An exploration of first-time mothers' experiences of exclusive breastfeeding and support in the Buffalo City Metropolitan, South Africa
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
- Full Text:
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
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The effectiveness of medium-fidelity simulation on the clinical readiness of student midwives
- Authors: Ntlokonkulu, Zukiswa Brenda
- Date: 2017
- Subjects: Obstetrics Midwifery Emergency medical services , Simulated patients
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/4503 , vital:28345
- Description: Simulation affords the student a safe and supportive environment in which to practise skills repeatedly without causing any harm to a real patient. The Department of Nursing Sciences at the University of Fort Hare has a laboratory that offers lowto medium-fidelity simulation in the form of task trainers and mannequins. These task trainers and mannequins are used in general nursing, and in community and midwifery nursing sciences, for the demonstration of skills, the practising of skills by students and for formative assessments. In midwifery, task trainers are used for vaginal examinations, abdominal palpation breech and vaginal deliveries and the management of post-partum haemorrhage (PPH). Given that in a real-life clinical environment limited opportunities exist for students to practise during an obstetrical emergency, medium-fidelity simulation (MFS) in midwifery ideally positions the student in a practical environment without risking the patient’s safety. Despite the availability of MFS at UFH, its benefit on the clinical readiness of student midwives is not known. The present study was designed to assess the effectiveness of MFS in enhancing the clinical readiness of student midwives at the University of Fort Hare. The main research objective of the study was to explore, describe and analyse the effect of medium-fidelity simulation on student midwives’ confidence, critical thinking ability, communication, satisfaction and team work in an obstetrical clinical emergency environment. This was a qualitative, interpretive, phenomenological analysis designed to explore the student midwives’ lived experiences regarding the effectiveness of mediumfidelity simulation and the effect of these experiences on clinical readiness. The target population was fourth-year Bachelor of nursing student midwives at the University of Fort Hare. Purposive sampling was used to select five student midwives who were team leaders during the management of PPH using MFS. Ethical approval was granted by the University of Fort Hare Ethics Committee. Informed consent was obtained from the participants prior to data collection. Trustworthiness was ensured by observing the principles of transferability, credibility, confirmability and dependability. Data was collected through individual face-to-face interviews and a semi-structured interview guide. All fourth-year student midwives had viewed an on-line video entitled Essential Steps in Management of Obstetrical Emergency(ESMOE) Postpartum Haemorrhage, in which the procedure was demonstrated. The video, sent via Backboard, was presented in such a way that student midwives had the opportunity to watch it repeatedly in order to thoroughly comprehend the demonstrated skill. A semi-structured interview guide was used for data collection. Interviews were conducted in the simulation laboratory. A Samsung smartphone was used to record interviews and a notepad was used to make notes of gestures, such as smiles or other facial expressions. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using the six steps: reading and re-reading; initial noting taking; developing emergent themes; searching for connections across the emergent themes; moving to the next case and lastly, looking for patterns across cases. The major findings indicated that the participants had differing views regarding the concept of clinical readiness; some held that clinical readiness meant being ready or prepared to handle any eventuality in the course of work, others opined that it was a state of being conversant with the policies and procedures in the clinical ward. Participants believed that clinical readiness was parallel to being competent and that midwives should always be ready to anticipate complications that might arise with the patient, endeavouring to analyse and interpret such conditions clinically. Participants expressed the need to see the simulation skill demonstrated repeatedly for thorough understanding of the technique, so that they could work independently in an obstetrical emergency situation. During simulation, participants were confident in delegating duties to team members, affirming that in order to ensure that tasks were carried out, team leaders should receive regular updates from team members.
- Full Text:
- Authors: Ntlokonkulu, Zukiswa Brenda
- Date: 2017
- Subjects: Obstetrics Midwifery Emergency medical services , Simulated patients
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/4503 , vital:28345
- Description: Simulation affords the student a safe and supportive environment in which to practise skills repeatedly without causing any harm to a real patient. The Department of Nursing Sciences at the University of Fort Hare has a laboratory that offers lowto medium-fidelity simulation in the form of task trainers and mannequins. These task trainers and mannequins are used in general nursing, and in community and midwifery nursing sciences, for the demonstration of skills, the practising of skills by students and for formative assessments. In midwifery, task trainers are used for vaginal examinations, abdominal palpation breech and vaginal deliveries and the management of post-partum haemorrhage (PPH). Given that in a real-life clinical environment limited opportunities exist for students to practise during an obstetrical emergency, medium-fidelity simulation (MFS) in midwifery ideally positions the student in a practical environment without risking the patient’s safety. Despite the availability of MFS at UFH, its benefit on the clinical readiness of student midwives is not known. The present study was designed to assess the effectiveness of MFS in enhancing the clinical readiness of student midwives at the University of Fort Hare. The main research objective of the study was to explore, describe and analyse the effect of medium-fidelity simulation on student midwives’ confidence, critical thinking ability, communication, satisfaction and team work in an obstetrical clinical emergency environment. This was a qualitative, interpretive, phenomenological analysis designed to explore the student midwives’ lived experiences regarding the effectiveness of mediumfidelity simulation and the effect of these experiences on clinical readiness. The target population was fourth-year Bachelor of nursing student midwives at the University of Fort Hare. Purposive sampling was used to select five student midwives who were team leaders during the management of PPH using MFS. Ethical approval was granted by the University of Fort Hare Ethics Committee. Informed consent was obtained from the participants prior to data collection. Trustworthiness was ensured by observing the principles of transferability, credibility, confirmability and dependability. Data was collected through individual face-to-face interviews and a semi-structured interview guide. All fourth-year student midwives had viewed an on-line video entitled Essential Steps in Management of Obstetrical Emergency(ESMOE) Postpartum Haemorrhage, in which the procedure was demonstrated. The video, sent via Backboard, was presented in such a way that student midwives had the opportunity to watch it repeatedly in order to thoroughly comprehend the demonstrated skill. A semi-structured interview guide was used for data collection. Interviews were conducted in the simulation laboratory. A Samsung smartphone was used to record interviews and a notepad was used to make notes of gestures, such as smiles or other facial expressions. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using the six steps: reading and re-reading; initial noting taking; developing emergent themes; searching for connections across the emergent themes; moving to the next case and lastly, looking for patterns across cases. The major findings indicated that the participants had differing views regarding the concept of clinical readiness; some held that clinical readiness meant being ready or prepared to handle any eventuality in the course of work, others opined that it was a state of being conversant with the policies and procedures in the clinical ward. Participants believed that clinical readiness was parallel to being competent and that midwives should always be ready to anticipate complications that might arise with the patient, endeavouring to analyse and interpret such conditions clinically. Participants expressed the need to see the simulation skill demonstrated repeatedly for thorough understanding of the technique, so that they could work independently in an obstetrical emergency situation. During simulation, participants were confident in delegating duties to team members, affirming that in order to ensure that tasks were carried out, team leaders should receive regular updates from team members.
- Full Text:
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