), and professional nursing issues (10.3%). Single authorship (90.7%) outnumbered multiple authorship (9.3%), though research-based (50.5%) and nonresearch-based articles (49.5%) were almost evenly distributed. CONCLUSIONS AND RECOMMENDATIONS More emphasis will be required for research concerning clinical studies; and collaborations--particularly multinational and across regions of Africa--should be developed. Efforts should be intensified to continue to build research capacity among nurses. CLINICAL RELEVANCE Emphasis on African-based clinical studies which directly relate to patient care and culture can advance evidence-based practice in nursing with particular reference to African settings.

Cracking the nut of service-learning in nursing at a higher educational institution

Background The readiness of academics to engage in the service-learning (SL) institutionalisation process is not accentuated in research on SL institutionalisation in South Africa. The argument has been advanced that SL scholarship and willingness of key stakeholders are crucial for SL institutionalisation at the academic programme level. Aim The research focus of the study being reported here was on readiness of respondents to embed SL in the curricula of the nursing programme. Method This study used a quantitative, exploratory and descriptive design. A self-administered structured questionnaire was used to collect data from a stratified sample comprising 34 respondents. The data were analysed for descriptive statistics using SPSS 19. Results The demographic profile of the respondents indicated that 31 (66%) were between 31 and 50 years old; 36 (75.16%) had a minimum of 10 years’ nursing experience; 19 (39.6%) had a masters degree, two (4.2%) had a doctorate; and 29 (60.4%) had been employed by the school for a maximum of five years. The results indicated that the nurse educators were in need of SL capacity-building because 9 (18.8%) had limited or no knowledge of SL and 24 (50%) confused SL with other forms of community engagement activities. However, only 15 (33%) of the clinical supervisors and 13 (27%) of the lecturers indicated a willingness to participate in such a programme. Conclusion The school was not ready to embed SL in the academic programme because of a lack of SL scholarship and willingness to remediate the identified theory–practice gaps.

An insight into the preoperative experiences of Ghanaian general surgical patients

The unknown outcome of surgery has always been a source of anxiety for patients and their relatives. However, the experiences of Ghanaian surgical patients have not been adequately explored. This study sought to have an in-depth exploration of the preoperative experiences of Ghanaian general surgical patients to inform effective preoperative care. The study employed an ethnographic design and was conducted at two hospitals in Accra. Thirteen general surgical patients were purposively recruited and interviewed. Data analysis occurred concurrently and themes that emerged included reaction to impending surgery with subthemes of inappropriate disclosure, fear of death, readiness for surgery, and effect of waiting in the theatre. Also, the theme information gap had subthemes of preoperative care, expectations at the theatre, and undue delays. The study emphasized the need for health professionals to provide effective education to the public and patients, on surgery and its effects, to curb negative perceptions about surgery.

Factors contributing to incivility amongst students at a South African nursing school

Background This study determined the experiences of nurse educators of the factors contributing to the uncivil classroom behaviours of nursing students at a South African school of nursing. Objective To describe what nurse educators consider to be factors contributing to incivility among nursing students in a South African nursing school. Method A qualitative descriptive design was used. Eleven nurse educators were purposively sampled for their experiences on the factors contributing to incivility. Individual face-to-face interviews were conducted until data saturation. Results The data analysed indicated that the educators had varying but often similar perspectives on which factors contribute to incivility among nursing students. The three themes that emerged from the data were academic, psycho-pathological and social factors. The themes were discussed on the basis of their reported impact on classroom behaviour and the implications for the teaching and learning environment. Conclusion Conclusions were made that an educational screening system to identify committed students before admission into nursing education should be explored; that a support system should be explored for nurse educators to deal with incidents of uncivil behaviour, perhaps within policy frameworks in the nursing institution; that emotional support should be provided for students who may be experiencing difficulties adjusting to the rigours of post-secondary education; and that a forum should be set up for nurse educators to compare notes and share ideas on what works best in reducing the incidence of uncivil behaviours in the classroom setting.

Validation of the integration of HIV and AIDS related nursing competencies into the undergraduate nursing curriculum in South Africa

Background Being in its fourth decade, HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV, increasing health care access, and strengthening the health care system. South Africa has made the fight one of its top priorities, and has developed plans to increase the role of nurses in the management of HIV, demonstrating its willingness, commitment and progress in the fight against HIV. Objective This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa. Methods This study adopted a constructivist paradigm, using a qualitative approach, applying the design step of the process model of curriculum development, to validate the integration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum. Results For each competency, outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum, as well as the feasibility and practicability of the integration. Conclusion Required resources for integration of HIV and AIDS related nursing competencies, such as human resources and nurse educators’ continued personal development were identified, as well as barriers to integration, and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated.