Dorah Ursula Ramathuba

Background: Cancer is a major global health burden associated with substantial mortality and long-term biopsychosocial challenges. In South Africa, limited oncology infrastructure and inequitable access to cancer care may contribute to delayed diagnosis and increased distress, particularly among patients in rural communities. This study assessed biopsychosocial distress among oncology patients in Limpopo Province, South Africa. Methods: A non-experimental, cross-sectional descriptive quantitative study was conducted between October 2017 and January 2018 among 207 oncology patients attending seven district hospitals in the Vhembe district. Participants were recruited using purposive and convenience sampling. Data were collected using a structured self-report questionnaire and analyzed using descriptive statistics and chi-square tests. Results: Most participants were female (62%), aged ≥51 years (42%), had secondary education (84%), were unemployed (50.7%), and had no medical insurance (100%); 45.8% depended on social grants. Most participants were diagnosed with stage II (49.7%) or stage III (21.7%) cancer, and 75.8% had received at least two chemotherapy sessions. Fear of premature death was the most frequently reported concern following diagnosis (87.9%). Substantial biopsychosocial effects were reported, including negative impacts on social life (79.7%), financial status (74.8%), physical pain (76.4%), fatigue (72.9%), psychological well-being (72.9%), and emotional health (70.5%). Pain and discomfort were reported by 88.9% of participants. Significant associations were identified between cancer diagnosis and emotional/psychological distress (p < 0.02), loss of interest in daily activities among older patients (p < 0.02), and greater interference with social life among younger patients (p < 0.017). Fear of death (p < 0.033) and limited social support (p < 0.01–0.09 across variables) were also associated with emotional burden. Conclusion: Oncology patients in rural Limpopo experience substantial biopsychosocial distress associated with advanced disease, socioeconomic vulnerability, and limited access to supportive oncology services. Integrating psychosocial care, palliative services, pain management, social support, and patient education into district-level oncology care is essential to improve quality of life and patient outcomes.

Background: Adolescents in low- and middle-income countries (LMICs) continue to face substantial challenges related to sexual and reproductive health (SRH), including high rates of unintended pregnancy, sexually transmitted infections (STIs), and limited access to accurate reproductive health information and services. Rural provinces of South Africa, such as Limpopo, are no exception, with notably higher pregnancy rates. Aim: This study aimed to explore adolescent girls’ perceptions and experiences associated with school-based comprehensive sexuality education (CSE) programs and their perceived role in pregnancy prevention in Bolobedu, Limpopo province, South Africa. Methods: A qualitative, descriptive, and contextual design was employed. Data were collected through individual interviews and field notes from adolescent girls aged 14–19 years who were accessing contraceptives or had given birth. Content analysis was conducted using Tesch’s method. Findings: Results suggest that the quality and contents of CSE programs varied widely, leading to CSE intervention programs not being successfully implemented, leading to poor uptake and no behavior change. Implications: While research on CES programs shows that the CSE programming varies and can be vital to reducing adolescent pregnancy, its success depends on the quality of the implementation, which leads to behavior change. The research finds that the adoption of Comprehensive Sexual Education in schools and communities is vital to tackling the high incidence of adolescent pregnancy. However, its success depends on the quality of implementation, facilitator training, and resource availability.

Background and objective: Diabetes mellitus is a growing global public health concern requiring effective self-care management to achieve optimal glycaemic control and prevent complications. Self-care practices, including blood glucose monitoring, dietary adherence, medication compliance, physical activity, and preventive care, remain suboptimal in many settings, particularly in low-resource contexts. This study aimed to explore self-care management practices among adult patients living with diabetes mellitus attending community health centers in Limpopo Province, South Africa.Methods: A qualitative, exploratory, and descriptive research design was employed. Data were collected through semi-structured, in-depth interviews with adult patients diagnosed with diabetes mellitus. Interviews were conducted in private settings, audio-recorded, transcribed verbatim, and translated into English. Data were analysed using thematic analysis, with an independent coder to ensure credibility and dependability. Results: The findings revealed poor overall adherence to comprehensive diabetes self-care practices. Two major themes emerged: adherence to core diabetes self-care practices and lifestyle and preventive self-care behaviors. The findings highlight a discrepancy between awareness and practice of diabetes self-care. Medication adherence was prioritized, whereas lifestyle and preventive practices were often neglected. Socioeconomic barriers, limited access to resources, and inadequate patient education contributed to poor adherence. These findings are consistent with existing literature, which reports low adherence to self-care practices, particularly in resource-constrained settings.Conclusion: The study underscores the need for context-specific interventions, including improved access to self-monitoring tools, enhanced patient education, and strengthened support systems to promote comprehensive diabetes self-management and reduce complications.

The rising prevalence of diabetes mellitus in South Africa presents a critical public health challenge. While the clinical definition involves persistent hyperglycaemia due to insulin irregularities, the daily reality of the disease is deeply rooted in the domestic sphere. Because diabetes often affects multiple family members, the household becomes the primary site of intervention. This study aimed to explore and describe the types of support provided by family members to adult patients with diabetes mellitus in the Mopani and Vhembe districts of Limpopo province, South Africa. A qualitative, exploratory, descriptive, and contextual approach was used to investigate family members’ support for patients with diabetes. A non-probability, purposive sampling was used to select participants. Semi-structured interviews were used for data collection, and Tesch’s open coding method was used for data analysis. Patient support by family members included lifestyle modification support and emotional support. Family support for individuals living with diabetes mellitus is vital. Time and again, family plays a key role in supporting a member living with diabetes mellitus.

Background: Specimen adequacy is an essential indicator of screening programme performance. The effectiveness and efficiency of Pap tests are classified in the laboratory based on their adequacy for interpretation as satisfactory or unsatisfactory. Purpose: The purpose of the study was to determine the processes of collecting, storing, transporting, and evaluating Pap smears in rural health facilities in Limpopo Province, South Africa. Method: A mixed-method research approach was used for the study. An exploratory sequential mixed-methods design was employed to collect and analyse qualitative data, and then use the findings to develop an instrument in a subsequent quantitative phase, thereby increasing the breadth and depth of understanding of the phenomena under study. The population comprised professional nurses, operational managers, and laboratory technicians. The qualitative strand explored challenges to cervical cancer screening, while the quantitative strand described factors contributing to the inadequacy of the cervical component. The study was conducted from July 2019 to February 2020. The results were merged for triangulation. Findings: The inadequacy rates reported by districts ranged between 38% and 50%. The findings revealed that professional nurses lacked adequate knowledge of the skills required for collecting, labelling, and storing Pap smears before dispatch. Furthermore, the in-service training provided was poorly coordinated and unstructured, and other professional nurses were not keen on screening for cervical cancer, resulting in poor health outcomes for women in the community who had to return for repeat smears. Conclusion: Inadequacy of the transformation zone component and unsatisfactory smears have a higher risk of progression to cervical cancer or pre-cancer lesion than adequacy of the transformation zone.

Background: Unlike other chronic diseases, cancer patients undergo different types of treatments that affect their well-being, and as a result, they tend to have different experiences from those of other chronic disease sufferers. The purpose of this study was to assess the effects of cancer diagnosis and coping strategies on patients in Vhembe District hospitals in Limpopo Province. Methodology: The study design used was a quantitative descriptive cross-sectional survey. The target population included patients in the Vhembe District of Limpopo who had started treatment within the last year. Probability-stratified sampling was used to sample 207 patients from seven selected hospitals in Vhembe District. A self-administered questionnaire was used to collect data, and the data were analyzed using a software package for descriptive statistics (SPSS version 23). Tables were used to display the results visually, and chi-square tests were used to compare the variables. Ethical principles were considered for the participants’ privacy, anonymity, and informed consent. Findings: The findings revealed that the majority of patients 185 (89.4%) experienced a sense of psychosocial distress such as emotional pain; 142 (68.6%) participants experienced hopelessness and despair, 127 (61.3%) resorted to substance use, 160 (77.3%) did not have a positive attitude towards seeking the medical and other support resources available, only a minority resorted to spirituality, and 121 (63.2%) indicated seeking further clarity about the disease. The study recommends supporting cancer patients and their families through the cancer journey. Contributions: Clinicians should provide psychosocial support interventions to enhance mental health and quality of life in cancer patients, and decentralize oncology services by including primary care professionals in delivering chronic illness disease management strategies.

Background: Ubuntu, a philosophy of human dignity, moral high ground, compassion, interconnectedness and community, significantly enhances ethical and caring practices in nursing and midwifery. Aim: This study explored student midwives’ experiences in applying Ubuntu principles in midwifery services in Vhembe District, Limpopo province. Setting: The study was conducted at the Vhembe District in Limpopo province, focusing on Level 4 student midwives learning at two tertiary nursing education institutions. Methods: This study used a qualitative, exploratory and descriptive approach. The study was conducted in three selected hospitals of Vhembe District, which were purposively selected. Thirty Level 4 student midwives from two tertiary nursing education institutions were purposefully selected from three district hospitals. Data were collected through face-to-face, semi-structured interviews, and thematically analysed using Tesch’s eight-step approach. Credibility, transferability, dependability and confirmability ensured trustworthiness. Ethical principles were rigorously followed throughout the research process. Results: The findings revealed both positive and negative experiences. Student midwives reported patient support, mutual respect and collegiality, alongside discrimination and abuse. These contrasting accounts point to a disconnect between Ubuntu principles and actual clinical practice, highlighting the gap between ethical ideals and the lived realities of midwifery care. Conclusion: While some areas of clinical practice support Ubuntu values, there are significant gaps. Student midwives are exposed to positive and negative experiences in the practice of Ubuntu in midwifery services. The study recommends Ubuntu principles in midwifery practice and education to promote human-oriented and ethical care. Contribution: The study advocates for the consistent affirmation of Ubuntu in midwifery practice and education to promote ethical integrity and enhance the quality of maternal care.

Background: The diagnosis and treatment of cancer are associated with substantial physical, psychological, and social morbidity for most patients. Distress can be seen as an unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer treatment. Purpose: The aim was to understand patients’ experiences of distress in their context and to analyze and interpret the findings. Method: An explorative, descriptive qualitative study was conducted among cancer patients receiving treatment and care at rural hospitals in Limpopo. A face-to-face individual interview was conducted to determine the participants’ cancer-related experiences and quality of life. Thematic analysis was conducted following Tesch’s method, and the themes developed were subjected to a triangulation process to ensure the validity and rigor of the findings. Findings: The participants revealed experiences of symptomatic distress resulting in biopsychosocial distress such as pain, fatigue, emotional distress related to prognosis and uncertainty about the future, psychosocial distress related to a lack or absence of support, financial instability, and poor self-esteem. Conclusions: Cancer patients face many challenges during their treatment journey. Participants were drained by anxiety and uncertainty of the cancer trajectory and required psychosocial support. The oncology team must provide supportive preventive measures for side effects management and culture-sensitive psychotherapy at an early stage to improve their quality of life.

Orientation: Globally, healthcare workplace environment is regarded as complex and interactive in nature, hence a supportive collegial environment is crucial in professional socialisation of newly qualified registered nurses, particularly (regulation regarding bridging course [R.683]) cohort who were labelled to can ‘hit the floor running’ due to their previous enrolled nursing experience. Employees friendly workplace environments are associated with job satisfaction, less stress and intent to abandon the nursing profession. Hence newly qualified registered nurses need support in their initial period of employment. Research purpose: The study explored and described the experiences of workplace environment by newly qualified registered nurses (NQRNs) (R.683) in their first 18 months of employment in selected hospitals of Limpopo province, South Africa. Motivation for the study: Previous studies documented much about challenges experienced by newly qualified registered nurses in their first year, yet less has been revealed from the views of newly qualified registered nurses (R.683) who upgraded from enrolled nursing about their workplace environment experiences in their first 18 months of employment. Research approach/design and method: The researcher used a qualitative approach following explorative, descriptive and contextual design. Seven focus group interviews were conducted with a sample of 51 newly qualified registered nurses (R.683), who were purposively sampled in their first 18 months of employment in different units of selected hospitals from Mopani and Vhembe districts of Limpopo province South Africa. Thematic analysis revealed one theme and five sub-themes that negatively influence their perception on workplace environment: negative attitudes and behaviours, bullying, lack of orientation, shortage of staff and workload, and insubordination. Main findings: Contrary to what has often been assumed, that newly qualified registered nurses (R.683) are work ready because they possess previous nursing experience. Our findings indicate that regardless of previous nursing experience, NQRNs’ (R.683) re-entry into the workplace environment is overwhelming and stressful like any other newly qualified nurse, hence they perceived their workplace environment as negative. Practical/managerial implications: Nurse managers should ensure a safe and supportive workplace environment. The negative attitudes and behaviours, bullying and insubordination among nursing staff should be acknowledged and addressed as they may hamper the easy adjustment of newly qualified registered nurses (R.683). Although less stress is a form of motivating newly qualified registered nurses (R.683) to acquire more knowledge and skills to independently manage challenging situations in the unit, newly qualified registered nurses (R.683) deserve to be supported to gain confidence in their performance. Contribution/value-add: Newly qualified registered nurses felt overwhelmed and stressed during their adaptation stage, especially when they were left to run units by themselves with little managerial skills. As newly qualified registered nurses (R.683) should learn unit management through accepting responsibility and accountability, managing unit prematurely to gain self-confidence to practise as an autonomous competent nurse practitioner.

Background: The World Health Organization’s (WHO) call to eliminate cervical cancer is essential in improving structures and processes at primary healthcare facilities by galvanising change in providing cervical cancer screening services. Aim: The main objective of this study was to explore challenges affecting the implementation of cervical cancer screening guidelines in selected districts in Limpopo Province. Setting: The study was carried out at primary health care services (PHCs) in Vhembe and Mopani districts, Limpopo province. Methods: Qualitative non-experimental research design of an exploratory, descriptive and contextual nature of a qualitative paradigm to understand cervical cancer screening programme challenges from healthcare professionals’ perspectives. The study population comprised two males and 16 female professional registered nurses working in Limpopo province’s PHC services. The sample size was 18 professional nurses. A face-to-face interview guided by unstructured questionnaires was undertaken to elicit information regarding the implementation of cervical cancer screening services. Captured data were analysed using Tesch’s open-coding method. Results: The study revealed that the cervical cancer guidelines were not effectively implemented as there were contradictions and gaps when applying the guidelines about the management of HIV and AIDS, age restrictions and gestation. Furthermore, structural factors contributed to the inadequacy rate and failure to reach the set targets. Conclusion: Primary health care is an essential health care and human right; therefore, the government should ensure that guidelines and policies are supported financially and that professional nurses are capacitated for the efficient implementation of services. Contribution: Addressing the inequalities in the implementation of social policies for the prevention of cervical cancer prevention and improving the nurses’ knowledge and practice behaviour regarding cervical cancer prevention are imperative.