Assessment of quality nursing care in healthcare facilities of Mnquma Sub-District
- Authors: Manyela, Nosiphiwo
- Date: 2019
- Subjects: Health facilities
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16747 , vital:40770
- Description: Aim: The purpose of the study was to assess the quality of patient care in the Primary Health Care (PHC) facilities of Mnquma Sub-district with the goal of improving or maintaining quality nursing in the area. Methodology: This study followed a quantitative research approach and it is descriptive in nature. The study involved 561 participants, of whom 406 participants were from urban clinics and 155 were from rural facilities, all these participants were attending clinics at Mnquma Sub-district. A structured questionnaire was used for data collection, since the participants were able to read and write in either English and or IsiXhosa. The data was analyzed with the help of a statistician using Statistical Package for Social Sciences (SPSS) program, software for windows version 21.0 Results: Results showed that participant’s responses to five of the twelve items on patient safety were found to have significant associations with residential setting. Rural participants were less likely to disagree with statements on availability of signage at the entrance of health establishment that indicates times when various services are offered, availability of the security guards to ensure patient safety, warning signs always put in place when the floors are wet, availability of at least one toilet for disabled patients in the health establishment and the fact that health professionals are always wearing name tags. This means that patient safety and security is practiced and implemented at the rural facilities according to the national core standards. The findings of the study confirmed that 13 items out of 19 under care and attitudes were found to have significant associations with residential setting. The items were patients spending less than 2 hours in the health facility; staff treating patients politely, illness being explained clearly to the patients, and ability of the patients to ask questions about their illness. Other items included nursing attitudes during opening and closing times of the health establishment, staff responding well when requested to assist, patients are being treated with empathy, patients are addressed by names and patients are being given all the treatment that they need, nurses explains the treatment side effects, and explains how to deal with side effects. This means that responses to these items depend on whether the patient is from a rural or urban clinic. Rural communities were found to be vi less likely to disagree with statements as compared to urban communities. This means that nurses are compliant with nursing care and attitudes in rural clinics. Findings of the study with respect to facility cleanliness, shows that there is no significant associations between the responses to the items which are: surroundings of the clinic are free of unpleasant smells, grounds of the clinic are clean, safe and clean grounds, bin waste inside and outside storage poses no health risks, and setting were detected. This means that the facilities are and cleanliness status remains the same across the residential settings. However, the younger age group was found be significantly more likely to disagree that toilets are clean and odorless and that grounds are safe and clean compared to the older age group. This suggests that the environment is clean except the toilets. Conclusion: Staffs at the facilities are at times ignorant and have negative attitudes at the opening and closing times and facilities have been reported to have long waiting times. The study indicated that the safety and security measures in the urban health facilities are not all practiced according to the National Core Standards checklist/Assessment tool, particularly wet warning signs, disabled toilets, and wearing of nametags. Majority of the participants indicated that, the status of cleanliness was on par at the urban and rural facilities.
- Full Text:
- Authors: Manyela, Nosiphiwo
- Date: 2019
- Subjects: Health facilities
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16747 , vital:40770
- Description: Aim: The purpose of the study was to assess the quality of patient care in the Primary Health Care (PHC) facilities of Mnquma Sub-district with the goal of improving or maintaining quality nursing in the area. Methodology: This study followed a quantitative research approach and it is descriptive in nature. The study involved 561 participants, of whom 406 participants were from urban clinics and 155 were from rural facilities, all these participants were attending clinics at Mnquma Sub-district. A structured questionnaire was used for data collection, since the participants were able to read and write in either English and or IsiXhosa. The data was analyzed with the help of a statistician using Statistical Package for Social Sciences (SPSS) program, software for windows version 21.0 Results: Results showed that participant’s responses to five of the twelve items on patient safety were found to have significant associations with residential setting. Rural participants were less likely to disagree with statements on availability of signage at the entrance of health establishment that indicates times when various services are offered, availability of the security guards to ensure patient safety, warning signs always put in place when the floors are wet, availability of at least one toilet for disabled patients in the health establishment and the fact that health professionals are always wearing name tags. This means that patient safety and security is practiced and implemented at the rural facilities according to the national core standards. The findings of the study confirmed that 13 items out of 19 under care and attitudes were found to have significant associations with residential setting. The items were patients spending less than 2 hours in the health facility; staff treating patients politely, illness being explained clearly to the patients, and ability of the patients to ask questions about their illness. Other items included nursing attitudes during opening and closing times of the health establishment, staff responding well when requested to assist, patients are being treated with empathy, patients are addressed by names and patients are being given all the treatment that they need, nurses explains the treatment side effects, and explains how to deal with side effects. This means that responses to these items depend on whether the patient is from a rural or urban clinic. Rural communities were found to be vi less likely to disagree with statements as compared to urban communities. This means that nurses are compliant with nursing care and attitudes in rural clinics. Findings of the study with respect to facility cleanliness, shows that there is no significant associations between the responses to the items which are: surroundings of the clinic are free of unpleasant smells, grounds of the clinic are clean, safe and clean grounds, bin waste inside and outside storage poses no health risks, and setting were detected. This means that the facilities are and cleanliness status remains the same across the residential settings. However, the younger age group was found be significantly more likely to disagree that toilets are clean and odorless and that grounds are safe and clean compared to the older age group. This suggests that the environment is clean except the toilets. Conclusion: Staffs at the facilities are at times ignorant and have negative attitudes at the opening and closing times and facilities have been reported to have long waiting times. The study indicated that the safety and security measures in the urban health facilities are not all practiced according to the National Core Standards checklist/Assessment tool, particularly wet warning signs, disabled toilets, and wearing of nametags. Majority of the participants indicated that, the status of cleanliness was on par at the urban and rural facilities.
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Efficacy, acceptability and feasibility of mhealth technology in promoting adherence to anti-diabetic therapy and glycaemic control among diabetic patients in Eastern Cape, South Africa”
- Authors: Owolabi, Eyitayo Omolara
- Date: 2019
- Subjects: Diabetes
- Language: English
- Type: Thesis , Doctoral , PhD (Nursing)
- Identifier: http://hdl.handle.net/10353/16792 , vital:40774
- Description: Background: Diabetes mellitus is a disease of a significant public health concern and a leading cause of death and disability worldwide. In Africa, South Africa ranks second among countries with the highest burden of diabetes, and with a poor level of glycaemic control. mHealth technology is an innovative and cost-effective measure of promoting health and the use of text messaging for fostering health is evolving. In South Africa, there is hardly any study involving the use of mobile health technology, including text messaging for promoting health among diabetic patients. Purpose: The aim of this study was to determine the efficacy, feasibility and acceptability of mHealth in promoting adherence and glycaemic control among diabetic patients in resource-poor settings of the Eastern Cape Province of South Africa. Also, the study assessed the impact of text messaging on knowledge, selfmanagement behaviour, self-efficacy and health-related quality of life. Methodology: The study adopted a multi-centre, two-arm, parallel, randomised controlled trial design. Participants were randomly assigned to the intervention (n=108) and control arm (n=108). Participants’ socio-demographic information was obtained using the widely validated WHO STEPwise questionnaire, and a selfdeveloped questionnaire, including previously validated measurement scales were used to obtain information on adherence, self-management behaviour, self-efficacy and health-related quality of life. Participants in the intervention arm received daily text messages related to diabetes management and care for six months. Data were collected at baseline and six months post-intervention. Blood glucose, blood pressure and anthropometric measurements followed standard procedure. Mixed-model analysis was used to assess the impact of the SMS on random blood glucose while xi | P a g e linear and bivariate logistic regression were used to assess for effect on other clinical outcomes. Results: The mean age of the participants was 60.64 (SD± 11.58) years. The majority of the study participants had secondary level of education (95.3%) and earned 1500 to 14200 Rand per month (67.7%). For both the intervention and the control group, majority never used tobacco (98.10% vs 94.40%) or alcohol (88.00% vs 87.00%). Both arms of the study showed improvement in the primary outcome (blood glucose level), with no significant difference, the mean adjusted difference in blood glucose from baseline to six months post-intervention was 0.26 (-0.81 to 1.32), p=0.634. Also, the intervention did not have a significant effect on the secondary outcomes (knowledge, medication adherence, dietary adherence, adherence to physical activity, healthrelated quality of life, self-management behaviour and diabetes distress). Similarly, the intervention did not have any significant effect on secondary clinical outcomes such as weight (p=0.654), body mass index (p=0.439), systolic (p=0.610) and diastolic blood pressure (p=0.535). An overwhelming majority of the participants (90.74%) were pleased with the intervention and felt it was helpful. Of those who took part in the intervention, 91% completed the follow-up study after six months. Conclusion: The use of SMS is a highly acceptable and feasible adjunct to standard clinical care in the promotion of health among diabetic patients in this study setting. Although there was a little improvement, the efficacy of a unidirectional text messaging in promoting health outcomes in this study setting is still doubt
- Full Text:
- Authors: Owolabi, Eyitayo Omolara
- Date: 2019
- Subjects: Diabetes
- Language: English
- Type: Thesis , Doctoral , PhD (Nursing)
- Identifier: http://hdl.handle.net/10353/16792 , vital:40774
- Description: Background: Diabetes mellitus is a disease of a significant public health concern and a leading cause of death and disability worldwide. In Africa, South Africa ranks second among countries with the highest burden of diabetes, and with a poor level of glycaemic control. mHealth technology is an innovative and cost-effective measure of promoting health and the use of text messaging for fostering health is evolving. In South Africa, there is hardly any study involving the use of mobile health technology, including text messaging for promoting health among diabetic patients. Purpose: The aim of this study was to determine the efficacy, feasibility and acceptability of mHealth in promoting adherence and glycaemic control among diabetic patients in resource-poor settings of the Eastern Cape Province of South Africa. Also, the study assessed the impact of text messaging on knowledge, selfmanagement behaviour, self-efficacy and health-related quality of life. Methodology: The study adopted a multi-centre, two-arm, parallel, randomised controlled trial design. Participants were randomly assigned to the intervention (n=108) and control arm (n=108). Participants’ socio-demographic information was obtained using the widely validated WHO STEPwise questionnaire, and a selfdeveloped questionnaire, including previously validated measurement scales were used to obtain information on adherence, self-management behaviour, self-efficacy and health-related quality of life. Participants in the intervention arm received daily text messages related to diabetes management and care for six months. Data were collected at baseline and six months post-intervention. Blood glucose, blood pressure and anthropometric measurements followed standard procedure. Mixed-model analysis was used to assess the impact of the SMS on random blood glucose while xi | P a g e linear and bivariate logistic regression were used to assess for effect on other clinical outcomes. Results: The mean age of the participants was 60.64 (SD± 11.58) years. The majority of the study participants had secondary level of education (95.3%) and earned 1500 to 14200 Rand per month (67.7%). For both the intervention and the control group, majority never used tobacco (98.10% vs 94.40%) or alcohol (88.00% vs 87.00%). Both arms of the study showed improvement in the primary outcome (blood glucose level), with no significant difference, the mean adjusted difference in blood glucose from baseline to six months post-intervention was 0.26 (-0.81 to 1.32), p=0.634. Also, the intervention did not have a significant effect on the secondary outcomes (knowledge, medication adherence, dietary adherence, adherence to physical activity, healthrelated quality of life, self-management behaviour and diabetes distress). Similarly, the intervention did not have any significant effect on secondary clinical outcomes such as weight (p=0.654), body mass index (p=0.439), systolic (p=0.610) and diastolic blood pressure (p=0.535). An overwhelming majority of the participants (90.74%) were pleased with the intervention and felt it was helpful. Of those who took part in the intervention, 91% completed the follow-up study after six months. Conclusion: The use of SMS is a highly acceptable and feasible adjunct to standard clinical care in the promotion of health among diabetic patients in this study setting. Although there was a little improvement, the efficacy of a unidirectional text messaging in promoting health outcomes in this study setting is still doubt
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Psychosocial behaviour of male learners after traditional male circumcision in Mdantsane, Eastern Cape
- Authors: Bokolo, Nokwanda
- Date: 2019
- Subjects: Circumcision
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16709 , vital:40764
- Description: Male circumcision is an old Xhosa tradition that is still widely practised throughout South Africa. The Xhosa community in Eastern Cape, South Africa, values traditional male circumcision and regard it as a heritage from the ancestors, which prepares the initiate for transition to manhood. There are health problems and physical complications related to circumcision, although parental decisions regarding circumcision and the medical hygiene have been widely researched. However, scanty information exists on the psychological and social behaviours of male learners after male circumcision. The present study aims to fill the gap by exploring the psychosocial behaviors of male learners after traditional male circumcision in Eastern Cape, South Africa
- Full Text:
- Authors: Bokolo, Nokwanda
- Date: 2019
- Subjects: Circumcision
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16709 , vital:40764
- Description: Male circumcision is an old Xhosa tradition that is still widely practised throughout South Africa. The Xhosa community in Eastern Cape, South Africa, values traditional male circumcision and regard it as a heritage from the ancestors, which prepares the initiate for transition to manhood. There are health problems and physical complications related to circumcision, although parental decisions regarding circumcision and the medical hygiene have been widely researched. However, scanty information exists on the psychological and social behaviours of male learners after male circumcision. The present study aims to fill the gap by exploring the psychosocial behaviors of male learners after traditional male circumcision in Eastern Cape, South Africa
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Tuberculosis knowledge, attitudes and health-seeking behaviour among tuberculosis patients in Nelson Mandela Bay Municipality, sub district C, South Africa
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
- Full Text:
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
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