One hundred per cent of the participants were professional nurses who care for psychiatric patients. Approximately 50 per cent of the PNs were in their late thirties. The age group of these nurses ranged in from 27 to 64 years. The majority of the participants were females, contributing 70 per cent of the sample. The study consisted of many married participants, a few single participants and only one separated participant. The highest level of education of the PNs was either a degree or a diploma in nursing. The PNs worked full-time in one of the following mental health institutions: Evuxani, Hayani, and Thabamoopo Hospital. The greatest number of these nurses were staying in rural areas; 20 per cent were based in the township and 7 per cent were based in town. From the feedback of the nurses, the common diagnoses of patients were schizophrenia, substance-induced psychosis, schizo-affective disorder, bipolar disorder, mood disorder, ADHD, and intellectual disability. Table 1 shows the characteristics of the PNs in details.
96 Table 1: Characteristics of Participants
Characteristic Number
Professional nurses 30
Age 27–64 years
Gender:
Male Female
30 7 23 Marital status:
Married Single Separated
30 17 12 1
Qualifications All of the participants are professional nurses.
Diploma= 20 Degree = 10 Mental health institutions:
Evuxakeni Hospital Hayani Hospital
Thabamoopo Hospital
10 10 10 Place of residence:
Town Township Rural
30 5 9 16
Common diagnoses: Schizophrenia
Substance-induced psychosis Schizo-affective disorder Bipolar disorder
Mood disorder ADHD
Intellectual disability
97 5.2.1 Professional Nurses
The targeted participants for the study were registered professional nurses from three mental health institutions (MHIs) in Limpopo Province. The total number of PNs who were interviewed at three LPMHIs were 39. Of the 39 interviews, 30 were selected owing to their relevance and depth of content. An equal number of 10 PNs were interviewed from each mental health institution. All of the PNs who form part of the study are currently registered with the South African Nursing Council (SANC). The years of experience of the participants ranged from 2 years to 28 years of service.
Amongst them, there were two operational managers who are responsible for all nurses and the daily functioning of the ward.
There were nurses who started working at these psychiatric hospitals as auxiliary nurses, then progress to becoming enrolled nurses and later qualified as PNs. This study consisted of day-shift PNs; 28 PNs were working from 07:00 to 19:00 while two were working from 07:00 to 16:30. Even though these PNs were working day shift at that time, they had previously worked nights and they were able to share some of their night-shift experiences. It is the nature and procedure of most hospitals in South Africa for nurses to work day and night shift because they provide a 24-hour service. All the nurses were permanent employees and worked on a full-time basis. Almost all of the nurses worked seven-day shifts, except two nurses who were operational managers. A large number of nurses were affiliated with some religion; with the majority (90 per cent) being Christians and 10 per cent practising the traditional African belief system. All the nurses who took part in the study were black.
5.2.2 Age
The age of the PNs who were interviewed at the three mental health institutions is between 27 and 64 years. The majority of the participants were young and still under 40 years of age. Two of the PNs were close to retirement; they were over 60 years. They decided to extend their service by five years because of their love for nursing and caring for patients. The results revealed that age did not contribute in understanding the
98 challenges and using healthy coping mechanisms. The understanding was the same across all age groups. Figure 6 Illustrates the age group of the participants.
Figure 6: Age Group of Participants 5.2.3 Gender
The gender of the participants was included under demographical information with the intention to receive feedback and lived experience from both genders. The current study consisted of both males and females. However, females were the predominant gender.
This is due to the fact that the population of the PNs at the three hospitals are predominately female. The study comprised 23 females and 7 males. Evuxakeni hospital had the highest number of male participants; coincidentally, Hayani and Thabamoopo hospitals had the same number of male participants. The number of female PNs at Evuxakeni was seven, at Hayani there were eight, and at Thabamoopo there were also eight. The study showed that men find the caring burden easier than women. For example, when patients become violent and aggressive, male PNs are able to handle the situation better than women. Table 2 explains in detail the gender of the participants in the study.
0 2 4 6 8 10 12 14
25-34 35-44 45-54 55-64
Number of participants
Age
Age category
99 Table 2: Gender of the Participants
Gender Evuxakeni Hayani Thabamoopo Total
Male 3 2 2 7
Female 7 8 8 23
Total 10 10 10 30
5.2.4 Marital Status
The current study included the marital status of participants under demographical information with the intention to see whether it contributes to social support systems.
This study comprised the following marital status: single, married and separated.
Married PNs contributed 57 per cent, single 40 per cent, and separated 3 per cent of the sample. A large number of participants had more than one child. This study results have revealed that marital status had no influence in the caring duties of the PNs.
Table 3: Marital Status of the Participants
Marital status Evuxakeni Hayani Thabamoopo
No. No. No. Total in %
Single 1 4 7 40
Married 9 4 4 57
Separated 1 0 0 3
Total 11 8 11 100
5.2.5 Qualifications
All nurses were fully qualified professional nurses and registered with the South African Nursing Council. These PNs have a tertiary qualification. They either have a nursing diploma or a nursing bachelor's degree. General nursing, mental nursing, and community health nursing are all included in the curriculum for both degrees. In Limpopo, there are a few colleges and two universities that offer these qualifications in the field of nursing. Eleven PNs have a bachelor's degree in nursing, and 19 of the PNs graduated from Limpopo Nursing College with nursing diplomas, which they obtained at the University of Venda and the other two PNs hold a bachelor’s degree in nursing,
100 which was acquired at the University of Limpopo. Four PNs had extra qualifications related to the nursing field. One hundred per cent of the PNs who participated in this study were academically qualified to work and care for patients with chronic mental illness.
5.2.6 Mental Health Institutions
As alluded to earlier, there are three mental health institutions in Limpopo Province, namely Evuxakeni, Hayani, and Thabamoopo Hospital. Evuxakani Hospital is situated in the Mopani district under the Giyani municipality. Hayani Hospital is located in the Vhembe district under the Thulamela municipality. Lastly, Thabamoopo Hospital is based in Capricorn municipality under Capricorn district. Evuxakeni Hospital has five referral hospitals, which are Nkhensani, Lebata, CN Phatudu, Sekororo and Maphuta Malatjie Hospital. Tshilidzini, Malamulele, Donald Fraser, Siloam, Elim, Botlokwa and Messina Hospital refer all patients with chronic mental illness to Hayani Hospital.
Thabamoopo Hospital receives patients from Makweng, Polokwane, Lebowakgomo, Seshego and Groblersdal Hospital.
These mental health facilities' main goal is to offer specialised interdisciplinary care to those with chronic mental illness who are admitted, either voluntarily or involuntarily. By recognizing mental health difficulties, preventing mental health issues, and providing care and treatment to those who have psychiatric disorders, nurses in the field of psychiatric nursing promote mental health and wellness (Standards and Scope 2006 Draft Revision). In these institutions, there are various wards that are utilised to admit patients. These wards included the forensic ward, chronic ward, acute ward, intellectual disability and ADHD ward, and the maximum-security ward. These MHIs provide users of mental health care with specialized interventions, such as care, treatment, and rehabilitation. Registered psychiatrists or medical professionals, psychiatric nurses, psychologists, social workers, and occupational therapists deliver the interventions utilizing a multidisciplinary approach.
101 5.2.7 Place of Residence
The three mental health institutions are located in townships in Limpopo Province.
However, their service is not limited to the residents of the place where the institution is located. The majority of the PNs participating in this study were not staying far from their place of work. This study found that 78 per cent of the PNs were staying in townships, 20 per cent were staying in rural areas and 2 per cent were based in town. The majority of the nurses stay close to their workplace, within 30 kilometers. As a result, they travel to and from work every day.
5.2.8 Common Diagnoses
All the PNs were caring for patients with chronic mental illness in one of the three mental health institutions. The patients who are admitted in these hospitals have been diagnosed with one or more chronic mental illness by either a medical doctor or a psychiatrist. From the feedback and responses given by PNs, the common diagnoses, in no particular order, were schizophrenia, substance-induced psychosis, schizo- affective disorder, bipolar disorder, mood disorder, ADHD and intellectual disability previously known as mental retardation. From this study, schizophrenia was found to be the leading admission diagnostic illness. Some of the patients also had medical conditions like hypertension, diabetes, and epilepsy.