Self-efficacy and Clinical Performance of Nurses Initiated and Management of Antiretroviral Therapy: Narrative Review

Prevention and health promotion regarding sexually transmitted infections (STI) among university students in Germany

Aim

University students are sexually active, and the sexual risk behavior of this group is higher than that of the general population. The prevention of sexually transmitted infections (STIs) emphasizes the need for comprehensive knowledge about behaviors for STI protection and the actual realization of these behaviors.

Subject and methods

First, an online questionnaire was developed to record the knowledge and realization of STI-protective behaviors among students at Hamburg University of Applied Sciences (HUAS) to conduct quantitative cross-sectional interviews. The sample included 1532 students. Specific aspects of the interview are based on lower response rates. The correlations were then tested by Spearman's rank correlation coefficient and Pearson's chi-squared test.

Results

Significant positive correlations were identified between the self-efficacy (SE) and the use of condoms, STI vaccinations, STI tests, and HIV pre-exposure prophylaxis (PrEP). Significant negative correlations were suggested between substance use and the use of condoms and the use of PrEP and the intake of antiretroviral therapy (ART). Significant positive correlations were identified between the knowledge about STI-protective behaviors and the usage of STI-protective vaccinations, STI tests, and ART. Significant positive correlations were identified between the experiences in terms of STIs and the knowledge about STI-protective vaccinations, use of PrEP, and use of ART.

Conclusion

Moreover, the results indicate that students with a divergent sexual identity have a higher level of knowledge about STI-protective behaviors. The sexual health of university students should be improved by preventive measures to improve the sexual health of individual students and their social environments.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01876-7.

Challenges and opportunities for implementation and dissemination of a task- sharing counselling intervention for depression at primary health care level in South Africa

BACKGROUND

The treatment gap for mental health services is a growing public health concern. A lay-counselling service located at primary health care (PHC) level could potentially help to close the large treatment gap for common mental disorders in South Africa. The aim of this study was to understand multilevel factors contributing to implementation and potential dissemination of such a service for depression at PHC level.

METHODS

Process qualitative data of the lay-counselling service for patients with depressive symptoms was collected alongside a pragmatic randomized controlled trial evaluating a collaborative care model that included a lay-counselling service for patients with depressive symptoms. Semi-structured key informant interviews (SSI) were conducted with a purposive sample of PHC providers (lay-counsellors, nurse practitioners, operational managers), lay-counsellor supervisors, district and provincial managers, and patients in receipt of services. A total of 86 interviews were conducted. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection as well as Framework Analysis to determine barriers and facilitators for implementation and dissemination of the lay-counselling service.

RESULTS

Facilitators identified include supervision and support available for counsellors; person focused counselling approach; organizational integration of the counsellor within facilities. Barriers included lack of organizational support of the counselling service, including lack of counselling dedicated space; high counsellor turnover, resulting in a counsellor not available all the time; lack of an identified cadre to deliver the intervention in the system; and treatment of mental health conditions including counselling not included within mental health indicators.

CONCLUSIONS

Several system level issues need to be addressed to promote integration and dissemination of lay-counselling services within PHC facilities in South Africa. Key system requirements are facility organizational readiness for improvement of integration of lay-counselling services; formal recognition of counselling services provided by lay counsellors as well as inclusion of lay counselling as a treatment modality within mental health treatment data element definitions and the need for diversification of the roles of psychologists to include training and supervision of lay counsellors was also emphasized.

Nursing students' attitude and preparedness for nurse prescribing and its relationship with self-efficacy

AIM

The number of countries where nurses are allowed to prescribe has increased over the past two decades. Nursing students' self-efficacy has the main impact on their clinical and cognitive skills. The aim of this study is to determine nursing students' attitudes and preparedness for nurse prescribing and its relationship with their perceived self-efficacy.

DESIGN

The descriptive-correlational study METHODS: This study was conducted at five Nursing and Midwifery schools of Tabriz, Ardebil, Ilam, Ramsar, and Mashhad, Iran from March to July 2018. Through random sampling 250 undergraduate nursing students from the different geographical areas of Iran were selected. The research tool consisted of three parts including demographic information, nurse prescribing questionnaire, and a questionnaire on self-efficacy in patient care.

RESULTS

Nursing students had a positive attitudes and relatively high levels of preparedness for nurse prescribing. However, near to half of the participants (48.4%) mentioned that they have not good knowledge of pharmacology. Also there was a significant positive correlation between the students' self-efficacy and their attitudes and preparedness to nurse prescribing (p < 0.001, rs= 0.467;p = 0.00, rs= 0.633).

CONCLUSIONS

Given the nursing students' positive attitude to and their preparedness for nurse prescribing, it is possible to make them more prepared for this new role by increasing their pharmacological knowledge and improving their accountability, management, and leadership skills.

Ten years of nurse-initiated antiretroviral treatment in South Africa: A narrative review of enablers and barriers

Background

The roll out of nurse-initiated and managed antiretroviral treatment (NIMART) was implemented in 2010 by the National Department of Health (NDoH) in South Africa in response to the large numbers of persons living with HIV who needed treatment. To enable access to treatment requires shifting the task from doctors to nurses, which had its own challenges, barriers and enablers.

Objectives

The aim of this narrative is to review content on the implementation of NIMART in South Africa over the period 2010–2020, with a focus on enablers and barriers to the implementation.

Method

A comprehensive search of databases, namely, PubMed, Google Scholar and Cumulative Index to Nursing and Allied Health Literature (CINAHL), yielded qualitative, quantitative and mixed-method studies that addressed various topics on NIMART. Inclusion and exclusion criteria were set and 38 publications met the inclusion criteria for the review.

Results

Training, mentorship, tailored tuberculosis (TB) and HIV guidelines, integration of services and monitoring and support have enabled the implementation of NIMART. This resulted in increased knowledge and confidence of nurses to initiate patients on antiretroviral treatment (ART) and decreased time to initiation and loads on referral facilities. Barriers such as non-standardised training, inadequate mentoring, human resource constraints, health system challenges, lack of support and empowerment, and challenges with legislation, policy and guidelines still hinder NIMART implementation.

Conclusion

Identifying barriers and enablers will assist policymakers in implementing a structured programme for NIMART in South Africa and improve access, as well as the training and mentoring of professional nurses, which will enhance their competence and confidence.