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Consensus statements for the transdisciplinary care of patients with epidermolysis bullosa in South Africa : Part 1
Chateau, Antoinette V.; Hlela, Carol; Dlova, Ncoza; Isaacs, Thuraya; Naicker, Thirona; Nupen, Tracey; Ambler, Julia; Maruma, Frans; Pillay, Lushen; Mankahla, Avumile; Moosa, Fatima; Makhubele, Jabulile Johanna; Lehloenya, Rannakoe; Visser, Willem I.; Velazquez, Caridad; Cameron-Mackintosh, Sinead; Todd, Gail; Blackbeard, David; Aldous, Colleen (AOSIS, 2025-08-06)
BACKGROUND : Epidermolysis bullosa (EB) is a rare, painful and blistering genodermatosis with no cure. Treatment aims to prevent new lesions and manage complications. Previously, there were no management guidelines or consensus recommendations for patients with EB in Africa. AIM : The aim of this study is to produce a comprehensive, transdisciplinary and practical care guide that is contextually appropriate to the cultural setting and resource limitations in South Africa. SETTING : Multicentre, multiprovincial study involving healthcare practitioners from five South African provinces – KwaZulu-Natal, Gauteng (Johannesburg, Pretoria), Western Cape (Cape Town, Stellenbosch), Free State (Bloemfontein) and the Eastern Cape (Umtata). METHODS : Consensus recommendations for the care of patients with EB were developed by a transdisciplinary team of specialists in consultation with EB patients. The modified Delphi technique was used to reach a robust consensus with a threshold of 80% for each action point to ensure the validity and reliability of the recommendations. RESULTS : In all, 16 consensus statements were developed, and the main themes included the clinical clues to the diagnosis, complications as per the subtype of EB, diagnostics in a resource-limited environment, management of EB, pruritus and pain, palliative care and genetic counselling. CONCLUSION : A transdisciplinary approach is essential for the holistic care of patients and their families with EB in the context of their resource limitations and cultural diversity providing much-needed guidance for clinicians in South Africa and similar settings. CONTRIBUTION : This is the first consensus recommendation of care for patients with EB in Africa.
Strategies for incorporating indigenous placenta disposal methods in public healthcare : a Delphi study in Tshwane District, Gauteng, South Africa
Moeti, Cecilia; Mulaudzi, Fhumulani Mavis; Rasweswe, Molatelo M. (AOSIS, 2025-11-28)
BACKGROUND : Indigenous placenta disposal strategies are essential to bridge clinical protocols with indigenous worldviews, allowing for safe and respectful handling without compromising health standards. Using Appreciative Inquiry in the Dream and Design phases, stakeholders collaboratively developed draft strategies that honour indigenous values while aligning with clinical protocols. These strategies further need inputs from a wider group of stakeholders to ensure that they fit both hospital rules and indigenous traditions. AIM : To refine and validate the draft strategies that incorporate indigenous placenta disposal methods for women birthing in the Tshwane District, Gauteng, South Africa. SETTING : The Delphi process was conducted remotely with subject-matter experts based in Gauteng province, South Africa. METHODS : Three iterative rounds of feedback using a modified e-Delphi technique were employed to ensure reliability. Twenty homogeneous experts were recruited to enrich validity. Of these, 14 participated in rounds one and two, while 10 participated in round three. For anonymity, questionnaires which included a 4-point Likert scale with five principles were sent through blind emails to the expert for them to rank the draft strategies. The consensus was set at 70% and the draft strategies that experts agreed on were repeated in the next rounds for further ranking until consensus was reached. RESULTS : Five strategies that focused on fostering collaboration between midwives and indigenous women, infection prevention and control on indigenous placenta disposal, the development of culturally competent policies and guidelines in the healthcare facilities, the provision of culture competency training and awareness on cultural maternal care were refined and validated. CONCLUSION : These strategies may facilitate the safe indigenous placenta disposal while creating a harmonious space between midwives and indigenous women. CONTRIBUTION : This study underscores the convergence of cultural values, healthcare policy, and sustainability, advancing culturally competent care by integrating Indigenous practices within contemporary medical frameworks.
Registered nurses' experiences regarding clinical virtual learning during COVID-19 in Gauteng
Simelane, Neliswa L.; Sepeng, Nombulelo Veronica; Mashao, Kapari Constance (AOSIS, 2025-11-05)
BACKGROUND : Virtual clinical learning variedly impacted newly registered nurses’ confidence. For some, it led to a lack of confidence in performing specific procedures, while for others, effective virtual learning fostered a high confidence level. This dynamic is likely to be even more complex when newly qualified nurses transition from education to practice, as healthcare facilities have high expectations, anticipating a certain level of knowledge and competence despite the challenges posed by coronavirus disease 2019 (COVID-19). AIM : The study explored newly registered nurses’ virtual experiences of learning clinical skills during COVID-19 and its impact on their transition into professional practice in the Tshwane District of Gauteng province in South Africa. SETTING : The study was conducted in two selected hospitals in the Tshwane District of Gauteng province. METHODS : Using unstructured interviews, a qualitative exploratory, descriptive and contextual design was executed to collect data. Purposive and snowballing sampling were utilised to reach to the sample of 12 registered nurses. RESULTS : Three themes emerged in this study, namely: (1) Impact of virtual learning on confidence in clinical practice, (2) Challenges of transitioning from virtual learning to practical application and (3) Recommendations for enhancing virtual learning in nursing education. CONCLUSION : The study revealed both potential benefits and drawbacks of virtual clinical teaching on registered nurses’ transition into professional practice. CONTRIBUTION : The findings may guide strategies to help nursing education institutions design virtual learning that ensures competent, practice ready nurses.
Psychosocial needs of women undergoing perinatal intimate examinations
Tshabalala, Ntsoaki M.; Yazbek, Mariatha; Maree, Carin (AOSIS, 2025-11-21)
BACKGROUND : Intimate examinations are a vital part of midwifery care during pregnancy, labour, and the postnatal period. Women’s experiences of these procedures vary greatly, and poor communication can lead to significant distress, particularly for first-time mothers. Despite its importance, psychological health during such examinations is often overlooked. AIM : The study aims to explore the psychosocial needs of women undergoing perinatal intimate examinations. SETTING : Data were gathered in postnatal wards and Midwife Obstetric Units (MOUs) of level 1/district hospitals within the Tshwane District, Gauteng province, South Africa. METHODS : Telephonic semi-structured interviews were conducted with 30 postnatal mothers from two district hospitals and four MOUs located in community health centres in the Tshwane District. RESULTS : Women expressed the need for competent, empathetic health care providers who create a respectful, safe, and dignified environment. Minimising the frequency of intimate examinations reduced both physical and emotional discomfort. The use of alternative, less invasive assessment techniques enhanced women’s comfort and alleviated anxiety. Emotional and practical support from health professionals and significant others also improved women’s overall experience, decreasing fear and embarrassment. CONCLUSION : Intimate examinations often evoke fear and embarrassment due to privacy concerns and past trauma. Women require psychosocial support during these procedures. Midwives should receive training to conduct examinations with sensitivity and care to ensure women’s comfort and emotional safety. CONTRIBUTION : The study provides South Africa-specific guidelines promoting holistic, respectful perinatal intimate examinations that emphasise communication, consent, and women’s psychosocial well-being.
Nurse educators’ experiences implementing workintegrated learning in the R171 nursing program at a college
Moremi, Moloko J.; Rasweswe, Molatelo M.; Nesengani, Tintswalo Victoria; Legodi, Modiehi H. (AOSIS, 2025-12-19)
BACKGROUND : The global call for nursing education transformation is gaining momentum. South Africa’s R171 nursing programme, revised since 1984, aims to produce generalist nurse practitioners with required competencies. This research aims to explore nurse educators’ experiences in implementing the R171 nursing programme. AIM : To explore the experiences of nurse educators implementing R171 work-integrated learning (WIL). Setting: The interviews took place at a nursing college in a private room with no interruptions. Unstructured interviews were used. METHODS : The study utilised a qualitative descriptive phenomenological design to investigate the experiences of nurse educators implementing the R171 nursing programme. The participants were selected through non-probability purposive sampling from the Gauteng College of Nursing (GCON) campuses. The sample size was determined by data saturation. Data were collected through unstructured interviews. RESULTS : The study identifies five themes: WIL allocation in the R171 nursing programme, challenges faced by nurse educators, consequences of these challenges, identified strengths and recommendations made by these educators for implementing the R171 WIL programme. CONCLUSION : The study revealed challenges in student nurse placements, including access to clinical practice areas, discipline time, assessments, staff shortage and resource limitations. CONTRIBUTION : The study recommends revising the R171 programme, phasing it out over a year, increasing WIL hours, starting the primary healthcare (PHC) module in the second year, improving infrastructure and re-establishing the Clinical Education and Training Unit (CETU).