The knowledge of registered nurses regarding the management of patients with diabetes mellitus in the primary health care clinics in Nelson Mandela Bay Health District
- Authors: Mbadu, Simnikiwe
- Date: 2023-04
- Subjects: Diabetes -- Treatment , Nursing services -- South Africa , Primary health care -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69625 , vital:77996
- Description: Diabetes mellitus (DM) is a chronic condition caused by inherited and/or acquired deficiency in the production of insulin or the ineffectiveness of the pancreas to produce insulin. DM is classified into general categories: type 1, type 2, gestational and non-specific types of diabetes mellitus and is considered a manageable disease, requiring lifestyle modification and medicinal treatment. DM is a global challenge, and its incidence is expected to increase in the next decades in both developed and developing countries. However, in the context of the study, as 90% of patients with DM are managed at public health care (PHC) clinics by registered nurses (RNs) with minimal or without help from doctors, RNs are expected to use their knowledge for diagnosis, treatment, review, referral and health education of patients with DM in the PHC clinics in the Nelson Mandela Bay Health District (NMBHD). Therefore, if RNs have inadequate knowledge about the management of patients with the disease in comparison with guideline recommendations, the results will be poor management and often complications. These complications have financial and social repercussions on the patient, health systems and the economy of developing countries. In the study, the researcher explored the knowledge of RNs regarding the management of patients with DM in PHC clinics located in NMBHD. The study identified inconsistencies and gaps in knowledge and recommended strategies to improve the quality of care for diabetic patients in the long run. A quantitative, explorative, descriptive design was utilised to determine the knowledge of RNs about the management of patients with DM in the PHC clinics in NMBHD. The researcher utilised Slovin’s formula to draw a sample for the study. Initially, the study aimed to recruit a sample size of 199 participants, as determined by Slovin's formula. However, due to unforeseen complications related to the COVID-19 pandemic, only 144 RNs were able to participate. After consulting with a statistician, it was determined that the sample size was still representative of the entire population of 398 RNs working in PHC clinics in Subdistricts B and C of NMBHD in the Eastern Cape. Data collection was conducted using a self-administered questionnaire. Prior to the main study, a pilot study was conducted using RNs from two clinics in Subdistricts A v to test the questionnaire. No changes were made and none of the data was included in the final data of the study. A descriptive, statistical method using Microsoft (MS) Excel was followed to analyse the data gathered through the questionnaire. The following ethical principles based on the Belmont report were adhered to throughout the study: respect for persons, beneficence and justice. The results of the data analysis revealed that RNs in the PHC clinics in NMBHD have inadequate knowledge about the most critical aspects of DM management, such as making the diagnosis, the correct drug management, as well as the review and referral of patients with DM. Therefore, the study recommended addressing the inconsistencies and gaps identified in PHC nursing policy, practice, education, and research to improve the knowledge of RNs in managing patients with diabetes mellitus (DM) in the PHC clinics of the NMBHD. This would ultimately lead to better patient care outcomes. , Thesis (MCur) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2023
- Full Text:
- Date Issued: 2023-04
- Authors: Mbadu, Simnikiwe
- Date: 2023-04
- Subjects: Diabetes -- Treatment , Nursing services -- South Africa , Primary health care -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69625 , vital:77996
- Description: Diabetes mellitus (DM) is a chronic condition caused by inherited and/or acquired deficiency in the production of insulin or the ineffectiveness of the pancreas to produce insulin. DM is classified into general categories: type 1, type 2, gestational and non-specific types of diabetes mellitus and is considered a manageable disease, requiring lifestyle modification and medicinal treatment. DM is a global challenge, and its incidence is expected to increase in the next decades in both developed and developing countries. However, in the context of the study, as 90% of patients with DM are managed at public health care (PHC) clinics by registered nurses (RNs) with minimal or without help from doctors, RNs are expected to use their knowledge for diagnosis, treatment, review, referral and health education of patients with DM in the PHC clinics in the Nelson Mandela Bay Health District (NMBHD). Therefore, if RNs have inadequate knowledge about the management of patients with the disease in comparison with guideline recommendations, the results will be poor management and often complications. These complications have financial and social repercussions on the patient, health systems and the economy of developing countries. In the study, the researcher explored the knowledge of RNs regarding the management of patients with DM in PHC clinics located in NMBHD. The study identified inconsistencies and gaps in knowledge and recommended strategies to improve the quality of care for diabetic patients in the long run. A quantitative, explorative, descriptive design was utilised to determine the knowledge of RNs about the management of patients with DM in the PHC clinics in NMBHD. The researcher utilised Slovin’s formula to draw a sample for the study. Initially, the study aimed to recruit a sample size of 199 participants, as determined by Slovin's formula. However, due to unforeseen complications related to the COVID-19 pandemic, only 144 RNs were able to participate. After consulting with a statistician, it was determined that the sample size was still representative of the entire population of 398 RNs working in PHC clinics in Subdistricts B and C of NMBHD in the Eastern Cape. Data collection was conducted using a self-administered questionnaire. Prior to the main study, a pilot study was conducted using RNs from two clinics in Subdistricts A v to test the questionnaire. No changes were made and none of the data was included in the final data of the study. A descriptive, statistical method using Microsoft (MS) Excel was followed to analyse the data gathered through the questionnaire. The following ethical principles based on the Belmont report were adhered to throughout the study: respect for persons, beneficence and justice. The results of the data analysis revealed that RNs in the PHC clinics in NMBHD have inadequate knowledge about the most critical aspects of DM management, such as making the diagnosis, the correct drug management, as well as the review and referral of patients with DM. Therefore, the study recommended addressing the inconsistencies and gaps identified in PHC nursing policy, practice, education, and research to improve the knowledge of RNs in managing patients with diabetes mellitus (DM) in the PHC clinics of the NMBHD. This would ultimately lead to better patient care outcomes. , Thesis (MCur) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2023
- Full Text:
- Date Issued: 2023-04
Unit managers’ perceptions of compassion fatigue among nurses at private hospitals in the Eastern Cape
- Authors: Els, Lisa Victoria
- Date: 2023-04
- Subjects: Medical personnel -- Job stress , Burn out (Psychology) -- Treatment , Compassion
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69637 , vital:78002
- Description: Caring has been described in literature as encompassing empathy, attentiveness, experience, and sensitivity, which is then translated into nursing bedside practice. However, the cost of caring may cause nurses to become withdrawn and unable to care for their patients. This phenomenon is called compassion fatigue (CF), where nurses feel unable to respond to their patients and become withdrawn from stressful scenarios in the unit. CF is prevalent globally among nurses based in all hospital disciplines. The aim of the study is to explore unit managers’ perceptions of CF among nurses in private hospitals in the Eastern Cape in order to develop recommendations for UMs on how to respond to CF among nursing staff. The study used a qualitative, exploratory-descriptive approach. The researcher used Williams, McDowell and Kautz’s (2011) Caring Leadership Model to explore the UMs’ perceptions of CF. The population chosen for this study was the UMs in private hospitals in the Eastern Cape. A minimum of 12 UMs were purposively sampled to take part in the study. Data was collected by means of semi-structured individual interviews. Lincoln and Guba’s four criteria of trustworthiness, namely: credibility, conformability, dependability and transferability were applied to enhance the quality of the study. The researcher upheld the ethical standards of the Belmont Report throughout the course of the study. Five themes were identified using Braun and Clarke’s data analysis method. The themes identified were: Theme 1: UMs’ perceptions of the manifestations of CF among their nursing staff; Theme 2: UMs’ perceptions of contributors to CF among their nursing staff; Theme 3: UMs identified that patient outcomes may have been hindered by CF among their nursing staff; Theme 4: UMs sought to enhance the well-being of their nursing staff which may have mitigated possible CF; Theme 5: Suggestions by UMs regarding UM self-awareness and improved support for each other. Hence the complex phenomenon of CF was explored through the UMs’ descriptions of their perceptions as leaders of nurses in the nursing practice setting. The UMs shared the difficulty of their roles, most especially related to how they struggled to vi support their staff while at the same time, feeling unsupported themselves. UMs were struggling, with staff who appeared to have CF. UMs reported that staff seemed more irritable, and angry. Added to these changes in behaviour, were signs that staff were not coping with the workload as well as with very ill patients. These changes in behaviour, signs of emotional and physical fatigue as well as higher rates of absenteeism all seemed to be aligned with the classical signs and symptoms of CF as described in much of the literature. Once the themes had been identified, a modified version of the AGREE II tool was used as a framework to develop the following recommendations: Recommendation 1: Facilitate UM peer support regarding CF management; Recommendation 2: Train UMs regarding CF and related conditions; Recommendation 3: Assist UMs to support their staff who are exhibiting CF. , Thesis (MCur) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2023
- Full Text:
- Date Issued: 2023-04
- Authors: Els, Lisa Victoria
- Date: 2023-04
- Subjects: Medical personnel -- Job stress , Burn out (Psychology) -- Treatment , Compassion
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69637 , vital:78002
- Description: Caring has been described in literature as encompassing empathy, attentiveness, experience, and sensitivity, which is then translated into nursing bedside practice. However, the cost of caring may cause nurses to become withdrawn and unable to care for their patients. This phenomenon is called compassion fatigue (CF), where nurses feel unable to respond to their patients and become withdrawn from stressful scenarios in the unit. CF is prevalent globally among nurses based in all hospital disciplines. The aim of the study is to explore unit managers’ perceptions of CF among nurses in private hospitals in the Eastern Cape in order to develop recommendations for UMs on how to respond to CF among nursing staff. The study used a qualitative, exploratory-descriptive approach. The researcher used Williams, McDowell and Kautz’s (2011) Caring Leadership Model to explore the UMs’ perceptions of CF. The population chosen for this study was the UMs in private hospitals in the Eastern Cape. A minimum of 12 UMs were purposively sampled to take part in the study. Data was collected by means of semi-structured individual interviews. Lincoln and Guba’s four criteria of trustworthiness, namely: credibility, conformability, dependability and transferability were applied to enhance the quality of the study. The researcher upheld the ethical standards of the Belmont Report throughout the course of the study. Five themes were identified using Braun and Clarke’s data analysis method. The themes identified were: Theme 1: UMs’ perceptions of the manifestations of CF among their nursing staff; Theme 2: UMs’ perceptions of contributors to CF among their nursing staff; Theme 3: UMs identified that patient outcomes may have been hindered by CF among their nursing staff; Theme 4: UMs sought to enhance the well-being of their nursing staff which may have mitigated possible CF; Theme 5: Suggestions by UMs regarding UM self-awareness and improved support for each other. Hence the complex phenomenon of CF was explored through the UMs’ descriptions of their perceptions as leaders of nurses in the nursing practice setting. The UMs shared the difficulty of their roles, most especially related to how they struggled to vi support their staff while at the same time, feeling unsupported themselves. UMs were struggling, with staff who appeared to have CF. UMs reported that staff seemed more irritable, and angry. Added to these changes in behaviour, were signs that staff were not coping with the workload as well as with very ill patients. These changes in behaviour, signs of emotional and physical fatigue as well as higher rates of absenteeism all seemed to be aligned with the classical signs and symptoms of CF as described in much of the literature. Once the themes had been identified, a modified version of the AGREE II tool was used as a framework to develop the following recommendations: Recommendation 1: Facilitate UM peer support regarding CF management; Recommendation 2: Train UMs regarding CF and related conditions; Recommendation 3: Assist UMs to support their staff who are exhibiting CF. , Thesis (MCur) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2023
- Full Text:
- Date Issued: 2023-04
An exploration of teachers’ views and experiences on the effects of community Violence on learners at Lusikisiki
- Authors: Gwarubana, Nolufefe
- Date: 2022-12
- Subjects: Kerr-Soltis model -- Lusikisiki , Posttraumatic Stress Disorder -- Lusikisiki
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60144 , vital:63206
- Description: A significant number of children in the South African context are exposed to community violence and become traumatised. In South Africa, many learners bring trauma histories into the classroom. To attend to this problem, it is important to understand how Exposure to Community Violence (ECV) affects learners, how this exposure is manifested in the classroom, and how teachers and schools can best support and mitigate adverse outcomes for trauma-impacted learners. The study aimed to understand teachers’ views and experiences on the effects of community violence on learners and the nature of the support that they offer to learners with trauma related to community violence. An exploratory design was used within which qualitative data was collected using semi-structured interviews. Data was gathered from Mkhankomo Full Service School, which is located in Lusikisiki. A maximum number of 10 teachers participated in the study and interviews were audio-recorded. Results of this study provide insight into the effects of community violence on the learners who were victims either directly or as witnesses. Based on thematic analysis, the results clearly showed that the effects of community violence were found to be mainly emotional, behavioural and psychological. All these effects were seen to affect the learners’ performance at school in the long run. In addition, the findings point to the teachers showing a willingness to support learners exposed to community violence, however, they felt ill-equipped to do so given that they had never worked with learners exposed to trauma. Also, in their attempts to support learners, teachers implemented support systems such as offering individual lessons to learners and additionally assuming supportive roles such as that of mentor and mother. Moreover, the findings indicated that teachers were not provided with any v training to help them work with learners exposed to trauma and their expectations for the Department of Basic Education to assist were not met. Consequently, the study provides an understanding of the effects of community violence on learners from the perspectives of teachers in the school. It also assists with information regarding teachers’ preparedness and ability to respond to learners’ chronic exposure to community violence. Furthermore, this study gives an understanding of teachers’ approach to supporting learners experiencing traumatic stress in the classroom. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Gwarubana, Nolufefe
- Date: 2022-12
- Subjects: Kerr-Soltis model -- Lusikisiki , Posttraumatic Stress Disorder -- Lusikisiki
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60144 , vital:63206
- Description: A significant number of children in the South African context are exposed to community violence and become traumatised. In South Africa, many learners bring trauma histories into the classroom. To attend to this problem, it is important to understand how Exposure to Community Violence (ECV) affects learners, how this exposure is manifested in the classroom, and how teachers and schools can best support and mitigate adverse outcomes for trauma-impacted learners. The study aimed to understand teachers’ views and experiences on the effects of community violence on learners and the nature of the support that they offer to learners with trauma related to community violence. An exploratory design was used within which qualitative data was collected using semi-structured interviews. Data was gathered from Mkhankomo Full Service School, which is located in Lusikisiki. A maximum number of 10 teachers participated in the study and interviews were audio-recorded. Results of this study provide insight into the effects of community violence on the learners who were victims either directly or as witnesses. Based on thematic analysis, the results clearly showed that the effects of community violence were found to be mainly emotional, behavioural and psychological. All these effects were seen to affect the learners’ performance at school in the long run. In addition, the findings point to the teachers showing a willingness to support learners exposed to community violence, however, they felt ill-equipped to do so given that they had never worked with learners exposed to trauma. Also, in their attempts to support learners, teachers implemented support systems such as offering individual lessons to learners and additionally assuming supportive roles such as that of mentor and mother. Moreover, the findings indicated that teachers were not provided with any v training to help them work with learners exposed to trauma and their expectations for the Department of Basic Education to assist were not met. Consequently, the study provides an understanding of the effects of community violence on learners from the perspectives of teachers in the school. It also assists with information regarding teachers’ preparedness and ability to respond to learners’ chronic exposure to community violence. Furthermore, this study gives an understanding of teachers’ approach to supporting learners experiencing traumatic stress in the classroom. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
An investigation into the psychological impact of unemployment and coping mechanisms amongst graduates in Pietermaritzburg
- Authors: Nkasa, Nonjabulo Fortunate
- Date: 2022-12
- Subjects: Unemployment -- Social aspects , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60209 , vital:63539
- Description: Graduates expect to find employment after completing their tertiary qualifications, but they often face various challenges in finding employment. These challenges may be due to a variety of factors such as the type of qualification, structural changes in the economy, lack of experience, or the lack of relevant social networks. This has the potential to affect a graduate’s psychological well-being. The current study explored the psychological impact of unemployment in 100 unemployed graduates between 21 and 35 years of age in Pietermaritzburg. The study was quantitative and used two questionnaires, the GHQ-12 and a self-designed questionnaire, to collect data. Purposive sampling was used to obtain research participants. The Excel spreadsheet and a statistical software package called JASP (2020, version 0.12) was used to analyse data. The findings revealed that unemployment had a negative impact on the participants’ psychological well-being. Participants experienced feelings of high anxiety and depression, and felt stigmatised. Participants also felt shame and experienced lower self-esteem. Unemployment had a financial impact on participants, including financial dependency on family and friends. Some participants blamed themselves, the government system, and the education system for their unemployment. Participants reported to have a positive attitude towards employment, including remaining optimistic about their chances of finding employment. Participants used adaptive coping mechanisms, such as keeping a positive attitude, and maladaptive coping mechanisms, such as hiding their feelings. Further research needs to focus on psychological services that could assist unemployed graduates to find employment through building and maintaining their self-esteem and confidence which are key factors when initially seeking and obtaining work. Unemployment and its impact on psychological well-being has been shown to be to be a complex subject that requires intervention from different parties such as employers and health-care workers, as well as the education system. Keywords: Coping, graduates, psychological impact and unemployment , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Nkasa, Nonjabulo Fortunate
- Date: 2022-12
- Subjects: Unemployment -- Social aspects , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60209 , vital:63539
- Description: Graduates expect to find employment after completing their tertiary qualifications, but they often face various challenges in finding employment. These challenges may be due to a variety of factors such as the type of qualification, structural changes in the economy, lack of experience, or the lack of relevant social networks. This has the potential to affect a graduate’s psychological well-being. The current study explored the psychological impact of unemployment in 100 unemployed graduates between 21 and 35 years of age in Pietermaritzburg. The study was quantitative and used two questionnaires, the GHQ-12 and a self-designed questionnaire, to collect data. Purposive sampling was used to obtain research participants. The Excel spreadsheet and a statistical software package called JASP (2020, version 0.12) was used to analyse data. The findings revealed that unemployment had a negative impact on the participants’ psychological well-being. Participants experienced feelings of high anxiety and depression, and felt stigmatised. Participants also felt shame and experienced lower self-esteem. Unemployment had a financial impact on participants, including financial dependency on family and friends. Some participants blamed themselves, the government system, and the education system for their unemployment. Participants reported to have a positive attitude towards employment, including remaining optimistic about their chances of finding employment. Participants used adaptive coping mechanisms, such as keeping a positive attitude, and maladaptive coping mechanisms, such as hiding their feelings. Further research needs to focus on psychological services that could assist unemployed graduates to find employment through building and maintaining their self-esteem and confidence which are key factors when initially seeking and obtaining work. Unemployment and its impact on psychological well-being has been shown to be to be a complex subject that requires intervention from different parties such as employers and health-care workers, as well as the education system. Keywords: Coping, graduates, psychological impact and unemployment , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Assessing Diabetes distress amongst type 2 Diabetic patients at the Mhlontlo sub-district healthcare clinics in the OR Tambo health District
- Authors: Mboniso, Veronica
- Date: 2022-12
- Subjects: Diabetes , Medical care , Primary health care -- OR Tambo Health District
- Language: English
- Type: Master's theses , Thesis
- Identifier: http://hdl.handle.net/10948/60111 , vital:63096
- Description: Diabetes mellitus is a chronic endocrine condition that requires lifestyle changes and a commitment to its management to ensure patient well-being, although this can be challenging for various reasons. In addition, diabetes is a behavioural and emotionally demanding condition that could affect the psychosocial well-being of a patient. Diabetes distress is quite common in people living with diabetes, as they lose hope easily, especially when their diabetes is uncontrolled. The research study identified and described factors contributing to diabetes distress amongst type 2 diabetic patients at Mhlontlo Sub-District healthcare clinics in the OR Tambo Health District. Probability sampling was used to select patients who were 18 years and older after approval from Nelson Mandela University (NMU) and relevant authorisation was obtained. The study was conducted between August and October 2021, using a quantitative, exploratory and descriptive research design. The data were collected using a self-administered questionnaire, which had been adapted from the Diabetes Distress Scale-17 (DDS-17) created by Polonsky et al. (2005). A total of 136 diabetic patients completed the questionnaire, which comprised three sections: demographic information (Section A); the DDS-17 (Section B); and contributing factors to diabetes distress in diabetic patients at Mhlontlo Sub-District healthcare clinics (Section C). The researcher conducted a pilot study in one of the clinics to check the feasibility of the questionnaire. After the data were collected, it was statistically analysed with the assistance of a statistician to generate descriptive and inferential statistics. The analysed data revealed that most of the diabetic patients indicated that they found travelling far to fetch medication and standing in long queues at the clinic distressing. Therefore, they wanted the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme to be rolled out to bring medication to them. The results also revealed that the patients' diabetes distress was exacerbated by them having to travel to clinics in search of medication when their usual clinic had no adequate v stocks of medication. Another factor contributing to the patients’ diabetes distress was the lack of a doctor on site. The patients indicated that doctors should be available at the clinics, even periodically, to address problems that cannot be solved by nurses. The absence of haemoglucotest (HGT machines at clinics was another contributing factor to diabetes distress. Most of the patients in the study felt that they would manage their diabetes better if the government supplied these machines. The results informed various recommendations that might help the management of OR Tambo Health District to make changes and thus minimise the diabetes distress reported by its patients. However, the study had limitations, although it observed the principles of reliability and validity. Moreover, ethical considerations were guided by the Belmont Report, and the study adhered to the principles of informed consent, respect for persons, anonymity, confidentiality, beneficence, nonmaleficence and distributive justice. , Thesis (MNur) -- Faculty of Health Sciences, School of Lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Mboniso, Veronica
- Date: 2022-12
- Subjects: Diabetes , Medical care , Primary health care -- OR Tambo Health District
- Language: English
- Type: Master's theses , Thesis
- Identifier: http://hdl.handle.net/10948/60111 , vital:63096
- Description: Diabetes mellitus is a chronic endocrine condition that requires lifestyle changes and a commitment to its management to ensure patient well-being, although this can be challenging for various reasons. In addition, diabetes is a behavioural and emotionally demanding condition that could affect the psychosocial well-being of a patient. Diabetes distress is quite common in people living with diabetes, as they lose hope easily, especially when their diabetes is uncontrolled. The research study identified and described factors contributing to diabetes distress amongst type 2 diabetic patients at Mhlontlo Sub-District healthcare clinics in the OR Tambo Health District. Probability sampling was used to select patients who were 18 years and older after approval from Nelson Mandela University (NMU) and relevant authorisation was obtained. The study was conducted between August and October 2021, using a quantitative, exploratory and descriptive research design. The data were collected using a self-administered questionnaire, which had been adapted from the Diabetes Distress Scale-17 (DDS-17) created by Polonsky et al. (2005). A total of 136 diabetic patients completed the questionnaire, which comprised three sections: demographic information (Section A); the DDS-17 (Section B); and contributing factors to diabetes distress in diabetic patients at Mhlontlo Sub-District healthcare clinics (Section C). The researcher conducted a pilot study in one of the clinics to check the feasibility of the questionnaire. After the data were collected, it was statistically analysed with the assistance of a statistician to generate descriptive and inferential statistics. The analysed data revealed that most of the diabetic patients indicated that they found travelling far to fetch medication and standing in long queues at the clinic distressing. Therefore, they wanted the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme to be rolled out to bring medication to them. The results also revealed that the patients' diabetes distress was exacerbated by them having to travel to clinics in search of medication when their usual clinic had no adequate v stocks of medication. Another factor contributing to the patients’ diabetes distress was the lack of a doctor on site. The patients indicated that doctors should be available at the clinics, even periodically, to address problems that cannot be solved by nurses. The absence of haemoglucotest (HGT machines at clinics was another contributing factor to diabetes distress. Most of the patients in the study felt that they would manage their diabetes better if the government supplied these machines. The results informed various recommendations that might help the management of OR Tambo Health District to make changes and thus minimise the diabetes distress reported by its patients. However, the study had limitations, although it observed the principles of reliability and validity. Moreover, ethical considerations were guided by the Belmont Report, and the study adhered to the principles of informed consent, respect for persons, anonymity, confidentiality, beneficence, nonmaleficence and distributive justice. , Thesis (MNur) -- Faculty of Health Sciences, School of Lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Challenges faced by healthcare professionals in reporting near miss incidents in a hospital, at the Amathole District, Eastern Cape Province, South Africa
- Authors: Ntlanganiso, Lindiwe
- Date: 2022-12
- Subjects: Industrial accidents , Accident investigation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27094 , vital:66276
- Description: Background Recording and investigation of NMIs can provide valuable information on monitoring and enhancing patient safety in the healthcare facilities. This in turn, can reduce the likelihood of medico-legal claims. Regardless of attempts to establish efficient incident reporting systems across the entire healthcare industry, underreporting of errors persists worldwide. Therefore, not only do near miss incidents serve as early warning signs of impending potential failure in the healthcare system, but they also provide a chance for patient safety improvement. With that in mind, this study was undertaken to investigate challenges faced by health care professionals in reporting near miss incidents at a hospital in the Amathole District, in the Eastern Cape province of South Africa. Aim The aim of the study was to develop recommendations for healthcare management and healthcare professionals on how to better manage NMIs, and by identifying the challenges faced by health care professionals and the impact they have on the quality of care at one state-funded district hospital. Setting The study was conducted with healthcare professionals at a district hospital in the Amathole District, Eastern Cape Province, South Africa. Methods This study used a mixed method study design. Purposive and convenience sampling were used for participants’ selection for the study. Quantitative data was collected using the WHO Near-Miss Approach while individual and focus group interviews with healthcare professionals were carried out for collecting qualitative data. The maternity and neonatal intensive care units were identified as the two high-risk areas from which most medical negligence claims are lodged. The number of complications that occurred in each month of the year 2019 was determined by using components of the WHO near miss approach. The researcher adopted this approach to serve as a baseline assessment. Data was analysed using both Nvivo Version 10 and SPSS Version 20. Findings The challenges that healthcare professionals face in reporting near miss incidents at the study site included lack of knowledge about the reporting tool and system, inability to identify a near miss incident and healthcare professional attitudes and practices. The document review revealed that the NMIs are existent but not reported on the prescribed reporting system, a total of 210 actual incidents had occurred in the maternity and neonatal units of the hospital, which accounts for 62% of the 357 deliveries in the year 2019. Conclusion Based on the study result and findings, the healthcare system should shift towards a proactive rather than a reactive approach to medical and clinical errors. Continuously reducing the incidence of all patient safety incidents requires improved prevention strategies and effective strategies for recovery from possible medico-legal claims. The study further suggests that additional focus should be placed on NMI reporting and investigation so that operative improvement plans can be developed, implemented, monitored and evaluated. In essence, these improvement plans should be designed to progress patient care, reduce avoidable PSIs and reduce medico-legal claims. , Thesis (MCur) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Ntlanganiso, Lindiwe
- Date: 2022-12
- Subjects: Industrial accidents , Accident investigation
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27094 , vital:66276
- Description: Background Recording and investigation of NMIs can provide valuable information on monitoring and enhancing patient safety in the healthcare facilities. This in turn, can reduce the likelihood of medico-legal claims. Regardless of attempts to establish efficient incident reporting systems across the entire healthcare industry, underreporting of errors persists worldwide. Therefore, not only do near miss incidents serve as early warning signs of impending potential failure in the healthcare system, but they also provide a chance for patient safety improvement. With that in mind, this study was undertaken to investigate challenges faced by health care professionals in reporting near miss incidents at a hospital in the Amathole District, in the Eastern Cape province of South Africa. Aim The aim of the study was to develop recommendations for healthcare management and healthcare professionals on how to better manage NMIs, and by identifying the challenges faced by health care professionals and the impact they have on the quality of care at one state-funded district hospital. Setting The study was conducted with healthcare professionals at a district hospital in the Amathole District, Eastern Cape Province, South Africa. Methods This study used a mixed method study design. Purposive and convenience sampling were used for participants’ selection for the study. Quantitative data was collected using the WHO Near-Miss Approach while individual and focus group interviews with healthcare professionals were carried out for collecting qualitative data. The maternity and neonatal intensive care units were identified as the two high-risk areas from which most medical negligence claims are lodged. The number of complications that occurred in each month of the year 2019 was determined by using components of the WHO near miss approach. The researcher adopted this approach to serve as a baseline assessment. Data was analysed using both Nvivo Version 10 and SPSS Version 20. Findings The challenges that healthcare professionals face in reporting near miss incidents at the study site included lack of knowledge about the reporting tool and system, inability to identify a near miss incident and healthcare professional attitudes and practices. The document review revealed that the NMIs are existent but not reported on the prescribed reporting system, a total of 210 actual incidents had occurred in the maternity and neonatal units of the hospital, which accounts for 62% of the 357 deliveries in the year 2019. Conclusion Based on the study result and findings, the healthcare system should shift towards a proactive rather than a reactive approach to medical and clinical errors. Continuously reducing the incidence of all patient safety incidents requires improved prevention strategies and effective strategies for recovery from possible medico-legal claims. The study further suggests that additional focus should be placed on NMI reporting and investigation so that operative improvement plans can be developed, implemented, monitored and evaluated. In essence, these improvement plans should be designed to progress patient care, reduce avoidable PSIs and reduce medico-legal claims. , Thesis (MCur) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Co-development of online violence against women and girls prevention interventions with school-going adolescents
- Authors: Ndungu, Jane
- Date: 2022-12
- Subjects: Prevention , Transformative communication
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60188 , vital:63214
- Description: Background: Violence against women and girls (VAWG)amongst adolescents remains a global public health problem. Globally, an estimated 24 per cent of girls aged 15-19 are reported to have experienced VAWG before the age of 20. Experience of VAWG has far reaching health and educational consequences. Thus, the prevention of VAWG needs to be a priority. In recent years, there has been an increase in web-based or online violence prevention interventions. However, these interventions are either secondary prevention interventions, or primary prevention interventions, focused on emergency or protective solutions. Current evidence indicates that group-based participatory violence prevention interventions are an important approach to the primary prevention of VAWG but there remains a gap in understanding if these interventions can be delivered online. Further, it remains unclear if co-development of group-based participatory violence prevention interventions with young people – which has been proposed to enhance contextualisation of interventions – can occur online. Goal and specific objectives: This study aimed to explore and understand the feasibility of co-developing an online group-based participatory VAWG prevention intervention for adolescents. The specific objectives of this study were (i) from the perspective of experts understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, (ii) from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online and (iii) Undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents. ix Methods: This qualitative study was conducted in Gqeberha (formerly known as Port Elizabeth), in the Nelson Mandela Bay municipality, Eastern Cape Province of South Africa. The study was guided by the intervention development framework: 6 Essential Steps for Quality Intervention Development (6SQuID). Data were collected online using in-depth semi-structured interviews, with 20 experts sampled through convenience and snowball strategies and 18 purposively sampled adolescents, to achieve objectives one and two. This was then followed by a co-development process with high school-going adolescents (ages 18- 19 years) to achieve objective three. In the co-development process, the candidate worked with a small group of adolescents (four adolescents) for five sessions online, over a period of two weeks. In these sessions, the co-development team engaged in discussions on sexual violence, which resulted in creation of a problem tree and populated a theory of change table. Data were transcribed in English, verbatim and analysed using thematic network analyses. Findings: Findings for the first objective about understanding from the perspective of experts the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, showed experts identified several opportunities for these. Specifically, experts identified the potential of bringing these interventions to scale, which has been a challenge for in-person interventions, as well as accessing hard to reach groups, such as people in conflict settings, those on the move and people with limited mobility. However, experts felt there were many complex questions in the development of an online VAWG prevention intervention that needed resolving. Some of the challenges raised by experts included concerns of achieving privacy, trust, and safety online, which are central to achieving transformative communication. Experts also struggled to grapple with how a sense of community could be achieved online. There were also concerns amongst experts about material challenges such as access to devices, access to data and poor connectivity. x Interestingly, younger experts were more open to online participatory interventions than the more experienced experts. Findings for objective two “from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online”, young people reported they were keen and open to the idea of online group-based participatory VAWG prevention interventions. They discussed how they enjoyed engaging in online groups and often experienced a sense of belonging in these groups. Yet, like the experts, school-going adolescents were concerned about safety, privacy, and trust in online groups. These concerns shaped adolescents’ willingness to disclose sensitive information online and ability to engage in open dialogue. Concern over privacy, trust and safety online also influenced adolescents’ choices over which apps to engage with, and with whom. Young people were active in thinking through and addressing how they dealt with safety, privacy and trust issues online. The third objective was “to undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents”, which was done over two weeks. A range of positive outcomes were identified. Firstly, young people enjoyed the level of autonomy and their depth of involvement in the process. They had come into the process anticipating being lectured to and were pleasantly surprised to find that their role was central, and they would drive the process. Secondly, adolescents were eager to be involved and appreciated being ‘heard’. This allowed for a more extensive exploration of their understanding on the topic, and development of the intervention activities that emerged. Thirdly, young people found it easy to build rapport online, both amongst each other, and with the facilitator, which made communication in the group easier. Importantly, this group of adolescents had their own laptops, or cell phones to use, and the project provided data for the young people to participate. However, there were also challenges to the process of coxi development. The central challenge was that young people and facilitator often slipped into a form of teacher-learner communication, driven by their prior histories of didactic education, which led the adolescents to ‘fearing’ to give ‘wrong’ responses. The facilitator also struggled on how to maintain adolescents’ autonomy of thought, while also incorporating ‘scientific evidence’ in the emerging intervention activities. Furthermore, the more talkative school-going adolescents took the centre stage in the discussions, with the quieter ones remaining quiet. Conclusions: The findings of this study showed that the feasibility of taking group-based participatory interventions online are possible, but this is shaped by a complex set of factors, that impact on the possibilities for transformative communication, and on the creation of safe social spaces – such as trust, privacy, safety. The central question is whether the theoretical constructs of transformative communication and safe social spaces are achievable online. A significant step in moving towards enabling transformative communication online will be addressing the issues of privacy, safety and trust. Careful training of facilitators around skills to facilitate group-based participatory VAWG prevention interventions online is also recommended. The complexities of delivering online participatory interventions require careful consideration, and this needs to be developed and thought about in conjunction with school-going adolescents (the target group), to ensure that interventions resonate with their needs and requirements. Future directions in this research field are provided. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Ndungu, Jane
- Date: 2022-12
- Subjects: Prevention , Transformative communication
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60188 , vital:63214
- Description: Background: Violence against women and girls (VAWG)amongst adolescents remains a global public health problem. Globally, an estimated 24 per cent of girls aged 15-19 are reported to have experienced VAWG before the age of 20. Experience of VAWG has far reaching health and educational consequences. Thus, the prevention of VAWG needs to be a priority. In recent years, there has been an increase in web-based or online violence prevention interventions. However, these interventions are either secondary prevention interventions, or primary prevention interventions, focused on emergency or protective solutions. Current evidence indicates that group-based participatory violence prevention interventions are an important approach to the primary prevention of VAWG but there remains a gap in understanding if these interventions can be delivered online. Further, it remains unclear if co-development of group-based participatory violence prevention interventions with young people – which has been proposed to enhance contextualisation of interventions – can occur online. Goal and specific objectives: This study aimed to explore and understand the feasibility of co-developing an online group-based participatory VAWG prevention intervention for adolescents. The specific objectives of this study were (i) from the perspective of experts understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, (ii) from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online and (iii) Undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents. ix Methods: This qualitative study was conducted in Gqeberha (formerly known as Port Elizabeth), in the Nelson Mandela Bay municipality, Eastern Cape Province of South Africa. The study was guided by the intervention development framework: 6 Essential Steps for Quality Intervention Development (6SQuID). Data were collected online using in-depth semi-structured interviews, with 20 experts sampled through convenience and snowball strategies and 18 purposively sampled adolescents, to achieve objectives one and two. This was then followed by a co-development process with high school-going adolescents (ages 18- 19 years) to achieve objective three. In the co-development process, the candidate worked with a small group of adolescents (four adolescents) for five sessions online, over a period of two weeks. In these sessions, the co-development team engaged in discussions on sexual violence, which resulted in creation of a problem tree and populated a theory of change table. Data were transcribed in English, verbatim and analysed using thematic network analyses. Findings: Findings for the first objective about understanding from the perspective of experts the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online, showed experts identified several opportunities for these. Specifically, experts identified the potential of bringing these interventions to scale, which has been a challenge for in-person interventions, as well as accessing hard to reach groups, such as people in conflict settings, those on the move and people with limited mobility. However, experts felt there were many complex questions in the development of an online VAWG prevention intervention that needed resolving. Some of the challenges raised by experts included concerns of achieving privacy, trust, and safety online, which are central to achieving transformative communication. Experts also struggled to grapple with how a sense of community could be achieved online. There were also concerns amongst experts about material challenges such as access to devices, access to data and poor connectivity. x Interestingly, younger experts were more open to online participatory interventions than the more experienced experts. Findings for objective two “from the perspective of adolescents, understand the feasibility, acceptability and challenges of a group-based participatory VAWG prevention intervention developed and delivered online”, young people reported they were keen and open to the idea of online group-based participatory VAWG prevention interventions. They discussed how they enjoyed engaging in online groups and often experienced a sense of belonging in these groups. Yet, like the experts, school-going adolescents were concerned about safety, privacy, and trust in online groups. These concerns shaped adolescents’ willingness to disclose sensitive information online and ability to engage in open dialogue. Concern over privacy, trust and safety online also influenced adolescents’ choices over which apps to engage with, and with whom. Young people were active in thinking through and addressing how they dealt with safety, privacy and trust issues online. The third objective was “to undertake an online co-development process of an online group-based participatory VAWG prevention intervention with adolescents”, which was done over two weeks. A range of positive outcomes were identified. Firstly, young people enjoyed the level of autonomy and their depth of involvement in the process. They had come into the process anticipating being lectured to and were pleasantly surprised to find that their role was central, and they would drive the process. Secondly, adolescents were eager to be involved and appreciated being ‘heard’. This allowed for a more extensive exploration of their understanding on the topic, and development of the intervention activities that emerged. Thirdly, young people found it easy to build rapport online, both amongst each other, and with the facilitator, which made communication in the group easier. Importantly, this group of adolescents had their own laptops, or cell phones to use, and the project provided data for the young people to participate. However, there were also challenges to the process of coxi development. The central challenge was that young people and facilitator often slipped into a form of teacher-learner communication, driven by their prior histories of didactic education, which led the adolescents to ‘fearing’ to give ‘wrong’ responses. The facilitator also struggled on how to maintain adolescents’ autonomy of thought, while also incorporating ‘scientific evidence’ in the emerging intervention activities. Furthermore, the more talkative school-going adolescents took the centre stage in the discussions, with the quieter ones remaining quiet. Conclusions: The findings of this study showed that the feasibility of taking group-based participatory interventions online are possible, but this is shaped by a complex set of factors, that impact on the possibilities for transformative communication, and on the creation of safe social spaces – such as trust, privacy, safety. The central question is whether the theoretical constructs of transformative communication and safe social spaces are achievable online. A significant step in moving towards enabling transformative communication online will be addressing the issues of privacy, safety and trust. Careful training of facilitators around skills to facilitate group-based participatory VAWG prevention interventions online is also recommended. The complexities of delivering online participatory interventions require careful consideration, and this needs to be developed and thought about in conjunction with school-going adolescents (the target group), to ensure that interventions resonate with their needs and requirements. Future directions in this research field are provided. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Development of a therapeutic drug monitoring model for aminoglycosides at a private hospital in the Eastern Cape
- Authors: Swanepoel, Caro Mae
- Date: 2022-12
- Subjects: Aminoglycosides -- Eastern Cape , Nephrotoxicity -- Eastern Cape , Drug Monitoring
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60276 , vital:64291
- Description: Background: Aminoglycosides are highly effective against Gram-negative bacteria, including ESKAPE pathogens. However, aminoglycosides can cause nephrotoxicity and ototoxicity. Therapeutic drug monitoring (TDM) performed in patients receiving aminoglycosides can potentially reduce the development of antimicrobial resistance as well as aminoglycoside-induced toxicity and side effects. Primary Aim: The study aimed to identify TDM practices and subsequently develop a model for aminoglycoside TDM at a private hospital in the Eastern Cape. Methodology: Phase One involved the collection of data from the hospital’s database, using a purpose-designed data collection tool. Data from 135 eligible patients who received aminoglycoside therapy from June 2019 to June 2020 were reviewed. Data was captured, coded and analysed (using differential analysis). Semi-structured interviews were conducted (Phase Two) with three physicians and five pharmacists. Interview transcripts were coded using a combination of inductive and deductive coding techniques, followed by thematic analysis. The data was triangulated and used, together with recommendations from similar guidelines, to design a context-specific model for aminoglycoside TDM at the hospital. Results and Discussion: Results from Phases One and Two showed that TDM was not being performed correctly at the hospital. The overall incidence of aminoglycoside TDM was 19.26% (N = 135). The highest incidence of TDM occurred in ICU patients (n = 31; 51.61%). Drug monitoring was not consistently conducted in elderly (≥65 years) patients, or in those with signs of renal impairment; even though interviewed physicians and pharmacists identified elderly and renally impaired patients as “high risk” patients. Challenges regarding implementation of aminoglycoside TDM were explored. A lack of competent staff and time constraints were identified as major barriers to quality TDM services. Conclusion: The daily practices and TDM challenges at the site were considered during the design of the aminoglycoside TDM model, which can potentially facilitate better execution and monitoring practices for aminoglycosides at the private hospital. , Thesis (MA) -- Faculty of Health Sciences 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Swanepoel, Caro Mae
- Date: 2022-12
- Subjects: Aminoglycosides -- Eastern Cape , Nephrotoxicity -- Eastern Cape , Drug Monitoring
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60276 , vital:64291
- Description: Background: Aminoglycosides are highly effective against Gram-negative bacteria, including ESKAPE pathogens. However, aminoglycosides can cause nephrotoxicity and ototoxicity. Therapeutic drug monitoring (TDM) performed in patients receiving aminoglycosides can potentially reduce the development of antimicrobial resistance as well as aminoglycoside-induced toxicity and side effects. Primary Aim: The study aimed to identify TDM practices and subsequently develop a model for aminoglycoside TDM at a private hospital in the Eastern Cape. Methodology: Phase One involved the collection of data from the hospital’s database, using a purpose-designed data collection tool. Data from 135 eligible patients who received aminoglycoside therapy from June 2019 to June 2020 were reviewed. Data was captured, coded and analysed (using differential analysis). Semi-structured interviews were conducted (Phase Two) with three physicians and five pharmacists. Interview transcripts were coded using a combination of inductive and deductive coding techniques, followed by thematic analysis. The data was triangulated and used, together with recommendations from similar guidelines, to design a context-specific model for aminoglycoside TDM at the hospital. Results and Discussion: Results from Phases One and Two showed that TDM was not being performed correctly at the hospital. The overall incidence of aminoglycoside TDM was 19.26% (N = 135). The highest incidence of TDM occurred in ICU patients (n = 31; 51.61%). Drug monitoring was not consistently conducted in elderly (≥65 years) patients, or in those with signs of renal impairment; even though interviewed physicians and pharmacists identified elderly and renally impaired patients as “high risk” patients. Challenges regarding implementation of aminoglycoside TDM were explored. A lack of competent staff and time constraints were identified as major barriers to quality TDM services. Conclusion: The daily practices and TDM challenges at the site were considered during the design of the aminoglycoside TDM model, which can potentially facilitate better execution and monitoring practices for aminoglycosides at the private hospital. , Thesis (MA) -- Faculty of Health Sciences 2022
- Full Text:
- Date Issued: 2022-12
Educational interventions for primary caregivers related to infection prevention and control in stroke patients in a rural setting of Mutasa district, Zimbabwe
- Authors: Chikanya, Violet Kestha
- Date: 2022-12
- Subjects: Educational interventions -- Zimbabwe , Cross infection -- Prevention -- Zimbabwe , Primary caregivers
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/60133 , vital:63146
- Description: Infection prevention and control offer safe and effective practices for patients and healthcare workers in any setting, including the home environment. Understanding and applying principles are based on knowledge and training of caregivers. The incidence of stroke has increased significantly in some sub-Saharan countries. Most patients with stroke are admitted into hospital during the acute phase of care, and are then discharged for further care and management at home. Recovery at home after a stroke takes a long time under the care of primary caregivers with either little or no health care training, exposing these patients to a variety of risky infections. Education on infection prevention and control is therefore encouraged to guide primary caregivers in caring for these patients. The study objectives sought to explore and describe knowledge and practices of primary caregivers, and information given by village health workers to primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients in a rural setting in Mutasa district, Zimbabwe. The study also sought to develop and validate educational interventions for primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients. A quantitative research paradigm was used in the study. Multistage random sampling was used to select 20 wards and 200 villages. Using a margin of error of 5% and 95% confidence, the sample consisted of 200 primary caregivers and 200 village health workers. The study was conducted in three phases. Phase One comprised data collection from primary caregivers and village health workers regarding prevention and control of chest, skin, and urinary tract infections. Data were collected using a structured interviewer-administered questionnaire for primary caregivers and a self-administered questionnaire for village health workers. The research instruments collected data on socio-demographics, knowledge, practices and infection prevention and control information given by village health workers to primary caregivers. The Visual Basic for Applications package was used for data analysis. x The study results revealed that a significant number of primary caregivers had low knowledge levels in terms of stroke and infections that frequently occur in home-based stroke patients. About a third of primary caregivers did not know the standard infection prevention and control measures to prevent infections, and a substantial proportion of the primary caregivers did not practise the recommended measures to prevent and control chest, skin and urinary tract infections in home-based stroke patients. It was found that village health workers provided limited health education on stroke, its complications, and measures to prevent and control chest, skin and urinary tract infections to primary caregivers. In Phase Two, educational interventions in the form of a job aid comprising worksheets for primary caregivers to prevent and control chest, skin and urinary tract infections in home-based stroke patients in a rural setting were developed. In Phase Three, the draft job aid was reviewed by an eight-member expert panel. Feedback from the reviewers was used to develop the final job aid for enhancing the knowledge and practices of primary caregivers in terms of infection prevention and control in home-based stroke patients. Throughout the study, the researcher adhered to ethical considerations, namely respect for persons, beneficence, and justice. The quality of data collected was ensured by applying the principles of validity and reliability in the development stage of the questionnaire and by conducting a pilot study. Rigorous evaluation of the developed job aid is required to establish its validity. It is recommended that the job aid be included in nurse training and continuing education programs. The trainings should be cascaded to the village health workers and primary caregivers of other bed-ridden patients. The job aid will also reach more caregivers if translated to other local languages. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Chikanya, Violet Kestha
- Date: 2022-12
- Subjects: Educational interventions -- Zimbabwe , Cross infection -- Prevention -- Zimbabwe , Primary caregivers
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/60133 , vital:63146
- Description: Infection prevention and control offer safe and effective practices for patients and healthcare workers in any setting, including the home environment. Understanding and applying principles are based on knowledge and training of caregivers. The incidence of stroke has increased significantly in some sub-Saharan countries. Most patients with stroke are admitted into hospital during the acute phase of care, and are then discharged for further care and management at home. Recovery at home after a stroke takes a long time under the care of primary caregivers with either little or no health care training, exposing these patients to a variety of risky infections. Education on infection prevention and control is therefore encouraged to guide primary caregivers in caring for these patients. The study objectives sought to explore and describe knowledge and practices of primary caregivers, and information given by village health workers to primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients in a rural setting in Mutasa district, Zimbabwe. The study also sought to develop and validate educational interventions for primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients. A quantitative research paradigm was used in the study. Multistage random sampling was used to select 20 wards and 200 villages. Using a margin of error of 5% and 95% confidence, the sample consisted of 200 primary caregivers and 200 village health workers. The study was conducted in three phases. Phase One comprised data collection from primary caregivers and village health workers regarding prevention and control of chest, skin, and urinary tract infections. Data were collected using a structured interviewer-administered questionnaire for primary caregivers and a self-administered questionnaire for village health workers. The research instruments collected data on socio-demographics, knowledge, practices and infection prevention and control information given by village health workers to primary caregivers. The Visual Basic for Applications package was used for data analysis. x The study results revealed that a significant number of primary caregivers had low knowledge levels in terms of stroke and infections that frequently occur in home-based stroke patients. About a third of primary caregivers did not know the standard infection prevention and control measures to prevent infections, and a substantial proportion of the primary caregivers did not practise the recommended measures to prevent and control chest, skin and urinary tract infections in home-based stroke patients. It was found that village health workers provided limited health education on stroke, its complications, and measures to prevent and control chest, skin and urinary tract infections to primary caregivers. In Phase Two, educational interventions in the form of a job aid comprising worksheets for primary caregivers to prevent and control chest, skin and urinary tract infections in home-based stroke patients in a rural setting were developed. In Phase Three, the draft job aid was reviewed by an eight-member expert panel. Feedback from the reviewers was used to develop the final job aid for enhancing the knowledge and practices of primary caregivers in terms of infection prevention and control in home-based stroke patients. Throughout the study, the researcher adhered to ethical considerations, namely respect for persons, beneficence, and justice. The quality of data collected was ensured by applying the principles of validity and reliability in the development stage of the questionnaire and by conducting a pilot study. Rigorous evaluation of the developed job aid is required to establish its validity. It is recommended that the job aid be included in nurse training and continuing education programs. The trainings should be cascaded to the village health workers and primary caregivers of other bed-ridden patients. The job aid will also reach more caregivers if translated to other local languages. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Experiences of Family Caregivers Caring for Mentally Ill Relatives in a Rural District of the Eastern Cape Province
- Authors: Koti, Tulisile
- Date: 2022-12
- Subjects: Caregivers -- Eastern Cape , Mental illness -- Eastern Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60166 , vital:63208
- Description: Mental illness refers to all diagnosable mental disorders, whether by a medical doctor or a psychiatrist. It includes significant changes in thinking, emotion, and behavior and may result in distress or difficulty functioning in society, work or family. South Africa has been on a de-institutionalization path for several decades, despite this, many mentally ill people are forced to live at home with their families. As a result, family caregivers have been faced with responsibilities for which they are unprepared. The burden of caring for the mentally ill causes distress and challenges for the primary caregiver and the family members involved in the care. This study aimed to explore the experiences and coping of caregivers living with mentally ill relatives. The researcher utilized Lazarus and Folkman's psychological stress and coping theory and other relevant literature to conceptualize the study. The study made use of a qualitative and exploratory design. Seven individual face-to-face interviews were conducted with semi-structured questions. Purposeful and snowball samples were used, and the study was analyzed using thematic analysis. Based on the study's findings, caring for a mentally ill relative had negative and positive outcomes for the caregiver. There were more negative experiences than there were positive ones. However, caregivers found ways to cope with these negative experiences. These findings should contribute to educating health professionals who are the primary contact for mentally ill patients and their family caregivers in rural communities. This will assist in pursuit of the third Sustainable Development goals (SDG3) which aims to “ensure healthy lives and promote well-being for all at all ages”. This study produced an understanding of the lived experiences of caregivers in a rural Eastern Cape. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Koti, Tulisile
- Date: 2022-12
- Subjects: Caregivers -- Eastern Cape , Mental illness -- Eastern Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60166 , vital:63208
- Description: Mental illness refers to all diagnosable mental disorders, whether by a medical doctor or a psychiatrist. It includes significant changes in thinking, emotion, and behavior and may result in distress or difficulty functioning in society, work or family. South Africa has been on a de-institutionalization path for several decades, despite this, many mentally ill people are forced to live at home with their families. As a result, family caregivers have been faced with responsibilities for which they are unprepared. The burden of caring for the mentally ill causes distress and challenges for the primary caregiver and the family members involved in the care. This study aimed to explore the experiences and coping of caregivers living with mentally ill relatives. The researcher utilized Lazarus and Folkman's psychological stress and coping theory and other relevant literature to conceptualize the study. The study made use of a qualitative and exploratory design. Seven individual face-to-face interviews were conducted with semi-structured questions. Purposeful and snowball samples were used, and the study was analyzed using thematic analysis. Based on the study's findings, caring for a mentally ill relative had negative and positive outcomes for the caregiver. There were more negative experiences than there were positive ones. However, caregivers found ways to cope with these negative experiences. These findings should contribute to educating health professionals who are the primary contact for mentally ill patients and their family caregivers in rural communities. This will assist in pursuit of the third Sustainable Development goals (SDG3) which aims to “ensure healthy lives and promote well-being for all at all ages”. This study produced an understanding of the lived experiences of caregivers in a rural Eastern Cape. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Infant feeding practices of mothers with infants under six months of age in the Nelson Mandela Bay Community Health Centres within Sub-district C
- Authors: Moss, Caryn Ruth
- Date: 2022-12
- Subjects: Breastfeeding , Breastfeeding -- Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60177 , vital:63212
- Description: Background: Infant feeding practices refers to the type of feeding methods that are used to provide nutrition to the infant. This includes breastfeeding, donor milk, formula milk, and complementary feeds. Globally, breastfeeding is the recommended infant feeding practice for infants under six months of age with the introduction of complementary feeds after six months of age (WHO, 2018a). The purpose of the study was to explore and describe the infant feeding practices of mothers with infants under six months of age in Nelson Mandela Bay. The researcher explored and described the different infant feeding practices of mothers with infants under six months of age. Method: A quantitative, descriptive study design was conducted and included 150 respondents, 18 years old and above, with infants under six months of age. Convenience sampling was used, and the respondents were from five Nelson Mandela Bay Community Health Centres (CHCs) in Sub-district C. Data were collected using a fieldworker employing a mask-to-mask approach to adhere to COVID-19 principles and a questionnaire with open-ended and closed-ended questions. Data were analysed using the statistical package for the social sciences (SPSS®) software with the use of descriptive statistical analysis. Results: The results revealed that 63% (n=94) of the respondents had breastfed their infant while 37% (n=56) had never breastfed their infant. Most of the respondents, 85% (n=128) recorded that they received advice after birth. Of the respondents, 37% (n=56), gave their infant formula milk instead of breastfeeding. In addition, 33% (n=29) of the infants were given soft foods at two months old as well as 32% (n=32.3) were given liquids at the same age. Conclusion: The study findings revealed that most mothers with infants under six months of age in the Nelson Mandela Bay CHCs Sub-district C introduced complementary feeds before their infants turned six months old. The results also revealed that respondents introduced complementary feeds because the infant was still hungry. Family members, friends, and healthcare practitioners play an important role when a mother chooses a feeding practice for her infant. Recommendations are made to mothers to provide age-appropriate feeding practices. Furthermore, viii recommendations are made to nurse educators to include training regarding up-to-date infant feeding practices to undergraduate nursing students. Lastly, it is recommended that research comparing infant feeding practices in the three Sub-districts in Nelson Mandela Bay be conducted. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Moss, Caryn Ruth
- Date: 2022-12
- Subjects: Breastfeeding , Breastfeeding -- Complications
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60177 , vital:63212
- Description: Background: Infant feeding practices refers to the type of feeding methods that are used to provide nutrition to the infant. This includes breastfeeding, donor milk, formula milk, and complementary feeds. Globally, breastfeeding is the recommended infant feeding practice for infants under six months of age with the introduction of complementary feeds after six months of age (WHO, 2018a). The purpose of the study was to explore and describe the infant feeding practices of mothers with infants under six months of age in Nelson Mandela Bay. The researcher explored and described the different infant feeding practices of mothers with infants under six months of age. Method: A quantitative, descriptive study design was conducted and included 150 respondents, 18 years old and above, with infants under six months of age. Convenience sampling was used, and the respondents were from five Nelson Mandela Bay Community Health Centres (CHCs) in Sub-district C. Data were collected using a fieldworker employing a mask-to-mask approach to adhere to COVID-19 principles and a questionnaire with open-ended and closed-ended questions. Data were analysed using the statistical package for the social sciences (SPSS®) software with the use of descriptive statistical analysis. Results: The results revealed that 63% (n=94) of the respondents had breastfed their infant while 37% (n=56) had never breastfed their infant. Most of the respondents, 85% (n=128) recorded that they received advice after birth. Of the respondents, 37% (n=56), gave their infant formula milk instead of breastfeeding. In addition, 33% (n=29) of the infants were given soft foods at two months old as well as 32% (n=32.3) were given liquids at the same age. Conclusion: The study findings revealed that most mothers with infants under six months of age in the Nelson Mandela Bay CHCs Sub-district C introduced complementary feeds before their infants turned six months old. The results also revealed that respondents introduced complementary feeds because the infant was still hungry. Family members, friends, and healthcare practitioners play an important role when a mother chooses a feeding practice for her infant. Recommendations are made to mothers to provide age-appropriate feeding practices. Furthermore, viii recommendations are made to nurse educators to include training regarding up-to-date infant feeding practices to undergraduate nursing students. Lastly, it is recommended that research comparing infant feeding practices in the three Sub-districts in Nelson Mandela Bay be conducted. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Justification of chest mobile radiographic examinations: experiences of radiographers in a private radiology practice in the Nelson Mandela Bay Health District
- Authors: Barnardo,Linda-Ann
- Date: 2022-12
- Subjects: Radiography, Medical -- Positioning , Radiation -- Safety measures , Radiologic technologists
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69669 , vital:78009
- Description: The principle of justification in radiographic imaging aims to best answer a medical question while evaluating the expected benefits of radiation exposure against the probable detriment to the individual patient. The implementation of justification in radiography requires the assessment and evaluation of chest mobile radiographic requests against justification criteria, considering the underpinning principles of radiation: justification, optimisation and authorisation. Diagnostic chest mobile radiographic imaging has been part of healthcare for the last century. Medico-legal requirements by the professional registration body, the Health Professions Council of South Africa (HPCSA), identify justification as an advocated and obligatory practice among radiographers. Yet, justification remains an inconsistent practice among South African radiographers due to several challenges in the healthcare setting. The aim of this study was to investigate the experiences of radiographers regarding the justification of chest mobile radiographic examination requests in a private radiology practice in the Nelson Mandela Bay Health District (NMBHD). A qualitative, exploratory-descriptive and contextual research design was used to gain in-depth data of the experiences of South African radiographers regarding the justification of chest mobile radiographic requests. Data were gathered from the participants using unstructured, open-ended, in-depth individual interviews. Data were transcribed verbatim and coded using Tesch’s eight steps of data coding and analysis process. Two principal themes were constructed during data analysis. Theme one identified the barriers and associated affective responses related to the appropriate implementation of justification of mobile chest radiographic examinations. Theme two recognised recommendations to enhance the implementation of justification by radiographers for mobile chest radiographic examinations. The research study was governed by methods to ensure trustworthiness and ethical practices. Based on the findings of this study, four recommendations were developed to assist radiographers to establish whether a request for mobile radiographic chest examinations is appropriately justified, which can contribute to establishing a radiation safety culture in the research setting pertaining to chest mobile radiography. , Thesis (MTech) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Barnardo,Linda-Ann
- Date: 2022-12
- Subjects: Radiography, Medical -- Positioning , Radiation -- Safety measures , Radiologic technologists
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/69669 , vital:78009
- Description: The principle of justification in radiographic imaging aims to best answer a medical question while evaluating the expected benefits of radiation exposure against the probable detriment to the individual patient. The implementation of justification in radiography requires the assessment and evaluation of chest mobile radiographic requests against justification criteria, considering the underpinning principles of radiation: justification, optimisation and authorisation. Diagnostic chest mobile radiographic imaging has been part of healthcare for the last century. Medico-legal requirements by the professional registration body, the Health Professions Council of South Africa (HPCSA), identify justification as an advocated and obligatory practice among radiographers. Yet, justification remains an inconsistent practice among South African radiographers due to several challenges in the healthcare setting. The aim of this study was to investigate the experiences of radiographers regarding the justification of chest mobile radiographic examination requests in a private radiology practice in the Nelson Mandela Bay Health District (NMBHD). A qualitative, exploratory-descriptive and contextual research design was used to gain in-depth data of the experiences of South African radiographers regarding the justification of chest mobile radiographic requests. Data were gathered from the participants using unstructured, open-ended, in-depth individual interviews. Data were transcribed verbatim and coded using Tesch’s eight steps of data coding and analysis process. Two principal themes were constructed during data analysis. Theme one identified the barriers and associated affective responses related to the appropriate implementation of justification of mobile chest radiographic examinations. Theme two recognised recommendations to enhance the implementation of justification by radiographers for mobile chest radiographic examinations. The research study was governed by methods to ensure trustworthiness and ethical practices. Based on the findings of this study, four recommendations were developed to assist radiographers to establish whether a request for mobile radiographic chest examinations is appropriately justified, which can contribute to establishing a radiation safety culture in the research setting pertaining to chest mobile radiography. , Thesis (MTech) -- Faculty of Health Sciences, School of Clinical Care & Medicinal Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Knee Joint Competence Post Anterior Cruciate Ligament Reconstruction in Amateur South Western Districts Rugby Players
- Potgieter, Quinten Christiaan
- Authors: Potgieter, Quinten Christiaan
- Date: 2022-12
- Subjects: Neuromuscular depolarizing agents , Knee--Wounds and injuries -- South Western Districts , Rugby Players
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60266 , vital:64289
- Description: Background: Globally, literature has shown that rugby players struggle to return to the same level of performance post anterior cruciate ligament (ACL) reconstruction. This phenomenon is further exacerbated amongst South African Rugby players, compounded by the ranking of the national team amongst the top ten rugby teams worldwide. Paired with the psychosocial aspect of return to play, the physical and physiological competence of the knee joint is of pivotal importance. Purpose: To compare relative dynamic stability scores paired with electromyography (EMG) scores between the injured and uninjured legs, thereby enabling an explorative, descriptive report on dynamic proprioceptive abilities post ACL reconstruction (ACLR). The study findings therefore aim to inform rehabilitative practice in a rugby player who underwent ACLR. Study Design: A quantitative, explorative and descriptive design was used, with a purposive sampling strategy. Methods: Biographical and anthropometrical data was measured upon inception. Muscular activation was measured using electromyography (EMG) placements on quadriceps muscles which included the vastus medialis obliques (VMO), and vastus lateralis (VL). Dynamic proprioception was measured using the star excursion balance test (SEBT) and normalised to leg length. A neuromuscular fatigue protocol was used to measure the impact of neuromuscular fatigue on dynamic stability, and muscle activation between the injured and uninjured lower limbs. Results: A sample of 15 participants from the South Western Districts (SWD) rugby team, fitting the inclusion criteria, were included in the study. The average age was 27±2.7 years. The results indicated that fatigue did not significantly affect the SEBT scores between the injured and uninjured lower limbs. However, the VMO muscle activation showed a statistically significant difference in muscle firing in a pre-fatigue state. This difference was evident in two of the eight directions namely anteromedial direction (p = 0.041), and in the lateral direction (p = 0.047). Furthermore, these result differences were favoured in the uninjured limb. No significant differences between the injured and uninjured lower limbs were found in respect to VMO and VL muscle activation, in a fatigued state. vi Conclusion: Practically translated, the study results showed that the injured lower limb, showed no significant differences in dynamic stability during both the non-fatigued and the fatigued SEBT. Therefore, the finding of this study is a steppingstone towards informing return to play criteria for adequate dynamic knee stability and proprioception. It should be noted that further research is necessary to refine return to play criteria and thereby decrease the risk for re-injury. Keywords: anterior cruciate ligament; dynamic stability; neuro-muscular fatigue; reconstruction; re-injury; return-to-sport; rugby. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Potgieter, Quinten Christiaan
- Date: 2022-12
- Subjects: Neuromuscular depolarizing agents , Knee--Wounds and injuries -- South Western Districts , Rugby Players
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60266 , vital:64289
- Description: Background: Globally, literature has shown that rugby players struggle to return to the same level of performance post anterior cruciate ligament (ACL) reconstruction. This phenomenon is further exacerbated amongst South African Rugby players, compounded by the ranking of the national team amongst the top ten rugby teams worldwide. Paired with the psychosocial aspect of return to play, the physical and physiological competence of the knee joint is of pivotal importance. Purpose: To compare relative dynamic stability scores paired with electromyography (EMG) scores between the injured and uninjured legs, thereby enabling an explorative, descriptive report on dynamic proprioceptive abilities post ACL reconstruction (ACLR). The study findings therefore aim to inform rehabilitative practice in a rugby player who underwent ACLR. Study Design: A quantitative, explorative and descriptive design was used, with a purposive sampling strategy. Methods: Biographical and anthropometrical data was measured upon inception. Muscular activation was measured using electromyography (EMG) placements on quadriceps muscles which included the vastus medialis obliques (VMO), and vastus lateralis (VL). Dynamic proprioception was measured using the star excursion balance test (SEBT) and normalised to leg length. A neuromuscular fatigue protocol was used to measure the impact of neuromuscular fatigue on dynamic stability, and muscle activation between the injured and uninjured lower limbs. Results: A sample of 15 participants from the South Western Districts (SWD) rugby team, fitting the inclusion criteria, were included in the study. The average age was 27±2.7 years. The results indicated that fatigue did not significantly affect the SEBT scores between the injured and uninjured lower limbs. However, the VMO muscle activation showed a statistically significant difference in muscle firing in a pre-fatigue state. This difference was evident in two of the eight directions namely anteromedial direction (p = 0.041), and in the lateral direction (p = 0.047). Furthermore, these result differences were favoured in the uninjured limb. No significant differences between the injured and uninjured lower limbs were found in respect to VMO and VL muscle activation, in a fatigued state. vi Conclusion: Practically translated, the study results showed that the injured lower limb, showed no significant differences in dynamic stability during both the non-fatigued and the fatigued SEBT. Therefore, the finding of this study is a steppingstone towards informing return to play criteria for adequate dynamic knee stability and proprioception. It should be noted that further research is necessary to refine return to play criteria and thereby decrease the risk for re-injury. Keywords: anterior cruciate ligament; dynamic stability; neuro-muscular fatigue; reconstruction; re-injury; return-to-sport; rugby. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Knowledge, attitude and perceptions of pre-hospital emergency care providers concerning pre-hospital clinical practice guidelines in the Mangaung Metropolitan area, Free State, South Africa
- Ramoshaba, Mapule Petronella
- Authors: Ramoshaba, Mapule Petronella
- Date: 2022-12
- Subjects: Emergency medical services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27220 , vital:66471
- Description: Background and Introduction. Pre-hospital emergency care provided in a timeous and efficient manner is a pivotal component in improved patient prognosis, after a life altering situation has occurred. This management of patients is rendered prior to arrival at a medical facility. This service is provided by pre-hospital emergency care providers who apply life saving techniques and knowledge within their scopes of practice and then transporting patients to appropriate medical facilities for definitive care. Pre-hospital emergency care providers of all levels of care, namely: Basic life support, Intermediate life support and Advanced life support render emergency care services to patients with a main goal of seeing patients return back to normal life living. For this to be achieved, the providers must be empowered with the best knowledge, appropriate skills and adequate equipment at their disposal. Clinical practice guidelines are recommendations that are based on evidence in order to support beneficial clinical practices. These were introduced in the pre-hospital setting in South Africa in 2018 to review the scopes of practice of all levels of care, and make appropriate changes and additions for the betterment of the patient and the upskilling of pre-hospital emergency care providers. Since the providers are the end users of these guidelines, and are expected to apply them on patients, they are the best candidates to provide clarity on their perceptions, experiences and challenges which leads to the research questions being: What are the perceptions of the Pre-hospital Emergency Care Providers on the Pre-hospital Clinical Practice in the Guidelines? And What are the challenges experienced by the Pre-hospital Emergency Care Providers with regards to the implementation of the Pre-hospital Clinical Practice Guidelines in the application of Pre-hospital emergency medicine? The aim of the study was to explore the perceptions of the Pre-hospital Emergency Care Providers using the implemented Pre-hospital Clinical Practice Guidelines. Methods The study adopted a qualitative research approach with a purposive sampling method used to select the participants. This type of non-probability technique was suitable in the study as it is based on the researcher’s judgement of the participants being knowledgeable on the questions asked. An interview guide was utilised to collect data through semi-structured one on one interviews during which participants perceptions on the Clinical practice guidelines were shared. The data analysis process brought forth themes and sub themes that were aligned to the research findings which yielded the results. Results/findings The results encompassed the participants’ perceptions about pre-hospital clinical Practice Guidelines, as well as their knowledge, attitude, challenges, suggestions and recommendations. These results unearthed some of the reasons for the pre-hospital emergency care providers perceptions towards the guidelines. The majority of PECPS have a positive attitude towards the pre-hospital clinical practice guidelines, but have challenges with the availability of equipment and drugs which is caused by the lack of due diligence in complying with the implementation of the guidelines. Conclusion The recommendations and suggestions from the participants and researcher come with divisive strategies to the implementation of the guidelines and activities to be applied for the smooth implementation of the pre-hospital clinical practice guidelines. The basis for these recommendations and suggestions were the results as per the research findings. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Ramoshaba, Mapule Petronella
- Date: 2022-12
- Subjects: Emergency medical services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27220 , vital:66471
- Description: Background and Introduction. Pre-hospital emergency care provided in a timeous and efficient manner is a pivotal component in improved patient prognosis, after a life altering situation has occurred. This management of patients is rendered prior to arrival at a medical facility. This service is provided by pre-hospital emergency care providers who apply life saving techniques and knowledge within their scopes of practice and then transporting patients to appropriate medical facilities for definitive care. Pre-hospital emergency care providers of all levels of care, namely: Basic life support, Intermediate life support and Advanced life support render emergency care services to patients with a main goal of seeing patients return back to normal life living. For this to be achieved, the providers must be empowered with the best knowledge, appropriate skills and adequate equipment at their disposal. Clinical practice guidelines are recommendations that are based on evidence in order to support beneficial clinical practices. These were introduced in the pre-hospital setting in South Africa in 2018 to review the scopes of practice of all levels of care, and make appropriate changes and additions for the betterment of the patient and the upskilling of pre-hospital emergency care providers. Since the providers are the end users of these guidelines, and are expected to apply them on patients, they are the best candidates to provide clarity on their perceptions, experiences and challenges which leads to the research questions being: What are the perceptions of the Pre-hospital Emergency Care Providers on the Pre-hospital Clinical Practice in the Guidelines? And What are the challenges experienced by the Pre-hospital Emergency Care Providers with regards to the implementation of the Pre-hospital Clinical Practice Guidelines in the application of Pre-hospital emergency medicine? The aim of the study was to explore the perceptions of the Pre-hospital Emergency Care Providers using the implemented Pre-hospital Clinical Practice Guidelines. Methods The study adopted a qualitative research approach with a purposive sampling method used to select the participants. This type of non-probability technique was suitable in the study as it is based on the researcher’s judgement of the participants being knowledgeable on the questions asked. An interview guide was utilised to collect data through semi-structured one on one interviews during which participants perceptions on the Clinical practice guidelines were shared. The data analysis process brought forth themes and sub themes that were aligned to the research findings which yielded the results. Results/findings The results encompassed the participants’ perceptions about pre-hospital clinical Practice Guidelines, as well as their knowledge, attitude, challenges, suggestions and recommendations. These results unearthed some of the reasons for the pre-hospital emergency care providers perceptions towards the guidelines. The majority of PECPS have a positive attitude towards the pre-hospital clinical practice guidelines, but have challenges with the availability of equipment and drugs which is caused by the lack of due diligence in complying with the implementation of the guidelines. Conclusion The recommendations and suggestions from the participants and researcher come with divisive strategies to the implementation of the guidelines and activities to be applied for the smooth implementation of the pre-hospital clinical practice guidelines. The basis for these recommendations and suggestions were the results as per the research findings. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Perceptions of Kwazulu-Natal radiographers regarding the role of professional development in clinical practice
- Authors: Zulu Anelisa
- Date: 2022-12
- Subjects: Radiography -- KwaZulu Natal , radiographers regarding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60290 , vital:64292
- Description: Professional development in the form of continuing education is associated with professional competence and good service delivery to the patient, and this understanding of professional development applies to the radiography profession. A manager may prompt participation in professional development, or the needs of a radiography department may influence it, or it may be driven by the personal and professional ambitions of the radiographer. Participation could also be due to regulatory body requirements, which require tracking and documentation as in the case of the Health Professions Council of South Africa (HPCSA) which may audit the professional’s continuing professional development (CPD) compliance. Professional development is a concept inclusive of all learning such as CPD; postgraduate qualifications; staff development; and reflective practice, pursued for the betterment of the radiographers’ professional expertise. Few if any qualitative studies have sought to explore South African radiographers’ perceptions of professional development as a concept inclusive of all learning. The purpose of the study was to explore and describe the perceptions of KwaZulu-Natal radiographers regarding the role of professional development in clinical practice to make recommendations to radiography managers on how to optimise the participation of radiographers in professional development. Bandura’s social learning theory was used as the theoretical framework for a study of the perceptions of practising KZN radiographers regarding the role of professional development in clinical practice and exploring how people learn from one another, including concepts such as observational learning, imitation, and modelling. The target population for the study consisted of practising radiographers working in the public and private, rural and urban hospitals in KZN. Data were gathered using semi-structured one-on-one interviews and were coded using Tesch’s eight steps. The trustworthiness of this study was enhanced using Lincoln and Guba’s (1985) model of trustworthiness, namely: credibility, transferability, dependability and confirmability. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Zulu Anelisa
- Date: 2022-12
- Subjects: Radiography -- KwaZulu Natal , radiographers regarding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60290 , vital:64292
- Description: Professional development in the form of continuing education is associated with professional competence and good service delivery to the patient, and this understanding of professional development applies to the radiography profession. A manager may prompt participation in professional development, or the needs of a radiography department may influence it, or it may be driven by the personal and professional ambitions of the radiographer. Participation could also be due to regulatory body requirements, which require tracking and documentation as in the case of the Health Professions Council of South Africa (HPCSA) which may audit the professional’s continuing professional development (CPD) compliance. Professional development is a concept inclusive of all learning such as CPD; postgraduate qualifications; staff development; and reflective practice, pursued for the betterment of the radiographers’ professional expertise. Few if any qualitative studies have sought to explore South African radiographers’ perceptions of professional development as a concept inclusive of all learning. The purpose of the study was to explore and describe the perceptions of KwaZulu-Natal radiographers regarding the role of professional development in clinical practice to make recommendations to radiography managers on how to optimise the participation of radiographers in professional development. Bandura’s social learning theory was used as the theoretical framework for a study of the perceptions of practising KZN radiographers regarding the role of professional development in clinical practice and exploring how people learn from one another, including concepts such as observational learning, imitation, and modelling. The target population for the study consisted of practising radiographers working in the public and private, rural and urban hospitals in KZN. Data were gathered using semi-structured one-on-one interviews and were coded using Tesch’s eight steps. The trustworthiness of this study was enhanced using Lincoln and Guba’s (1985) model of trustworthiness, namely: credibility, transferability, dependability and confirmability. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Psychologists’ perceptions of the growth and change promoting factors in psychotherapy within a culturally diverse South Africa
- Authors: Heyneke, Wilmie
- Date: 2022-12
- Subjects: Psychotherapy -- South Africa , therapeutic alliance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60155 , vital:63207
- Description: The therapeutic relationship established between a psychologist and a client is considered one of the main factors determining successful psychotherapy outcomes. While this may be the case, there remain inconsistencies in the literature and debate regarding its influence, especially when contextual factors such as diverse beliefs, may influence the therapeutic relationship. Furthermore, there is a scarcity of information focusing on psychologists’ experiences working within the culturally diverse South African context. This study aimed to better understand, from a psychologist’s perspective, the growth and change promoting factors they feel are influencing successful therapeutic outcomes within the South African context. This was pursued recognising that the diverse belief systems in South Africa, which do not always adhere to biomedical conceptualisations of health and illness, may influence the therapeutic interaction. This study explored the following research question: What are the key factors that promote growth and change in individual psychotherapy within the diverse South African context? Drawing on a qualitative approach, an explorative descriptive research design was chosen as it enabled the researcher to explore the perceptions of the participants on the given topic. The sampling technique that was employed was non-probability purposive sampling and psychologists registered with the Health Professionals Council of South Africa formed part of the sample. In-depth online interviewing was employed as the data collection tool, using online platforms like Microsoft Teams and Zoom. Data were analysed using Braun and Clarke’s thematic analysis guidelines and themes that were identified was reported. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Heyneke, Wilmie
- Date: 2022-12
- Subjects: Psychotherapy -- South Africa , therapeutic alliance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60155 , vital:63207
- Description: The therapeutic relationship established between a psychologist and a client is considered one of the main factors determining successful psychotherapy outcomes. While this may be the case, there remain inconsistencies in the literature and debate regarding its influence, especially when contextual factors such as diverse beliefs, may influence the therapeutic relationship. Furthermore, there is a scarcity of information focusing on psychologists’ experiences working within the culturally diverse South African context. This study aimed to better understand, from a psychologist’s perspective, the growth and change promoting factors they feel are influencing successful therapeutic outcomes within the South African context. This was pursued recognising that the diverse belief systems in South Africa, which do not always adhere to biomedical conceptualisations of health and illness, may influence the therapeutic interaction. This study explored the following research question: What are the key factors that promote growth and change in individual psychotherapy within the diverse South African context? Drawing on a qualitative approach, an explorative descriptive research design was chosen as it enabled the researcher to explore the perceptions of the participants on the given topic. The sampling technique that was employed was non-probability purposive sampling and psychologists registered with the Health Professionals Council of South Africa formed part of the sample. In-depth online interviewing was employed as the data collection tool, using online platforms like Microsoft Teams and Zoom. Data were analysed using Braun and Clarke’s thematic analysis guidelines and themes that were identified was reported. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Barriers to utilisation of antenatal care services in Bloemfontein, sub-district of Mangaung Metro, Free State, South Africa
- Montshiwa, Kgalalelo Christine
- Authors: Montshiwa, Kgalalelo Christine
- Date: 2022-11
- Subjects: Prenatal care
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26995 , vital:66212
- Description: Background: Maternal and child mortality remain a global health problem, regardless of preventative measures put in place. Antenatal care is crucial to decrease maternal and child morbidity and mortality. However, in Bloemfontein, the sub-district of Mangaung Metro in the Free State, it has been identified that women utilise this kind of service sub-optimally. The study aimed to explore and describe barriers to the utilisation of antenatal care by pregnant women in the Bloemfontein sub-district of Mangaung Metro. Methodology: This study was qualitative and used an explorative, descriptive design. Qualitative data was collected by using focus group discussions and key informants’ interviews. Three focus group discussions with twenty-five pregnant and lactating mothers, aged between 18 and 49 years, were conducted. Participants took part in one focus group discussion at each healthcare facility. Four key informant interviews were conducted with four facility managers and one professional midwife who conducted ANC at the clinic at the time of the study in the three healthcare facilities. A thematic analysis process was used to analyse the collected qualitative data under each identified barrier. The STATA version 15 was used in the analysis of the demographic characteristics of the participants. Results: Most of the participants indicated that they are aware of the importance of attending ANC appointments however, they have voiced that the delayed waiting times and staff attitudes contribute to how they feel about visiting a clinic early. Some of the participants mentioned that they have cultural barriers as they still believe that a traditional pregnant woman should not reveal her pregnancy in the early days but must rather wait until her stomach has grown significantly for her to visit the clinic. Two participants indicated that they had unplanned pregnancies and wanted to do an abortion, but their religious beliefs prevented them to choose to terminate their pregnancies. Economically, not all participants complained about their financial situation though the majority were unemployed and single. Participants from the Bloemspruit facility complained of transport as they stay far from the clinic and they are sometimes forced to walk alone which makes it difficult to attend all their booked sessions with their midwives. The results of the study revealed that there are several factors contributing to late antenatal care attendance namely provider and personal factors contributing to late antenatal care attendance in the Bloemfontein sub-district of Mangaung Metro. Personal factors that were found to be contributing to late antenatal care booking were lack of transport, especially for Bloemspruit participants, unwanted pregnancy, lack of financial support, lack of partner support, cultural and religious beliefs, and lack of knowledge. Provider factors that were found to be contributing to late booking were lack of resources like tools of the trade, long waiting times, poor infrastructure, human resources, and midwives’ attitudes. Recommendations. To deploy qualified midwives to conduct antenatal care clinics, to extend the service over the weekends as participants mentioned that they struggle to get time off from work during the week. Health promotion and community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services. , Thesis (MPA) -- Faculty of Health Sciences, 2023
- Full Text:
- Date Issued: 2022-11
- Authors: Montshiwa, Kgalalelo Christine
- Date: 2022-11
- Subjects: Prenatal care
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26995 , vital:66212
- Description: Background: Maternal and child mortality remain a global health problem, regardless of preventative measures put in place. Antenatal care is crucial to decrease maternal and child morbidity and mortality. However, in Bloemfontein, the sub-district of Mangaung Metro in the Free State, it has been identified that women utilise this kind of service sub-optimally. The study aimed to explore and describe barriers to the utilisation of antenatal care by pregnant women in the Bloemfontein sub-district of Mangaung Metro. Methodology: This study was qualitative and used an explorative, descriptive design. Qualitative data was collected by using focus group discussions and key informants’ interviews. Three focus group discussions with twenty-five pregnant and lactating mothers, aged between 18 and 49 years, were conducted. Participants took part in one focus group discussion at each healthcare facility. Four key informant interviews were conducted with four facility managers and one professional midwife who conducted ANC at the clinic at the time of the study in the three healthcare facilities. A thematic analysis process was used to analyse the collected qualitative data under each identified barrier. The STATA version 15 was used in the analysis of the demographic characteristics of the participants. Results: Most of the participants indicated that they are aware of the importance of attending ANC appointments however, they have voiced that the delayed waiting times and staff attitudes contribute to how they feel about visiting a clinic early. Some of the participants mentioned that they have cultural barriers as they still believe that a traditional pregnant woman should not reveal her pregnancy in the early days but must rather wait until her stomach has grown significantly for her to visit the clinic. Two participants indicated that they had unplanned pregnancies and wanted to do an abortion, but their religious beliefs prevented them to choose to terminate their pregnancies. Economically, not all participants complained about their financial situation though the majority were unemployed and single. Participants from the Bloemspruit facility complained of transport as they stay far from the clinic and they are sometimes forced to walk alone which makes it difficult to attend all their booked sessions with their midwives. The results of the study revealed that there are several factors contributing to late antenatal care attendance namely provider and personal factors contributing to late antenatal care attendance in the Bloemfontein sub-district of Mangaung Metro. Personal factors that were found to be contributing to late antenatal care booking were lack of transport, especially for Bloemspruit participants, unwanted pregnancy, lack of financial support, lack of partner support, cultural and religious beliefs, and lack of knowledge. Provider factors that were found to be contributing to late booking were lack of resources like tools of the trade, long waiting times, poor infrastructure, human resources, and midwives’ attitudes. Recommendations. To deploy qualified midwives to conduct antenatal care clinics, to extend the service over the weekends as participants mentioned that they struggle to get time off from work during the week. Health promotion and community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services. , Thesis (MPA) -- Faculty of Health Sciences, 2023
- Full Text:
- Date Issued: 2022-11
Older persons’ perceptions of services that support positive ageing in the Khayelitsha and Gugulethu districts of the Western cape
- Authors: Tshefu-Mavimbela, Siphokazi
- Date: 2022-11
- Subjects: Aging -- Western Cape , Older people -- Western Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60389 , vital:64705
- Description: Globally people are growing older, and nearly every country is experiencing an increase in their ageing populace. In 1960 older people made up 5 % of the world population, while in 2018, they were about 9% of the overall population. Projections are that in 2050 people over the age of 65 will make up 16% of the overall population. To respond to an ageing population, a government must ensure that its policy framework can respond to the needs of its citizens. A society that supports a positive ageing environment improves older people’s well-being. In our complex society, each person is dependent on others in various ways, and social, emotional and practical interdependence is a feature of the human social condition. This means that older people do not function well in isolation but need support for positive ageing. This research project focused on older people’s perceptions of services that support their positive ageing in the Khayelitsha and Gugulethu districts of the Western Cape, South Africa. The theoretical framework employed in the study is Systems Theory. The research approach utilised in the study is qualitative with an explorative and descriptive research design. A non-probability purposive, criterion-based sampling technique was employed. The researcher recruited eleven older persons aged sixty years and above in the Khayelitsha and Gugulethu areas. An NGO that works with older persons’ served as gatekeepers. Semi-structured telephonic interviews were conducted. The data collected was analysed using thematic data analysis. The trustworthiness of the research process was enhanced using Guba’s model. Ethical principles as set out in the Belmont report were also adhered to. The key findings of the current study indicated that in Khayelitsha and Gugulethu areas, there are available services that support positive ageing, such as clubs, excursions and social grants. Environmental aspects challenging positive ageing included unfavourable home conditions such as financial burden and ill-treatment, poverty and unemployment, health problems, and COVID-19 effects. Older people mentioned that there are available but inadequate services such as municipal services and care facilities. Thus, they recommended that there should be poverty alleviation schemes, community development projects such as crafting, gardening, sewing, and more institutions and home-based care for older people. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-11
- Authors: Tshefu-Mavimbela, Siphokazi
- Date: 2022-11
- Subjects: Aging -- Western Cape , Older people -- Western Cape
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/60389 , vital:64705
- Description: Globally people are growing older, and nearly every country is experiencing an increase in their ageing populace. In 1960 older people made up 5 % of the world population, while in 2018, they were about 9% of the overall population. Projections are that in 2050 people over the age of 65 will make up 16% of the overall population. To respond to an ageing population, a government must ensure that its policy framework can respond to the needs of its citizens. A society that supports a positive ageing environment improves older people’s well-being. In our complex society, each person is dependent on others in various ways, and social, emotional and practical interdependence is a feature of the human social condition. This means that older people do not function well in isolation but need support for positive ageing. This research project focused on older people’s perceptions of services that support their positive ageing in the Khayelitsha and Gugulethu districts of the Western Cape, South Africa. The theoretical framework employed in the study is Systems Theory. The research approach utilised in the study is qualitative with an explorative and descriptive research design. A non-probability purposive, criterion-based sampling technique was employed. The researcher recruited eleven older persons aged sixty years and above in the Khayelitsha and Gugulethu areas. An NGO that works with older persons’ served as gatekeepers. Semi-structured telephonic interviews were conducted. The data collected was analysed using thematic data analysis. The trustworthiness of the research process was enhanced using Guba’s model. Ethical principles as set out in the Belmont report were also adhered to. The key findings of the current study indicated that in Khayelitsha and Gugulethu areas, there are available services that support positive ageing, such as clubs, excursions and social grants. Environmental aspects challenging positive ageing included unfavourable home conditions such as financial burden and ill-treatment, poverty and unemployment, health problems, and COVID-19 effects. Older people mentioned that there are available but inadequate services such as municipal services and care facilities. Thus, they recommended that there should be poverty alleviation schemes, community development projects such as crafting, gardening, sewing, and more institutions and home-based care for older people. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-11
Perceptions of stakeholders in schools on the implementation of school sport policy in school sport development in the Amathole-west district, Eastern Cape
- Authors: Xakaxa, M Z
- Date: 2022-11
- Subjects: Sports administration , Sports and state
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27959 , vital:70943
- Description: This study aimed to explore the perceptions of stakeholders in schools regarding the implementation of school sport policy and its impact on school sport development in the Amathole-west district of the Eastern Cape, South Africa. The research sought to examine teachers' knowledge of the Department of Basic Education's school sport policy, assess whether the policy promotes school sport development, identify ways to enhance its implementation in Amathole-west, and propose strategies for the effective implementation of the policy by the Department of Basic Education. Adopting a qualitative interpretivist research approach, the study employed in-depth one-on-one interviews, focus group discussions, and document analysis. A purposive sample of 20 participants was selected, grouped into four focus groups, to contribute valuable insights to the study. Drawing on the Participatory School Governance model and the Social Ecological Model, the findings revealed that teachers, members of the School Management Team, and School Governing Body members perceive sports as essential for learners, as they promote physical health and instill discipline and moral behavior. However, the study also highlighted that teachers and School Governing Body members play a limited role in the implementation of school sport policy and development. Instead, they tend to rely on externally qualified sports experts, resulting in reduced involvement in policy implementation. The study emphasizes the need for improved involvement and investment in school sport policy implementation. Additionally, several strategies were suggested to ensure the effective implementation of school sport policy. These include providing Continued Professional Development (CPD) opportunities for teachers and increasing awareness about the sports policy. In conclusion, this study sheds light on the perceptions of school stakeholders regarding the implementation of school sport policy and the development of school sports in Amathole-west, South Africa. The findings underscore the importance of enhancing teachers' involvement and knowledge in policy implementation and recommend strategies for the successful implementation of the school sport policy , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-11
- Authors: Xakaxa, M Z
- Date: 2022-11
- Subjects: Sports administration , Sports and state
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27959 , vital:70943
- Description: This study aimed to explore the perceptions of stakeholders in schools regarding the implementation of school sport policy and its impact on school sport development in the Amathole-west district of the Eastern Cape, South Africa. The research sought to examine teachers' knowledge of the Department of Basic Education's school sport policy, assess whether the policy promotes school sport development, identify ways to enhance its implementation in Amathole-west, and propose strategies for the effective implementation of the policy by the Department of Basic Education. Adopting a qualitative interpretivist research approach, the study employed in-depth one-on-one interviews, focus group discussions, and document analysis. A purposive sample of 20 participants was selected, grouped into four focus groups, to contribute valuable insights to the study. Drawing on the Participatory School Governance model and the Social Ecological Model, the findings revealed that teachers, members of the School Management Team, and School Governing Body members perceive sports as essential for learners, as they promote physical health and instill discipline and moral behavior. However, the study also highlighted that teachers and School Governing Body members play a limited role in the implementation of school sport policy and development. Instead, they tend to rely on externally qualified sports experts, resulting in reduced involvement in policy implementation. The study emphasizes the need for improved involvement and investment in school sport policy implementation. Additionally, several strategies were suggested to ensure the effective implementation of school sport policy. These include providing Continued Professional Development (CPD) opportunities for teachers and increasing awareness about the sports policy. In conclusion, this study sheds light on the perceptions of school stakeholders regarding the implementation of school sport policy and the development of school sports in Amathole-west, South Africa. The findings underscore the importance of enhancing teachers' involvement and knowledge in policy implementation and recommend strategies for the successful implementation of the school sport policy , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-11
Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: COVID-19 (Disease) , Contact tracing (Epidemiology) , Public health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23533 , vital:58105
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3percent), 18 in April (10.5percent), 41 in May (22.9percent), and 28 in June (15.6percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5percentby the end of June 2020. Of all the contacts traced, 7.9percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09