Research Articles (Centre for Health Systems Research & Development)

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Browsing Research Articles (Centre for Health Systems Research & Development) by Author "Engelbrecht, Michelle C."

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    Construct validity and reliability of the perceived stress scale for nursing students in South Africa
    (AOSIS, 2022) Engelbrecht, Michelle C.
    Background: Increased levels of stress in nursing students are negatively related to caring behaviours and also result in poorer job proficiency and nurses who are more inclined to leave the profession. The Perceived Stress Scale (PSS), developed by Sheu and colleagues, is one of the most cited instruments for measuring stress and sources of stress amongst nursing students in international studies. However, it has not been widely validated for this purpose. Objectives: This research aimed to test the construct validity and reliability of the PSS for South African nursing students. Method: A cross-sectional survey was conducted at a Central South African University, and 471 of the 685 registered nursing students (68.8% response rate) participated in the study. Questionnaires were distributed and collected during classes. Confirmatory factor analysis was performed to test the hypothesised six-factor latent structure and determine the construct validity of the PSS. The internal consistency of the PSS was measured using Cronbach’s alpha. Results: The model fit was a good fit and supported the six-factor latent structure as stress from (1) taking care of patients, (2) teachers and nursing staff, (3) assignments and workload, (4) peers and daily life, (5) lack of professional knowledge and skills and (6) clinical environment. Overall the PSS had a Cronbach’s alpha of 0.93. Conclusion: The results confirm the construct validity and the internal consistency of the PSS for South African nursing students.
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    Factors associated with limited vaccine literacy: lessons learnt from COVID-19
    (MDPI, 2022) Engelbrecht, Michelle C.; Kigozi, N. Gladys; Heunis, J. Christo
    Compared to many other developed countries, South Africa has a lower uptake of COVID-19 vaccinations. Although not widely researched, there is evidence that vaccine literacy (VL) is positively associated with vaccination uptake. Therefore, this study aimed to assess levels of VL among the adult population in South Africa, as well as to identify factors associated with limited VL. A cross-sectional, anonymous online survey was conducted during September 2021. The survey, which included the standardized Health Literacy about Vaccination in adulthood (HLVa) Scale, was widely advertised, yielding a total of 10,466 respondents. The average scores for the two HLVa sub-scales were relatively high: functional (M = 2.841, SD 0.799) and interactive-critical (M = 3.331, SD 0.559) VL. A proposed ‘limited’ VL score (score value ≤ 2.50) was observed in 40% of respondents for functional literacy and 8.2% of respondents for interactive-critical literacy. The main factors associated with limited VL included lower levels of education, lower socio-economic status, not being vaccinated against COVID-19, self-identifying as Black/African or Colored (i.e., people of mixed ethnic descent), having poorer health, and being a woman. The significant association between VL and vaccination uptake provides an impetus for policy makers such as the South African Department of Health to promote VL in the attempt to increase COVID-19 vaccination uptake.
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    Post-traumatic stress and coping strategies of South African nurses during the second wave of the COVID-19 pandemic
    (MDPI, 2021) Engelbrecht, Michelle C.; Heunis, J. Christo; Kigoze, N. Gladys
    Prior to the 2019 novel coronavirus (COVID-19) outbreak, the South African healthcare system was already under severe strain due to amongst others, a lack of human resources, poor governance and management, and an unequal distribution of resources among provinces and between the public and private healthcare sectors. At the center of these challenges are nurses, the backbone of the healthcare system, and the first point of call for most patients in the country. This research investigated post-traumatic stress and coping strategies of nurses during the second wave of COVID-19 in the country. A structured self-administered questionnaire captured the biographic characteristics, perceived risk factors for COVID-19, and views on infection control of 286 nurses Data were subjected to descriptive and binomial logistic regression analyses. More than four in every 10 nurses screened positive for higher levels of post-traumatic disorder (PTSD). Self-reported risk for contracting COVID-19 mainly centered on being a health worker and patients’ non-adherence to infection prevention guidelines. Unpreparedness to manage COVID-19 patients, poorer health, and avoidant coping were associated with PTSD. Nurses voiced a need for emotional support and empathy from managers. Emotional, psychological, and debriefing intervention sessions that focus on positive coping strategies to actively address stress are recommended.