An assessment of quality health care in the operating theatres of Frere Hospital in the Eastern Cape
- Authors: Bennett, Fabion Charton
- Date: 2018
- Subjects: Medical care Surgical instruments and apparatus -- Safety measures
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13425 , vital:39660
- Description: BACKGROUND: Operating theatres are one of most expensive resources in a hospital. The management of operating theatres is complex due to the conflicting priorities and preferences of all stakeholders. Operating theatres also pose one of the greatest medico legal risks to any hospital. This study was conducted at Frere Hospital in East London to assess the functioning of the operating theatre system. The focus of this study was on Pre-operative categorisation of emergency cases, the utilisation of the World Health Organisation Safety Checklist, compliance to the National Core Standards for Health, the effectiveness of governance and review processes, theatre staffing as well as theatre efficiency indicators (start time/tardiness, utilisation, turn-around time, re-admission to theatre rate, cancellation on day of procedure, slate under/over runs, Anaesthetic time as a percentage of theatre time). OBJECTIVE: The purpose of this study was to promote the adherence to the various operating theatre universal approaches by operating theatre staff with the goal of reducing costs and errors caused by poor quality in operating theatres and improving the overall health system. METHOD: In this research a convergent parallel mixed method research design was applied. The research was non-experimental and descriptive in approach, using a mixed method questionnaire, a structured open ended interview, a structured infrastructure assessment, a structured observation checklist and an audit of patient files for a review of emergency surgical cases. Data was collected during October 2016 and January 2017.The study population consisted of 13 operating rooms across 6 operating theatre suites, surgical management staff as well as clinical and nursing staff in the operating theatres at Frere Hospital in East London. RESULTS: The study showed opportunities for improvement in the overall management of the operating theatres to ensure efficient quality care; the data from the observations, questionnaires, interviews as well as the analysis of the efficiency indicators consistently showed that an effective process of operating theatre governance and performance is non-existent, the Pre- operative categorisation of emergency cases is inconsistently applied, the compliance to the principles of the World Health Organisation Safety Checklist Is very low, theatre nursing staff levels per case is low, staff are also demotivated and theatre efficiency indicators require improvement. During this study, the Paediatric theatre suite appeared to be well run and compliant with opportunity to increase theatre utilisation, the casualty theatre is underutilised and has potential to be utilised as an enabler to improve the efficiency of other theatres. The main theatre and endoscopy suites have opportunities to improve its compliance to universal operating theatre quality and efficiency standards, the Orthopaedics and Obstetrics theatre suites, however, require urgent improvement focus. DISCUSSION: According to the findings, a structured operating theatre governance and performance review processes should be implemented with the intention of ensuring consistency across the management of the 6 operating theatre suites in the hospital. A review of staffing allocation and relative task allocation should be conducted. Interventions should be implemented to increase utilisation rates, improve the pre-operative categorisation of emergency cases, improve the compliance to the principles of the World Health Organisation Safety Checklist, reduce case start time variance/tardiness, reduce cancellation on day of procedure, increase anaesthetic time as a percentage of theatre time by introducing pre- anaesthetic induction prior to the patient being wheeled into the operating room.
- Full Text:
An assessment of quality health care in the operating theatres of Frere Hospital in the Eastern Cape
- Authors: Bennett, Fabion Charton
- Date: 2018
- Subjects: Medical care Surgical instruments and apparatus -- Safety measures
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13425 , vital:39660
- Description: BACKGROUND: Operating theatres are one of most expensive resources in a hospital. The management of operating theatres is complex due to the conflicting priorities and preferences of all stakeholders. Operating theatres also pose one of the greatest medico legal risks to any hospital. This study was conducted at Frere Hospital in East London to assess the functioning of the operating theatre system. The focus of this study was on Pre-operative categorisation of emergency cases, the utilisation of the World Health Organisation Safety Checklist, compliance to the National Core Standards for Health, the effectiveness of governance and review processes, theatre staffing as well as theatre efficiency indicators (start time/tardiness, utilisation, turn-around time, re-admission to theatre rate, cancellation on day of procedure, slate under/over runs, Anaesthetic time as a percentage of theatre time). OBJECTIVE: The purpose of this study was to promote the adherence to the various operating theatre universal approaches by operating theatre staff with the goal of reducing costs and errors caused by poor quality in operating theatres and improving the overall health system. METHOD: In this research a convergent parallel mixed method research design was applied. The research was non-experimental and descriptive in approach, using a mixed method questionnaire, a structured open ended interview, a structured infrastructure assessment, a structured observation checklist and an audit of patient files for a review of emergency surgical cases. Data was collected during October 2016 and January 2017.The study population consisted of 13 operating rooms across 6 operating theatre suites, surgical management staff as well as clinical and nursing staff in the operating theatres at Frere Hospital in East London. RESULTS: The study showed opportunities for improvement in the overall management of the operating theatres to ensure efficient quality care; the data from the observations, questionnaires, interviews as well as the analysis of the efficiency indicators consistently showed that an effective process of operating theatre governance and performance is non-existent, the Pre- operative categorisation of emergency cases is inconsistently applied, the compliance to the principles of the World Health Organisation Safety Checklist Is very low, theatre nursing staff levels per case is low, staff are also demotivated and theatre efficiency indicators require improvement. During this study, the Paediatric theatre suite appeared to be well run and compliant with opportunity to increase theatre utilisation, the casualty theatre is underutilised and has potential to be utilised as an enabler to improve the efficiency of other theatres. The main theatre and endoscopy suites have opportunities to improve its compliance to universal operating theatre quality and efficiency standards, the Orthopaedics and Obstetrics theatre suites, however, require urgent improvement focus. DISCUSSION: According to the findings, a structured operating theatre governance and performance review processes should be implemented with the intention of ensuring consistency across the management of the 6 operating theatre suites in the hospital. A review of staffing allocation and relative task allocation should be conducted. Interventions should be implemented to increase utilisation rates, improve the pre-operative categorisation of emergency cases, improve the compliance to the principles of the World Health Organisation Safety Checklist, reduce case start time variance/tardiness, reduce cancellation on day of procedure, increase anaesthetic time as a percentage of theatre time by introducing pre- anaesthetic induction prior to the patient being wheeled into the operating room.
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An exploration of first-time mothers' experiences of exclusive breastfeeding and support in the Buffalo City Metropolitan, South Africa
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
- Full Text:
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
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An intervention for high-risk type 2 diabetic clients during preconception and internatal in re-engineering of primary health care
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
- Full Text:
- Authors: Ngoma, Siphokazi Amanda
- Date: 2018
- Subjects: Diabetes Diabetes Mellitus, Type 2
- Language: English
- Type: Thesis , Masters , (MCur) Nursing
- Identifier: http://hdl.handle.net/10353/10199 , vital:35375
- Description: The South African disease profile has changed significantly and has increasing prevalence of overweight and obesity in relation to body mass index. Type 2 diabetes mellitus is greatly associated with increased body mass index and poses a great health concern for women of childbearing age. Complications of type 2 diabetes mellitus in pregnancy has life-threatening for the mother and baby. South African women have a tendency of avoiding and neglecting routine screening before pregnancy, that is part of preconception care or internatal care. The aim of the study sought to identify women of childbearing age with predisposing factors of type 2 diabetes, in order to intervene, using a lifestyle modification to delay and prevent the occurrence of type 2 diabetes. A quantitative intervention study using parallel group randomized control trials was used. One hundred and forty-six women of childbearing age (18-45 years) were recruited and assigned to either control (n=73 + 9) or experimental group (n=73 +9). using a computer software randomizer application to avoid bias in selection of participants by the researcher. Both groups received health education from the researcher and the dietician from hospital. The control group had no intervention done, whereas the experimental group attended physical activity sessions which were administered by a hired lay coach. The findings showed that both groups are at risk of developing type 2 diabetes although they both groups lose weight. The weight loss of the control group was owed to education during recruitment. Vegetable consumption was minimal to the younger age group than the older age groups. Waist circumference above 105cm consumed less vegetables, a higher waist circumference is associated with insulin resistance. There was also minimal exercises and knowledge about the preconception care. Diabetes prevention is vital for the women of childbearing age as it affects both mother and child. The study recommends lifestyle modification (exercise and healthy diet) to prevent and delay of type 2 diabetes and gestational diabetes mellitus. The study also recommends Preconception care and Re- engineering of Primary health care uses community health care workers for screening high risk women during home visits.
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An intervention study for low risk pregnant women and high risk pregnant women with GDM in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
- Full Text:
- Authors: Vellem, Nonceba Mercy
- Date: 2018
- Subjects: Diabetes in pregnancy -- South Africa Nursing services -- South Africa -- Eastern Cape -- Administration Pregnancy -- Complications
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/9723 , vital:34891
- Description: Low risk and high risk pregnant women (HRPW) with gestational diabetes mellitus (GDM) who practise sedentary life style are at risk of overweight and obesity that predispose to gestational diabetes mellitus (GDM). The purpose of the study is to describe the effectiveness of an intervention strategy of modified diet and planned physical activity implemented amongst low-risk and high-risk pregnant women with GDM in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Quantitative experimental intervention design and stratified random sampling was used for drawing a sample of low-risk and high risk pregnant women with GDM. A sample size 291 of LRPW and n=34 HRPW were eligible for the study. The sample frame of the study was taken from the registers of the CHCs, Frere Hospital and Cecilia Makiwane Hospital (CMH). Questionnaires were used to collect data from the low and high risk pregnant with GDM. Descriptive statistics (frequency, percentages, mean and standard deviation) were used for categorical variables. A p-value of < 0.05 was considered statistically significant. The total analysed of LRPW were n=135 and HRPW n=34 all in control group due to miscarriages, phone loss and relocation. LRPW had some risk factors of overweight (6.2 percent), obesity (15.5 percent), family history of diabetes (16.5 percent). HRPW also had overweight and obesity of (14.7 percent) and family history of (26.4 percent) as the Pvalue was statistically significant of weight was 001, MUAC Pvalue of 000 and Pvalue of BMI 000. There were alarming abnormalities of urinalysis of protein, glucose, leucocytes and blood in urine. The LRPW and HRPW had consumption of high content of carbohydrates, vegetables, fats and low in fruit, vegetables and fibre diet. Both LRPW and HRPW were also interested on the education about modified diet benefits (95.1 percent) and modified diet programs networks (87.5 percent). The barriers showed that LRPW and HRPW were low motivation (90 percent) minimal knowledge and benefits of modified diet (93 percent) and socio-cultural issues (86 percent). The majority of participants both LRPW and HRPW showed the interest in the planned physical activity benefits especially frequent education (96.9 percent) and encouragement of social support networks (90.2 percent) and convenient location (89.4 percent). But the HRPW had lower engagement than the LRPW in planned physical activity and is associated with risk of GDM. Although pregnant women were faced with fatigue and low energy (98.6 percent), as pregnancy progresses, minimum information regarding benefits of planned physical activity (87.6 percent) and the socio-cultural influence (77.8 percent). The recommendations are education on frequent use of modified diet and planned physical activity that is available, less economical and within their context. Frequent screening of all pregnant women during pregnancy of BMI, MUAC and weight and educate accordingly. The availability of dietician and physical activity speciality is needed.
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An investigation into births before arrival in healthcare facilities in uThungulu Health District during a period of 1 April 2014 to 31 March 2015
- Mkhwanazi, Cynthia Nqobile Nokuthula
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
- Full Text:
- Authors: Mkhwanazi, Cynthia Nqobile Nokuthula
- Date: 2018
- Subjects: Childbirth Childbirth at home
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11161 , vital:37198
- Description: Births Before Arrival (BBAs) in healthcare facilities is a worldwide health challenge. These births results with diverse obstetric and neonatal complications which could be avoided should delivery took place in an accredited environment. Delivery in health facility rate and Births Before Arrival is one of the vital measures used to monitor access as well as quality of Maternal and Child health services. A birth before arrival in health institutions happens accidentally and unattended by skilled health professionals outside the healthcare facilities (Lazic & Takač, 2011). It is found in both developed and developing countries with various adverse outcomes ranging from haemorrhage to death. Important strides had been taken to improve maternal and child health globally but the healthcare facilities are still experiencing an overwhelming number of births before arrival in healthcare facilities. This is a public health concern. The purpose of the study was to identify factors associated with Births before Arrival in UThungulu Health District facilities and determine the prevalence of BBAs and the neonatal and maternal morbidity and mortality associated with it. A retrospective quantitative research design was used. Maternity clinical records Reviews of 238 Births Before Arrival (BBA) in healthcare facilities that occurred between 1 April 2014 to 31 March 2015 were conducted in the six hospitals in UThungulu Health District. The births before arrival data was analysed using SPSS (Statistical Package for Social Science) version 23, for Windows and used for descriptive and inferential analysis. The reasons for BBA included poor ante natal education of mothers on early signs of labour, lack of transport, poor use of maternity waiting areas and some clinics do not conduct deliveries. The majority of study participants were single (unmarried) and this accentuates the importance of strengthening family planning coverage in this area. Poor reporting of early neonatal deaths and stillbirths was one of the significant observations made during the study. Deceased babies were left at home and buried without being registered at home affairs. Taking cognizance of diverse risks and health needs of expectant women would assist the Health department in planning for adequate coverage for provision of suitable pregnancy care that would improve the health of women and their babies.
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An investigation into factors influencing lack of improvement towards achieving compliance with the quality national core standards in KSD clinics, O.R. Tambo District
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
- Full Text:
- Authors: Mnyamana, Tozama Nobom
- Date: 2018
- Subjects: Health facilities--Standards , Health facilities--South Africa , Medical care--South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/19498 , vital:43133
- Description: The purpose of this study was to explore factors associated with lack of improvement in the health care provided towards achieving compliance with the National Core Standards (NCS) in King Sabata Dalindyebo (KSD) sub-district clinics, in OR Tambo District in the Eastern Cape. A quantitative design was seen as the most suitable for this study. This method was chosen as the one that would best assist the researcher to meet the objectives of the study. A purposive sampling method was chosen, according to which the researcher selected five sites; all clinics that had been previously inspected for quality standards by the Office of Health Standards Compliance at least once. Participants for the study were all employees of those clinics and one representative of the governing structure of each. Twenty-eight participants in total formed part of the study as two did not return their responses. For collecting data from the participants, self-administered questionnaires were used. Throughout the data collection process, ethical standards of nursing research regarding anonymity, confidentiality and privacy were adhered to. Collected data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of results is presented in tables and bar graphs. The results of the study reveal that a quality-oriented culture is lacking in our clinics with poor participation of clinics teams in quality improvement processes. Leadership and management at clinic level need strengthening. It was also found that there is insufficient capacitation of departmental strategic shift innovations, revealed in the complete absence of information sharing and feedback regarding previous assessments. In addition, there is a shortage of resources including basic equipment in clinics. , Thesis (MPH) -- University of Fort Hare, 2018
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Analysis of the role of unions in health services delivery at Uitenhage district hospital
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
- Full Text:
- Authors: Tshamase, Nozibele Yvonne
- Date: 2018
- Subjects: Public health Health services accessibility Labor unions
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12348 , vital:39255
- Description: Purpose: According to Khan and Khan (2011:56), a trade union is an organization of employee tasked with activities which include negotiating on behalf of their members for “pay and conditions of employment”. Several authors have purported that these roles extend beyond ensuring not only that the rights of workers are not violated and that their working environment complies with health and safety standards, but also that unions may have an effect on management practices, generally and specifically, on efficiencies and performance (Zulu, 2009; McGuire, 2011; & Dhliwayo, 2012). Health care workers including professionals are organised by the unions in a bid to influence social and economic reforms in the South African democracy. The main aim of this study was to examine the role of public sector unions and how they exercise their functions in delivery of health services Method: A qualitative research method based on phenomenological and case approaches was applied. Semi-structured interviews with open ended questions were used to prompt discussions. Documents were used to obtain complementary data. Senior managers, middle managers, union/employee representatives and employees who are members of the unions in the district hospital of Nelson Mandela Bay health district constituted the target population. Purposive non-probability sampling, which was the preferred method for this study, yielded 16 participants. Results Analysis followed Creswell’s thematic analysis involving coding responses categorising them and identifying themes. This followed repeated and thorough listening to the recorded interviews and transcribing. Themes identified were organisational functioning in line with the service delivery context; worker’s rights protection; negotiating better service conditions; implementing legislation, policies and resolutions; union-management interaction; engaging in strikes and impact on services delivery. Conclusion and Recommendations: The study found that the presence of unions in health care services was necessary because there are various categories of employees – working class – whose interests must be served. The role of the unions leaned heavily towards protection of the rights of the workers. As far as the observation of legislation is concerned, the unions demonstrated knowledge of the legislation applicable to the health care personnel, that is, the BCEA, the LRA and the PSA. The study found that unions were a hindrance to health services delivery in their quest to exercise voice monopoly. The unions tended to exert undue influence on management resulting in lack of discipline and dereliction of duty. The strike actions compromised quality of health care and the rights of citizens to access health care. There was no active participation nor positive contributions in committees where advancement of service delivery standards were deliberated and promoted. Recommendations included training of shop stewards; capacitation and training of managers, and development and communication of departmental labour relations policies.
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Application of health belief model in developing contextual guidelines for adherence to antiretroviral treatment among adolescents and youths in Buffalo City Metropolitan Municipality District, East London, South Africa
- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
- Full Text:
- Authors: Mayeye, Bulelwa
- Date: 2018
- Subjects: HIV-positive children--Treatment--Management AIDS (Disease) in adolescence HIV-positive youth
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/15572 , vital:40472
- Description: Background: Adhering to the treatment instructions for a long-term illness poses a great challenge to the client especially adolescents and youths. In public health centers it is observed that most adolescents and youths on Ante Retroviral Treatment (ART) do not continue taking ART and do not honor their Art related scheduled appointments at the clinic. An increase loss to follow up among these cohorts is noticeable in Buffalo City Metropolitan Municipality district. Inconsistent adherence to ART may result in the development of resistance mutations. Purpose: The purpose of the study was to develop and describe context – specific antiretroviral treatment guidelines based on the biomedical, cognitive and psychosocial needs of the adolescents and youths at the Buffalo City Metropolitan Municipality district. Methodology: The study was conducted in two phases, phase one consisted of quantitative and qualitative approaches. For phase one an explanatory sequential mixed method of quantitative and qualitative designs was employed. The study was guided by Health Belief Model. The target population were adolescents and youths receiving ART from the selected health facilities in Buffalo City Metropolitan Municipality District in the Province of the Eastern Cape. Participants were chosen based on purposive sampling. A convenience sample of 206 adolescents and youths between the ages of 14 to 24 attending ARV clinics were approached. Ethical considerations, that is, the rights of all the participants were honoured. Data was collected using self administered questionnaires followed by semi-structured interview where face to face interviews were conducted. Reliability validity and trustworthiness of the research was ensured. Quantitative data was analysed through descriptive statistics. For qualitative approach transcrips were coded thematically. In Phase 2, context – specific antiretroviral treatment guidelines were developed to promote adherence to ART by adolescents and youths of Buffalo City Metropolitan Municipality district. Results: About 35percent of the participants indicated low adherence, 31percent for moderate adherence and 34percent for high adherence. A strong correlation between interpersonal relationship and adherence (p = 0.008), a correlation between aspect of care related to clinic and adherence (p = 0.028), a significant correlation between social support and adherence to ART (p = 0.006) and a significant relationship between self- efficacy and adherence to ART (p = 0.000) were obtained. No correlation between demographic status and adherence except for race. Results from the interviews revealed that barriers to adherence were more evident than enabling factors. Recommendations: Health service providers should strengthen ART adherence programmes for adolescents and youths by applying principles as they appear in the context – based guidelines.
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Assessment of the effect of the down-referral chronic medication distribution system on patients' adherence to chronic medication in the Buffalo City sub-district
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
- Full Text:
- Authors: Ndwandwe, Miriam
- Date: 2018
- Subjects: Health services accessibility Pharmacology Patient compliance
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13248 , vital:39626
- Description: The purpose of the study is to determine the effect of the down referral chronic medication distribution system on patient's adherence to chronic medicine in Buffalo City sub - district by ensuring that chronic patients receive their correct medication on time and in correct quantities every month so that they can take the medication as recommended by the health professional. Adherence to chronic medication lead to better health outcome and reduced hospital re-admission. A non-experimental and descriptive quantitative research methodology was used. A data abstraction form developed by the researcher was used to record data from the medical records of chronically ill patients. The results of the study revealed that most of the chronically ill patients who were admitted to hospital were not adherent to their chronic medication. Patients are non-adherent even if they have chronic medication with them. This was evident in the number of patients who do not remember how many days did they not take their treatment. Others indicated that they share their medication with other family members who suffer from the same chronic condition. The patients' lack of understanding of their chronic condition and the consequences of not taking medication as instructed by the health professional contribute to non-adherence. Strengthening of health promotion programmes to educate the patients about their chronic condition would improve adherence. Most of the chronic conditions are life-style modifiable diseases. Patients must be educated about the changes they can make to improve their quality of life.
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Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape: views of students and educators
- Terblanche, Delcia Jill Nora
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
- Full Text:
- Authors: Terblanche, Delcia Jill Nora
- Date: 2018
- Subjects: AIDS (Disease) -- Study and teaching , AIDS (Disease) -- Prevention , Universities and colleges
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12359 , vital:39256
- Description: Background: HIV/AIDS is a major global public health problem. The higher education sector too, is affected by the scourge of HIV/AIDS. Universities are considered to be high- risks areas for HIV infection because many students indulged in high risky behaviour link to HIV infection; therefore developing ways to prevent students for acquiring HIV and as well reducing HIV prevalence rates through training and teaching about HIV/AIDS will contribute to change in behaviour of students. Anecdotal evidence suggests that the majority of the students at Fort Hare lack the general awareness and education in HIV/AIDS due to lack of information coupled with their general disadvantaged background with the ultimate result being threatened by high infection rates. The University of Fort Hare (UFH), in a bid to capacitate the academic staff in respect of the laudable initiative to integrate HIV/AIDS in curricula, decided to embark on a pilot study that is anticipated to form fundamental strategies to sustainable HIV/AIDS curricula integration across all faculties, at least by the end of 2030. The university has planned to engage in the curriculum integration process by implementing a two year cycle pilot study during the grant period. Aim: The main aim of the study was to assess the challenges faced by students and educators concerning the integration and implementation of HIV/AIDS curriculum at the University of Fort Hare. Methods: The study adopted a quantitative, explorative descriptive design to examine the challenges associated with the Integrated HIV/AIDS curriculum at the University of Fort Hare. The target population was the educators and students who had training and teaching in the Integrated HIV/AIDS curriculum. A purposive sampling was used to select 487 students and 23 educators from across three departments: Nursing Science, LKA (Life, Knowledge and Action) and Law involved in the HIV/AIDS Curriculum Integration programme at the university. A self-design questionnaire was used for data collection focusing on the demographic profiles of the participants, the teaching strategies and methodologies adopted in the Integrated HIV/AIDS curriculum, the usefulness and relevance of the newly integrated HIV/AIDS curriculum content in addressing the needs of the students and the community, and the challenges faced by the educators and students in the Integrated HIV/AIDS curriculum. Ethical approved was obtained from the Research Ethics Committee of the University of Fort Hare. Permission was obtained from the participants through written consent forms. The data was analysed using descriptive statistics (frequency counts, percentage, means and standard deviations (SD)). The Chi-square test was used to examine the relationship between the variables of interest across the departments. A p-value of 0.05 was set for statistical significant testing. Results: The majority of the participants have adequate knowledge of HIV transmission, as 93.2 percent indicated HIV can be contracted through unprotected sex, sharing of needles (92.1 percent), receiving a blood transfusion that has not been screened for HIV (83.9 percent), sharing razor blades that has not been disinfected (83.0 percent), and having more than one sexual partner (86 percent). Age, gender, race and department were significantly associated with knowledge of route of HIV transmission. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3 percent), followed by undated materials, and curriculum overloading and teaching. The study indicated that majority of the students would like to compile a portfolio of evidence in the teaching of HIV, followed by creative arts, DVD/movies, and internet research. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants stated that HIV/AIDS information would be useful to them to apply in their communities and in their profession (97 percent), emphasizing that such knowledge and information will empower them to participate in roadshows and voluntary work at HIV/AIDS Shelters. The findings of this study pertaining to the challenges faced by educators during the implementation of the Integrated HIV/AIDS curriculum revealed that the majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. Conclusions: Majority of the students received teaching of HIV as part of a course, and HIV teaching as an integrated component in a subject, while few received it as a stand-alone subject offered by a lecturer/facilitator. The present study indicated that the participants experienced several challenges during the teaching of the Integrated HIV/AIDS curriculum. Time allocated was the biggest challenge (58.3percent), followed by undated materials, and curriculum overloading and teaching. The majority of students preferred HIV/AIDS to be taught by their peers experience in HIV, by face-to face by a person who is HIV/AIDS infected or affected. The majority of the lecturers preferred to teach HIV/AIDS through expressive arts, followed by role play, and formal lectures. The majority of the participants affirmed the relevancy of HIV information taught. They further indicated that the information and knowledge gain would able them to make informed decisions on sexual behaviour. The majority of the participants stated that the HIV information was not updated, heavy workload, and adequate training. Most of the educators used formal lectures, followed by compilation of a portfolio of evidence, storytelling, DVD and movies, and experiential learning in hospitals and clinics in teaching HIV/AIDS integrated curriculum. The lecturers expressed that they would prefer to teach HIV/AIDS curriculum by expressive art through drawing and creating art that expresses HIV and the relevance in the students’ community. It is recommended that student’s involvement in the decision making processes of the integrated HIV/AIDS curriculum at the University of Fort Hare would make the programme more successful. HIV/AIDS resource materials need to be updated regularly and relevant to provide educators with specialized knowledge to be able to teach HIV/AIDS.
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Challenges hindering the implementation of quality supervision in primary health care facilities in Oliver Reginald Tambo District, Eastern Cape Province
- Zamxaka, Nontlantla Caroline
- Authors: Zamxaka, Nontlantla Caroline
- Date: 2018
- Subjects: Hospitals -- Administration , Health services administration , Hospitals -- Business management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/29256 , vital:77707
- Description: The study investigated the factors that prevent quality supervision in primary health care(PHC) facilities in Oliver Reginald Tambo (O.R. Tambo) district of the Eastern Cape Province of South Africa. The motivation for this study was a concern regarding consistently poor performance by PHC facilities in the province despite regular supervisory visits. The objectives of the study were to explore practices of PHC supervisors in implementing supervision, and to assess perceptions, opinions, and attitudes of PHC supervisors and PHC operational managers with regards to PHC supervisory visits. On search methodology, qualitative approach was predominating whilst quantitative data was supplementing the study. A purposive sample of PHC supervisors and operational managers was drawn from PHC facilities which had a consistent, 100% rate of supervisory visits. The data was analysed thematically. The results revealed systemic and structural challenges that affect the implementation of quality supervision, rendering supervisory visits inefficient. These were: a high workload resulting from inconsistency in the allocation of facilities, as well as the many other responsibilities which supervisors have; a lack of knowledge and experience in supervisors; a lack of health service resources including transport; a high turnover of nurses; lack of support from the district and sub-district leadership and management; lack of collaboration, coordination and integration of activities; and delayed procurement processes resulting in a recurring lack of equipment and medical supplies. The findings of the study brought an understanding of the systemic and structural requirements that need to be made for a functioning quality supervisory system. Successful interventions require strengthening of leadership and governance, and the diligent application of the systems approach to solving problems at facility, district and provincial level. An improvement in leadership and governance should include innovative strategies to utilise the limited resources available without compromising the key objective of quality health care. , Thesis (MPH) -- Faculty of Health Sciences, 2018
- Full Text:
- Authors: Zamxaka, Nontlantla Caroline
- Date: 2018
- Subjects: Hospitals -- Administration , Health services administration , Hospitals -- Business management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/29256 , vital:77707
- Description: The study investigated the factors that prevent quality supervision in primary health care(PHC) facilities in Oliver Reginald Tambo (O.R. Tambo) district of the Eastern Cape Province of South Africa. The motivation for this study was a concern regarding consistently poor performance by PHC facilities in the province despite regular supervisory visits. The objectives of the study were to explore practices of PHC supervisors in implementing supervision, and to assess perceptions, opinions, and attitudes of PHC supervisors and PHC operational managers with regards to PHC supervisory visits. On search methodology, qualitative approach was predominating whilst quantitative data was supplementing the study. A purposive sample of PHC supervisors and operational managers was drawn from PHC facilities which had a consistent, 100% rate of supervisory visits. The data was analysed thematically. The results revealed systemic and structural challenges that affect the implementation of quality supervision, rendering supervisory visits inefficient. These were: a high workload resulting from inconsistency in the allocation of facilities, as well as the many other responsibilities which supervisors have; a lack of knowledge and experience in supervisors; a lack of health service resources including transport; a high turnover of nurses; lack of support from the district and sub-district leadership and management; lack of collaboration, coordination and integration of activities; and delayed procurement processes resulting in a recurring lack of equipment and medical supplies. The findings of the study brought an understanding of the systemic and structural requirements that need to be made for a functioning quality supervisory system. Successful interventions require strengthening of leadership and governance, and the diligent application of the systems approach to solving problems at facility, district and provincial level. An improvement in leadership and governance should include innovative strategies to utilise the limited resources available without compromising the key objective of quality health care. , Thesis (MPH) -- Faculty of Health Sciences, 2018
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Comparison of contraceptive discontinuation in users of a copper intrauterine device against depot medroxyprogesterone acetate injectable
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
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Developing a model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province, South Africa
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
- Full Text:
- Authors: Gomwe, Howard
- Date: 2018
- Subjects: Physical fitness for children -- South Africa Physical education for children Schools -- Health promotion services
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10050 , vital:35307
- Description: The challenge of low level participation in physical activity and, consequently, limited physical fitness has been acknowledged as being a national public health concern in South African schools. The main aim of this study was to develop a behavioural model for promoting physical fitness and healthy lifestyle of primary school learners in the Eastern Cape Province in South Africa. The first thing was to determine their physical fitness level and body composition then develop a behavioural model based on the findings. The study was conducted in three phases. A quantitative, qualitative and theory-generating research design was conducted using questionnaires, deductive and inductive strategies and literature triangulation. The study involved primary school learners: 356 boys and 520 girls aged 9-14 years old, who were randomly selected. Anthropometric assessments were conducted using ISAK (Marfell-Jones et al., 2006) and EUROFIT (1988) test batteries.The following measurements of body mass, stature, skinfolds (triceps and subscapular), waist circumference and gluteal were taken. The percent BF was calculated from a sum of two skinfolds (triceps and subscapular), using Slaughter et al.‘ s (1988) equation to predict body fat. Physical fitness measurements included sit and reach, push-ups, sit-ups and a 20 metre shuttle run. Physical activity level and sedentary behaviour were assessed by means of self-report questionnaires. Demographic, psychological and environmental variables were also measured by a self-report questionnaire. Six focus group discussions were conducted with school learners. The physical fitness levels were categorized as hypoactive, minimal active and inactive. Sedentary behaviours were categorized by number of minutes spent on sedentary activities. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ). Food intake was classified as healthy, unhealthy/junk and traditional food. Body composition was measured by calculating body mass index (BMI) (weight/height2) and waist-to-hip ratio, respectively. Categories: underweight: 0<18, normal weight: 18, 5<25, overweight: 25<30 or obese: 30 and blood pressure measurements were classified as healthy and unhealthy. The main findings were as follows: underweight 60, 25 percent: normal weight 30, 54 percent: overweight 4, 18 percent: and obese 5, 02 percent: for the peri-urban school learners. Underweight 64, 78 percent: normal 31, 52 percent: overweight 2,83 percent: and obesity 0,87 percent:for the rural school learners. 56,25 percent underweight: 36,93 percent normal weight: 5,68 percent overweight: and 1,14 percent obese for the urban school learners. The mean body mass of learners from three locations were urban 40.0±10.185; peri-urban 39.8±10.181 and rural 38.7±10.279, respectively. (Chi-square = 3.3107; P=0.191). The mean values stature of all the three residences are urban; 144.1 ±10.400 peri-urban 144.4±9.187 and rural 143.7±12.617 (Chi-square = 1.2651; P=0.5312). The mean waist circumference for urban was (78.4±9.493), peri-urban (78.4±9.399) and rural was (77.1±10.214), respectively (Z=2.474;p=0.2903). The triceps value (z=21.4565p <.0001). Urban (13.9±5.589), (12.5±6.023) for peri-urban and (12.1±6.390) for rural. Subscapular (z=4.1151;p=0.1278). Urban area had (9.3±5.426), (9.3±5.463) for peri-urban and (8.9±6.381) for rural. The mean systolic blood pressure of urban school learners was (109.2±19.512), (107.9±19.273) for peri-urban and (107.4±19.488) for rural school learners. Lumbar and hamstring flexibility (z= 57.733; p<.0001). (25.3±5.507) for urban, (23.0±6.435) for peri-urban and (26.9±6.854) for rural. Sit-up (z=9.8414;p=0.0073). (18.3±12.571) for urban, (19.7±12.323) for peri-urban and (21.7±13.782) for rural area. Push-ups (z= 37.7591p=<.00001). (15.8±10.285) for urban, (18.5±11.086) for peri-urban and (20.9±9.981) for rural area. Maximal oxygen intake (z= 163.186p=<.0001). (25.0±6.454) for urban, (29.9±7.225) for peri-urban and (35.5±11.085) for rural area. PA enjoyment (4.1±0.698) for urban, (4.0±0.764) for peri-urban, (4.0±0.799) for rural. With regard to health-related physical fitness, the learners in the rural and peri-urban better than those in urban areas. PA attitude (z=7.5507;p=0.0563), (2.5±0.792) for urban area, (2.6±0.802) for peri-urban and (2.7±0.890) for rural area. Parental role modelling in PA (z=0.3083; p=<.000). (3.1±1.008) for urban area, (3.3±0.916) for peri-urban (3.1±0.981) for rural area. Peer encouragement (z=2.5367; p=0.2813) (3.4±0.893) for urban, (3.3±1.064) for peri-urban, (3.3±1.005) for rural area. Parental encouragement (z= 7.2266p=0.027),(3.7±0.985) for urban area, (3.5±0.906) for peri-urban and (3.7±0.774 ) for rural area. Teacher encouragement (z=2.0069p=0.3668).The mean values for three residences are (3.5±0.802) for urban area, (3.4±0.784) for peri-urban, (3.5±0.733) for rural areas. Most of the school learners in all the three residences prefer unhealthy/junky food. Based on the results, an exploratory factor analysis was conducted on data to identify and analyse the factors for model development. The findings indicated that there is evidence of low level of physical fitness and high prevalence of excessive weight and obesity among primary school learners, the study, therefore, suggests the development of the behavioural model to enhance physical fitness and prevent or reduce overweight/obesity among school learners.
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Development of health promotion guidelines for weight management among primary health care nurses in the Eastern Cape Province, South Africa
- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
- Full Text:
- Authors: Monakali, Sizeka
- Date: 2018
- Subjects: Health promotion Body weight -- Regulation Obesity -- prevention and control
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10006 , vital:35285
- Description: Overweight and obesity have become significant public health threats both globally and in South Africa. PHC professional nurses are first contact to patients and the community as well as key stakeholders in the management and education of obese patients. However, anecdotal evidence seems to question their suitability as good models of the advocated healthy lifestyle behaviours and weight management, as overweight and obesity is also prevalent among the professional nurses. This study examines the prevalence and determinants of overweight and obesity among PHC professional nurses in the Eastern Cape (EC) Province of South Africa. This was a workplace, cross-sectional study involving 203 PHC professional nurses conveniently selected across 41 PHC facilities in EC, South Africa. A WHO STEP wise questionnaire was used to collect demographic and behavioural data. Anthropometric (weight, height and waist circumference [WC]) measurements were taken following a standard protocol. Overweight and obesity was defined as a BMI of 25-29.9kgm-2, and BMI ≥ 30kgm-2, respectively. Seventy six percent of the nurses were obese. An additional 18 percent were overweight. Age, gender, marital status, duration of practice, alcohol use and smoking were significantly associated with obesity. There was no association between physical activity and obesity. After adjusting for confounders, only age more than 30 years (OR=5.2, 95 percentCI=1.6-16.4) and not using alcohol (OR= 4.0 95 percentCI= 1.7-9.1) were significant and independent predictors of obesity among the nurses. In conclusion is an alarmingly high prevalence of obesity among primary healthcare professional nurses in Eastern Cape, South Africa. This shows that PHC professional nurses in EC are not good models of the healthy behaviours, judge be BMI indicator, if they do advocates for healthy weight management to patients. This constitutes a future risk for an increased prevalence of chronic diseases and a handicapped healthcare workforce. There is a need to implement measures to promote healthy lifestyle behaviour and weight management among professional nurses in this setting.
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Exploring experiences of student nurses regarding the implementation of community-based education at the nursing college in the Eastern Cape
- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
- Full Text:
- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
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Exploring women's experience of fundal pressure during the second stage of labour
- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
- Full Text:
- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
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Factors affecting patient perceptions of service delivery in Postmasburg Hospital in the Z.F. McGawu District, Northern Cape Province, South Africa
- Rakumakoe, Jacob Mogapi Chocky
- Authors: Rakumakoe, Jacob Mogapi Chocky
- Date: 2018
- Subjects: Public health -- South Africa -- Northern Cape Medical care -- South Africa -- Northern Cape Health services accessibility
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/17805 , vital:41262
- Description: Background: There is a requirement to provide proper and safe quality service to patients, hence a view from patients was deemed important as it can help the hospital to improve services rendered to them. There were two Provincial assessments done on National Core Standards in Postmasburg Hospital (overall scores were 32percent in 2013 and 48percent in 2014) and on both occasions, the Hospital failed to comply with the assessments and the implication were a suspected negative impact on the Hospital service delivery. The repercussions could be that the hospital might not be certified or not funded through National Health Insurance following a national assessment if the status quo remains. Aim: The aim of the study was to describe the factors affecting patients’ perceptions of service delivery in order to inform health policy decisions to improve service delivery. Methodology: A quantitative descriptive design was used to collect data on 133 adult patients admitted for a minimum of three days in the different hospital wards. Participants were administered a structured pre-tested questionnaire to collect data relating to their employment status, the number of hospital admissions and the reason for hospital admission. Results: About 41.4percent of participants were neutral or not sure whether the nurses/doctors came often to the ward where they were admitted. The majority (51.9percent) were neutral or not sure whether the quality of food in the hospital was good; 53.4percent expressed uncertainty concerning the adequacy of benches/chairs in the hospital for patients to sit while waiting to be seen by the health worker; and 55.6percent participants were neural or not sure whether the ward/room had enough space for consulting. Asked whether the hospital was user-friendly to disabled persons, 53.4percent participants were not sure. About 43.6percent participants expressed uncertainty regarding the registration satisfactory nature of the procedures in the hospital; the water cleanliness for patients in the hospital (42.1percent); whether their privacy was respected by all the staff within the hospital (51.9percent); permission to be examined and treated (51.1percent); the nurse/doctor who treated them being polite (53.4percent); and the nurse/doctor who treated them being able to answer all their questions about their illness (56.8percent). On whether they will visit the hospital again, 49.6percent participants were uncertain. The majority (69.7percent) agreed that all prescribed medicine was available in the hospital; the staff explained to them on how to use the medicine/pills (67percent); and they were told on how to store their pills/medication (47percent). Gender, education and employment status of the participants affect exactly one dimension each. Females, those with secondary education and employed were more satisfied on the respective dimensions. Conclusion: Patient involvement is an essential feature in healthcare services. Patients influence outcome quality through compliance, defining the right symptoms and physically experiencing treatment. Patient perceptions and satisfaction with service delivery is a multi-dimensional concept that should be studied by operationalising it within its context. Consequently, a conceptual model to understand and measure patient perception and satisfaction of service delivery and care quality in hospital health care services is proposed.
- Full Text:
- Authors: Rakumakoe, Jacob Mogapi Chocky
- Date: 2018
- Subjects: Public health -- South Africa -- Northern Cape Medical care -- South Africa -- Northern Cape Health services accessibility
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/17805 , vital:41262
- Description: Background: There is a requirement to provide proper and safe quality service to patients, hence a view from patients was deemed important as it can help the hospital to improve services rendered to them. There were two Provincial assessments done on National Core Standards in Postmasburg Hospital (overall scores were 32percent in 2013 and 48percent in 2014) and on both occasions, the Hospital failed to comply with the assessments and the implication were a suspected negative impact on the Hospital service delivery. The repercussions could be that the hospital might not be certified or not funded through National Health Insurance following a national assessment if the status quo remains. Aim: The aim of the study was to describe the factors affecting patients’ perceptions of service delivery in order to inform health policy decisions to improve service delivery. Methodology: A quantitative descriptive design was used to collect data on 133 adult patients admitted for a minimum of three days in the different hospital wards. Participants were administered a structured pre-tested questionnaire to collect data relating to their employment status, the number of hospital admissions and the reason for hospital admission. Results: About 41.4percent of participants were neutral or not sure whether the nurses/doctors came often to the ward where they were admitted. The majority (51.9percent) were neutral or not sure whether the quality of food in the hospital was good; 53.4percent expressed uncertainty concerning the adequacy of benches/chairs in the hospital for patients to sit while waiting to be seen by the health worker; and 55.6percent participants were neural or not sure whether the ward/room had enough space for consulting. Asked whether the hospital was user-friendly to disabled persons, 53.4percent participants were not sure. About 43.6percent participants expressed uncertainty regarding the registration satisfactory nature of the procedures in the hospital; the water cleanliness for patients in the hospital (42.1percent); whether their privacy was respected by all the staff within the hospital (51.9percent); permission to be examined and treated (51.1percent); the nurse/doctor who treated them being polite (53.4percent); and the nurse/doctor who treated them being able to answer all their questions about their illness (56.8percent). On whether they will visit the hospital again, 49.6percent participants were uncertain. The majority (69.7percent) agreed that all prescribed medicine was available in the hospital; the staff explained to them on how to use the medicine/pills (67percent); and they were told on how to store their pills/medication (47percent). Gender, education and employment status of the participants affect exactly one dimension each. Females, those with secondary education and employed were more satisfied on the respective dimensions. Conclusion: Patient involvement is an essential feature in healthcare services. Patients influence outcome quality through compliance, defining the right symptoms and physically experiencing treatment. Patient perceptions and satisfaction with service delivery is a multi-dimensional concept that should be studied by operationalising it within its context. Consequently, a conceptual model to understand and measure patient perception and satisfaction of service delivery and care quality in hospital health care services is proposed.
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Factors contributing to non-adherence in HIV positive patients on antiretroviral treatment in primary health care facilities, East London, Eastern Cape
- Authors: Petse, Siphokazi
- Date: 2018
- Subjects: Antiretroviral therapy -- Eastern Cape -- South Africa , Patient compliance , HIV-positive persons -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/9734 , vital:34905
- Description: Aim: South Africa is faced with the major challenge of ensuring and sustaining the quality of services, including preventing and managing side- effects, and improving drug adherence, which are all critical, for the success of a comprehensive HIV programme. The aim of this study was to examine the underlying contributing factors to antiretroviral treatment adherence among HIV positive patients attending primary health care facilities in East London. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in xx primary health care facilities in East London, South Africa. The study utilized a self- designed structured questionnaire with both open- ended and closed ended questions, divided into socio-demographic, socio- economic, level of understanding and knowledge on HIV, quality of care and waiting times. Results: About 64 percent of the participants had a good knowledge of HIV, 25 percent had an average knowledge with few participants having poor knowledge of HIV (11 percent). Majority (92.2 percent) were counselled before starting ARVs treatment. Majority of participants (70.7 percent) do have money for transport to come to the clinic, while 53.1 percent experienced side effects. The majority (70 percent) of the participants were non-adherents. Concerning viral load distribution, 52 percent were undetectable, 26 percent unsuppressed and 22 percent suppressed. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant association with non-adherence to ARV treatment among participants. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Conclusion: The main contributing factors to ART non-adherence among participants on ARVs were marital status, level of education, religion, and Christians were more adherent to the treatment than non-Christians. Alcohol consumption also contributed to non-adherence and viral load. Adherence counseling should be done on each and every visit to remind the participants on the importance of taking their treatment. These factors need to be addressed to improve adherence to the treatment, decrease the virus in the blood (viral load) and improve their health in general.
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- Authors: Petse, Siphokazi
- Date: 2018
- Subjects: Antiretroviral therapy -- Eastern Cape -- South Africa , Patient compliance , HIV-positive persons -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/9734 , vital:34905
- Description: Aim: South Africa is faced with the major challenge of ensuring and sustaining the quality of services, including preventing and managing side- effects, and improving drug adherence, which are all critical, for the success of a comprehensive HIV programme. The aim of this study was to examine the underlying contributing factors to antiretroviral treatment adherence among HIV positive patients attending primary health care facilities in East London. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in xx primary health care facilities in East London, South Africa. The study utilized a self- designed structured questionnaire with both open- ended and closed ended questions, divided into socio-demographic, socio- economic, level of understanding and knowledge on HIV, quality of care and waiting times. Results: About 64 percent of the participants had a good knowledge of HIV, 25 percent had an average knowledge with few participants having poor knowledge of HIV (11 percent). Majority (92.2 percent) were counselled before starting ARVs treatment. Majority of participants (70.7 percent) do have money for transport to come to the clinic, while 53.1 percent experienced side effects. The majority (70 percent) of the participants were non-adherents. Concerning viral load distribution, 52 percent were undetectable, 26 percent unsuppressed and 22 percent suppressed. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant association with non-adherence to ARV treatment among participants. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Conclusion: The main contributing factors to ART non-adherence among participants on ARVs were marital status, level of education, religion, and Christians were more adherent to the treatment than non-Christians. Alcohol consumption also contributed to non-adherence and viral load. Adherence counseling should be done on each and every visit to remind the participants on the importance of taking their treatment. These factors need to be addressed to improve adherence to the treatment, decrease the virus in the blood (viral load) and improve their health in general.
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Factors influencing adherence to treatment among clients living with type 2 diabetes mellitus in Insika Yethu sub-district, Eastern Cape Province
- Authors: Somkala, Nwabisa
- Date: 2018
- Subjects: Diabetics Public health Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13161 , vital:39470
- Description: BACKGROUND: Diabetes mellitus (DM) is one of the problematic non-communicable diseases and is a major global public health challenge which affects more than 300 million individuals globally. It is predicted that by the year 2025, approximately 12.3 million South Africans will be receiving treatment for chronic conditions; included in that number will be those living with HIV and diabetes. An individual’s health behaviour is mainly determined by one’s demographic factors such as social, economic and cultural background. These influence people living with type 2 diabetes mellitus and have an impact on their treatment adherence. OBJECTIVES: The purpose of the study was to examine the economic, psycho-social and cultural factors influencing adherence to treatment amongst patients with type 2 diabetes mellitus in order to inform public health policy concerning the treatment and management of diabetic patients. METHODOLOGY: This was a cross-sectional, descriptive quantitative study involving 300 purposively selected clients attending health facilities in Intsika Yethu sub district of Chris Hani, Eastern Cape Province. A self-designed questionnaire was used for data collection. The questionnaire focuses on demographic information (age, gender, marital status, level of education, employment status, number of dependents, duration of taking anti-diabetic medication and existence of other chronic conditions) and the knowledge and attitude of diabetic clients regarding anti-diabetic treatment adherence. Other sections of the questionnaire solicit information on economic, psychosocial and cultural factors affecting adherence to diabetic treatment. The questionnaire was tested in a pilot study in order to identify unclear questions, so that they can be rectified before the main study was conducted. FINDINGS: Based on the findings from the study, a total of 177 (59.0percnt) of the diabetic clients had hypertension and that showed the relationship between diabetes and hypertension. On the attitude session, respondents have shown a positive attitude towards treatment. Furthermore, other objectives such as those focusing on economic, cultural and psychosocial factors were found not to be associated with poor adherence to anti-diabetic treatment. According to respondents’ responses, economic factors showed no influence on treatment adherence. Socio-cultural factors indicated that respondents never missed social gatherings and never used traditional medication to treat their diabetes. On the knowledge section which had fourteen questions, most clients seemed to be aware of the complications of diabetes and the benefits of adhering to anti-diabetic treatment because the lowest score was 50percnt. DATA ANALYSIS: The data was captured in Microsoft Excel (MSEXCEL) for onward processing. Data was analysed using data analysis and statistical software version 14. (STATA). Frequencies and percentages were used for describing the categorical variables while mean and standard deviation were used for describing age, number of dependents, duration of illness and knowledge. An independent t-test was used to determine the differences between males and females across the variables. A p-value of 0.05 was of statistical significance. CONCLUSION: Economic, psychosocial and socio-cultural factors were not found to have impacted on adherence to treatment. These findings should not be generalised as the study was done on a small sample; further research and more studies need to be conducted.
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- Authors: Somkala, Nwabisa
- Date: 2018
- Subjects: Diabetics Public health Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13161 , vital:39470
- Description: BACKGROUND: Diabetes mellitus (DM) is one of the problematic non-communicable diseases and is a major global public health challenge which affects more than 300 million individuals globally. It is predicted that by the year 2025, approximately 12.3 million South Africans will be receiving treatment for chronic conditions; included in that number will be those living with HIV and diabetes. An individual’s health behaviour is mainly determined by one’s demographic factors such as social, economic and cultural background. These influence people living with type 2 diabetes mellitus and have an impact on their treatment adherence. OBJECTIVES: The purpose of the study was to examine the economic, psycho-social and cultural factors influencing adherence to treatment amongst patients with type 2 diabetes mellitus in order to inform public health policy concerning the treatment and management of diabetic patients. METHODOLOGY: This was a cross-sectional, descriptive quantitative study involving 300 purposively selected clients attending health facilities in Intsika Yethu sub district of Chris Hani, Eastern Cape Province. A self-designed questionnaire was used for data collection. The questionnaire focuses on demographic information (age, gender, marital status, level of education, employment status, number of dependents, duration of taking anti-diabetic medication and existence of other chronic conditions) and the knowledge and attitude of diabetic clients regarding anti-diabetic treatment adherence. Other sections of the questionnaire solicit information on economic, psychosocial and cultural factors affecting adherence to diabetic treatment. The questionnaire was tested in a pilot study in order to identify unclear questions, so that they can be rectified before the main study was conducted. FINDINGS: Based on the findings from the study, a total of 177 (59.0percnt) of the diabetic clients had hypertension and that showed the relationship between diabetes and hypertension. On the attitude session, respondents have shown a positive attitude towards treatment. Furthermore, other objectives such as those focusing on economic, cultural and psychosocial factors were found not to be associated with poor adherence to anti-diabetic treatment. According to respondents’ responses, economic factors showed no influence on treatment adherence. Socio-cultural factors indicated that respondents never missed social gatherings and never used traditional medication to treat their diabetes. On the knowledge section which had fourteen questions, most clients seemed to be aware of the complications of diabetes and the benefits of adhering to anti-diabetic treatment because the lowest score was 50percnt. DATA ANALYSIS: The data was captured in Microsoft Excel (MSEXCEL) for onward processing. Data was analysed using data analysis and statistical software version 14. (STATA). Frequencies and percentages were used for describing the categorical variables while mean and standard deviation were used for describing age, number of dependents, duration of illness and knowledge. An independent t-test was used to determine the differences between males and females across the variables. A p-value of 0.05 was of statistical significance. CONCLUSION: Economic, psychosocial and socio-cultural factors were not found to have impacted on adherence to treatment. These findings should not be generalised as the study was done on a small sample; further research and more studies need to be conducted.
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Knowledge, attitudes and practice of professional nurses regarding organ donation in critical care units of public and private hospitals in Eastern Cape Province
- Authors: Green, Bukelwa
- Date: 2018
- Subjects: Organ donors--Supply and demand Donation of organs, tissues, etc Transplantation of organs, tissues
- Language: English
- Type: Thesis , Masters , Magister Curationis
- Identifier: http://hdl.handle.net/10353/11116 , vital:37138
- Description: Globally there is an overwhelming increase in the number of patients waiting for donated organs for transplantation, with a gross shortage of available organs. There are many contributing factors to this dearth of donated organs, including level of knowledge, cultural beliefs, lack of clear practice and the attitudes of health care providers, as the gatekeepers of the health system. This non-experimental research study assessed the attitudes, level of knowledge, and practices of professional nurses working in critical care units in public and private hospitals in Eastern Cape Province regarding organ donation. The study was conducted in both private and public hospital intensive care and renal care units. The targeted population in the study was professional nurses working in intensive and renal care units, trained in critical care or nephrology, as well as those who were not trained but working in these specialised areas. The non-probability, purposive sampling method was employed and total population was 187 professional nurses working in public and private critical care units but only 108 managed to yield data for this study. Data was collected with anonymous, self - developed questionnaires. The questionnaire was submitted to supervisors and statistician for validity. Reliability was established by conducting pretest of the instrument, which yielded positive results because all questionnaires were correctly completed.Data captured and analysed using the Statistical Package for Social Sciences (SPSS) software for Windows version 22 and is presented by means of percentages and tables. Results: The findings were that, there is insufficient knowledge on the topic of organ donation, with subsequent inadequate practice, which derives from lack of pre-registration training and ongoing in-service education regarding the topic. The unavailability of full organ transplantation services in the province is viewed as a hindrance in the practice of organ donation. There was generally a positive attitude towards organ donation, particularly among Christian nurses. The knowledge deficit and limited practice seem not to have affected the attitudes of the participants, who supported the idea of organ donation. However, despite the positive attitudes, only 13 participants (12.0 percent) agreed to be registered as organ donors. 50 percent of participants lacked knowledge about availability and contact details of the provincial organ donation foundation, which may indicate inadequate marketing on the part of the foundation. There was no significant difference in knowledge, attitudes and practice between nurses in the private and public sectors. Rather differences were noted between the different levels of health care services, i.e. between the secondary and tertiary level. The tertiary level outperformed the secondary level institutions. It is recommended that organ donation be incorporated into the syllabi of health sciences courses both in universities and colleges, and that awareness campaigns be strengthened.
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- Authors: Green, Bukelwa
- Date: 2018
- Subjects: Organ donors--Supply and demand Donation of organs, tissues, etc Transplantation of organs, tissues
- Language: English
- Type: Thesis , Masters , Magister Curationis
- Identifier: http://hdl.handle.net/10353/11116 , vital:37138
- Description: Globally there is an overwhelming increase in the number of patients waiting for donated organs for transplantation, with a gross shortage of available organs. There are many contributing factors to this dearth of donated organs, including level of knowledge, cultural beliefs, lack of clear practice and the attitudes of health care providers, as the gatekeepers of the health system. This non-experimental research study assessed the attitudes, level of knowledge, and practices of professional nurses working in critical care units in public and private hospitals in Eastern Cape Province regarding organ donation. The study was conducted in both private and public hospital intensive care and renal care units. The targeted population in the study was professional nurses working in intensive and renal care units, trained in critical care or nephrology, as well as those who were not trained but working in these specialised areas. The non-probability, purposive sampling method was employed and total population was 187 professional nurses working in public and private critical care units but only 108 managed to yield data for this study. Data was collected with anonymous, self - developed questionnaires. The questionnaire was submitted to supervisors and statistician for validity. Reliability was established by conducting pretest of the instrument, which yielded positive results because all questionnaires were correctly completed.Data captured and analysed using the Statistical Package for Social Sciences (SPSS) software for Windows version 22 and is presented by means of percentages and tables. Results: The findings were that, there is insufficient knowledge on the topic of organ donation, with subsequent inadequate practice, which derives from lack of pre-registration training and ongoing in-service education regarding the topic. The unavailability of full organ transplantation services in the province is viewed as a hindrance in the practice of organ donation. There was generally a positive attitude towards organ donation, particularly among Christian nurses. The knowledge deficit and limited practice seem not to have affected the attitudes of the participants, who supported the idea of organ donation. However, despite the positive attitudes, only 13 participants (12.0 percent) agreed to be registered as organ donors. 50 percent of participants lacked knowledge about availability and contact details of the provincial organ donation foundation, which may indicate inadequate marketing on the part of the foundation. There was no significant difference in knowledge, attitudes and practice between nurses in the private and public sectors. Rather differences were noted between the different levels of health care services, i.e. between the secondary and tertiary level. The tertiary level outperformed the secondary level institutions. It is recommended that organ donation be incorporated into the syllabi of health sciences courses both in universities and colleges, and that awareness campaigns be strengthened.
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