Kgatla Mamoeng Nancy, Mothiba Tebogo M, Sodi Tholene, Makgahlela Mpsanyana
Faculty of Health Sciences, University of Limpopo, Sovenga 0727, South Africa.
Department of Psychology, University of Limpopo, Sovenga 0727, South Africa.
Int J Environ Res Public Health. 2021 Mar 4;18(5):2570. doi: 10.3390/ijerph18052570.
Deaths caused by cardiovascular diseases (CVDs) account for 60% of all deaths that occur in rural and remote areas. Disease management programs are increasingly used to improve the effectiveness of chronic care. Nurses are a key component of the health workforce and have an important role to play in CVD prevention, treatment, and the care of sick people in remote areas. Due to the nature of their work, nurses are prone to working hard, and to experience burnout, sleep, or eating disorders. This is often exacerbated by a shortage of staff and equipment. The objectives of the study were to explore and describe the experiences of professional nurses in managing CVDs in South African rural and peri-urban clinics. A qualitative, explorative-descriptive design and a contextual research approach were adopted for the present study. Purposive sampling was employed to recruit nurses who were managing patients with CVD from 11 primary health care facilities. Data were collected through semi-structured individual interviews and analyzed using Tesch's open coding method. Interview transcripts were coded and analyzed for common themes. The following two major themes emerged from the data: perceived institutional challenges affecting the management of CVDs and nurses' perceptions of patient challenges that impede the effective management of CVD. The study concludes by highlighting that apart from a resource challenge, the shortage of nurses in rural clinics is the biggest reason behind overcrowding, waiting long hours for consultations, and an increase in the workload, resulting in medical errors and poor quality care. It is, therefore, recommended that, for improved care and management of CVD in rural populations, local governments need to employ more skilled nurses whilst availing the necessary material resources.
心血管疾病（CVDs）导致的死亡占农村和偏远地区所有死亡人数的60%。疾病管理项目越来越多地被用于提高慢性病护理的有效性。护士是卫生人力的关键组成部分，在心血管疾病的预防、治疗以及偏远地区病人的护理方面发挥着重要作用。由于工作性质，护士容易努力工作，进而出现职业倦怠、睡眠或饮食失调。人员和设备短缺往往会加剧这种情况。本研究的目的是探索和描述专业护士在南非农村和城郊诊所管理心血管疾病方面的经验。本研究采用了定性、探索性描述设计和情境研究方法。采用目的抽样法从11个初级卫生保健机构招募管理心血管疾病患者的护士。通过半结构化的个人访谈收集数据，并使用泰施的开放编码方法进行分析。对访谈记录进行编码并分析共同主题。数据中出现了以下两个主要主题：影响心血管疾病管理的机构挑战以及护士对阻碍心血管疾病有效管理的患者挑战的看法。研究最后强调，除了资源挑战外，农村诊所护士短缺是导致过度拥挤、长时间等待咨询以及工作量增加的最大原因，进而导致医疗差错和护理质量低下。因此，建议为改善农村人口心血管疾病的护理和管理，地方政府需要雇佣更多技术熟练的护士，同时提供必要的物质资源。
