Ellemes Phuma-Ngaiyaye

BACKGROUND: Life is said to be meaningful only when the individual is able to cope with challenges associated with it. Challenges at the workplace, whether physical, psychological or social, all contribute to occupational trauma. Coping with the challenges of work is an important part of achieving occupational wellbeing, irrespective of how difficult the job may be. Midwives are trained to be responsible for safe motherhood. However, when faced with maternal deaths, work becomes difficult as they have to cope with trauma resulting from their encounters with these deaths. Thus, the aim of this study was to explore and describe the coping challenges of maternal deaths among midwives in the Ashanti Region of Ghana.METHOD: An exploratory descriptive qualitative design was used in the study. Data were collected by means of semi-structured interviews (18) and focus group discussions (8) with inclusion criteria of being a midwife with at least one year working experience and having witness...

The disclosure of an HIV infection to infected children is stressful. Children react with anger, sadness, disbelief and denial. As a result, parents/caregivers are reluctant to disclose the HIV diagnosis to the child to prevent negative psychosocial effects. The purpose of the study was to explore the experiences of children (10-14 years) living with HIV following their diagnosis. Using a qualitative research design, 10 children and 7 parents/caregivers participated. Data were collected through semi-structured in-depth interviews using an interview schedule. The study findings indicate that, children move from being worried to acceptance, when they learn about their HIV diagnosis. Children were unhappy because parents and/or caregivers delayed the disclosure. Some children experienced stigma and frequent illnesses, which further contributed to their worries and uncertainty with their future. However, despite some children being worried, most of the children accepted the HIV diagnosi...

The ability to cope and adapt in a stressful work environment is a sign of good mental health. Some work environments are challenging and the individual employee is expected to take responsibility for his/her safety, whether physical or psychological. Coping and adaptation are functional roles for all humans, and are important for survival and well-being of every individual. Naturally, midwives working in challenging environment would employ some strategies to help them cope with the effects of maternal deaths. However, literature has little on the coping strategies adopted by midwives in the Ashanti Region of Ghana to deal with the effects of maternal deaths. Therefore, this article highlights the coping strategies adopted by midwives to mitigate the effects of maternal deaths and how they adapt to their work environment. A qualitative research approach, with an exploratory descriptive design was employed in the study. Purposive sampling was utilized in selecting 18 ward supervisor...

Background: Practice-based learning is important in clinical teaching of nursing and midwifery as students develop the necessary competencies and confidence aligned by the outcomes of their learning programs. However, in Malawi, research shows that clinical teaching in neonatal nursing has not been given adequate consideration. This article reports on challenges faced by educators and students in clinical teaching and learning in neonatal nursing for nurse-midwife technicians. Method: An explorative qualitative study was conducted. Data were collected through 23 focus group discussions with 140 students and 31 clinical teachers from eight nursing colleges. Audiorecorded data were transcribed verbatim and analyzed using Hennink's content analysis stages. Results: Challenges faced by clinical teachers and students were short duration and variation in clinical placements, lack of emphasis in clinical teaching, and lack of skills among clinical staff. Conclusion: Nursing training in...

Emotional distress associated with the death of human beings cannot be underestimated. Much as it affects the immediate family members, midwives who witness death of pregnant patients are not spared the emotional distress. Emotional distress affects the general health, behaviour, productivity and job satisfaction of nurses and midwives. However, there is inadequate literature on how midwives in the Ashanti Region of Ghana become emotionally distressed after they experience maternal death. This study sought to explore and describe lived experiences of midwives’ emotional distress over maternal death at work using a qualitative approach. The study consisted of 57 participants (18 supervisors and 39 ward midwives) selected using the purposive sampling technique. Data collection was done through focus group discussions using semi-structured interviews. The responses collected were managed by qualitative computer data analysis package (Atlas.ti version 7.1.7) and the Thematic Content Ana...

Grief does not only affect human emotions but also impacts their physical health. Understanding physical grief of people can bring to bear the grip of its daunting nature, a situation where routines become challenging. A qualitative explorative descriptive research method was used. A purposive sample of 18 ward supervisors and 39 ward midwives was used to ascertain the physical effects of maternal deaths on these caregivers in the Ashanti Region of Ghana. Data were collected through semistructured and focus group discussions. Data analysis was done parallel with data collection till saturation was reached. Ethics was obtained from the University of the Western Cape, South Africa, and Ghana Health Service. The findings indicated that generally, as a result of grieving over the deaths of their patients, midwives experienced physical health sufferings. Therefore, reported depression is expressed as insomnia, appetite loss, exhaustion, and social isolation. There is the need to reduce t...

The disclosure of a diagnosis of human immunodeficiency virus (HIV) to infected
children is not only difficult but stressful to both children and caregivers. Caregivers
are reluctant to disclose the HIV diagnosis to the infected children because of fear that
the children may react with anger, sadness, disbelief and denial. This study explored
the experiences of children (10–14 years) living with HIV following the diagnosis
disclosure. The study used an explorative and descriptive qualitative research design.
Ten children and seven caregivers participated. Data were collected through semistructured
interviews using an interview schedule. The findings show that children
move from ‘being worried for being put on the lifelong medications before knowing
their problem to acceptance of the condition’ when they learn about their HIV
diagnosis. Additionally, children were unhappy because caregivers delayed the disclosure.
Some children experienced stigma, which further contributed to their worries
and uncertainty with their future. It is therefore recommended that health care providers
should assist caregivers disclose children’s HIV diagnosis early, depending on the
child’s age, to enhance positive coping. In addition, guidelines should be put in place,
with developmentally appropriate information for guidance and counselling of children
living with HIV, to enhance coping and positive living.

Background: Effective clinical teaching is a key to the delivery of Primary Healthcare services. However, clinical teaching has been faced with challenges that would lead to poor quality services if not handled appropriately. In Malawi, as in other sub-Saharan areas, clinical teaching has been a challenge, with most of the time relying on the clinical staff to teach the nursing students, in the face of high nurse-patient ratios.
Aim: This paper describes the challenges faced by both clinical teachers and nurse-midwife technician students in neonatal nursing clinical teaching and learning. 
Methodology: The paper is part of a study which used focus group discussions to explore clinical assessment approaches used in neonatal nursing for nurse-midwife technicians in Malawi. 23 focus group discussions were conducted in 8 Christian Heath Association of Malawi (CHAM) Nursing Colleges providing a nurse/midwife technician diploma program. 16 focus group discussions comprised of students, 6-12 per FGD and 7 focus group discussions comprised of clinical teachers and tutors, 3-4 per FGD. FGD data were transcribed verbatim and analysed using Atlas ti version 7.0.91.
Findings: Inadequate clinical placements for practice and limited time for students’ practice are some of the challenges affecting the students learning experience and achievement of competence.  Furthermore, students are left in the neonatal clinical setting without guidance due to inadequate clinical staff and lack of supervision from college staff.
Conclusion: Clinical teaching in neonatal nursing, among the nurse-midwife technicians, is inadequately performed with students being left alone to go through the experience. As a result, nurse-midwife technicians may not acquire the necessary competence in neonatal health care, thereby negatively affecting the delivery of quality primary healthcare services. Being the majority in primary healthcare delivery system, diploma nurse-midwife technicians need adequate learning experience to enhance the achievement of competence in neonatal health service.

The disclosure of an HIV infection to infected children is stressful. Children react with anger, sadness, disbelief and denial. As a result, parents/caregivers are reluctant to disclose the HIV diagnosis to the child to prevent negative psychosocial effects. The purpose of the study was to explore the experiences of children (10-14 years) living with HIV following diagnosis. Using a qualitative research design, 10 children and 7 parents/caregivers participated. Data were collected through semi-structured in-depth interviews using an interview schedule. The study findings indicate that, children move from being worried to acceptance, when they learn about their HIV diagnosis. Children were unhappy because parents and/or caregivers delayed the disclosure. Some children experienced stigma and frequent illnesses, which further contributed to their worries and uncertainty with their future. However, despite some children being worried, most of the children accepted the HIV diagnosis and felt that they could do nothing about it. Children used play and secrecy as mechanisms of coping. In addition, parental or caregiver support also helped the children to adjust and/or live positively with the HIV diagnosis. The researcher recommends that health care providers should assist parents and/or caregivers to disclose the child’s HIV diagnosis early, depending on child’s age, to enhance positive coping. Children living with HIV need continuous support and counselling to promote HIV prevention behaviours and long-term coping with the HIV diagnosis.