Assessment of the integrated HIV/AIDS curriculum at a university in the Eastern Cape: views of students and educators
- 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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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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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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Risk factors of cardio-metabolic diseases among student nurses at Lilitha College of Nursing, East London, South Africa
- Authors: Mkanzi, Noluthando
- Date: 2018
- Subjects: Risk assessment Cardiovascular system -- Diseases Human physiology
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/12924 , vital:39404
- Description: Background: Non-communicable diseases are a growing public health concern and its prevalence is escalating exponentially, with a high frequency of morbidity, premature mortality, disability and loss of productivity. Since health education has become an important part of medical care, student nurses are potentially well suited to assist with the combat of these diseases. Early identification and treatment of modifiable risk factors among young adults would reduce the risk of developing cardio-metabolic diseases, thus, promoting health, prolonging life as well as saving costs related to healthcare. Objective: This study aimed to investigate the prevalence of cardio-metabolic risk factors among student nurses. Method: This was a descriptive cross sectional study, involving a convenience sample of 228 students during the educational year of 2017-2018 at Lilitha Collegeof Nursing in East London, South Africa. The WHO STEPwise standardized questionnaire was used to collect information on socio-demographic data (age, gender, year of study) and behavioural characteristics (smoking, alcohol consumption, physical inactivity, and dietary intake) of the participants. Anthropometric screening included measurement of height, weight and waist circumference. The biochemical screening included measurement of blood pressure and determination of fasting blood glucose concentration. Only students with complete data set were included in the data analysis. Statistical Package for Social Science (SPSS) version 23.0 was employed for descriptive and inferential analysis. Results: About half (41.7 percent) of the study participants were between the ages of 21 to 25 years and majority were females (67.5 percent).The prevalence of overweight and obesity were found to be 33 percent and 44 percent respectively. The prevalence of overweight was higher in males (44.6 percent), while females (53.9 percent) had higher prevalence of obesity. Female gender and increasing age are the only independent predictors of obesity. Results on blood pressure measurement showed that 25 percent of the participants had elevated blood pressure, and 22 percent were on stage 1 of hypertension while 2 percent were on stage 2. According to Joint National Committee on hypertension (JNC)’s criteria for defining hypertension, 44 percent of the participants had pre hypertension and 11percent had hypertension, diabetes and vegetables consumption were statistically associated with hypertension. The prevalence of pre-diabetes and diabetes was 6 percent and 7 percent respectively. Only abdominal obesity measured by waistto- hip ratio had a significant relationship with diabetes. Just 4.8 percent of the participants smoked daily and 33.3 percent consumed alcohol. Regarding physical activity, males were more active (60.8 percent) compared to females (54.8 percent). Conclusion: A high burden of overweight, obesity, and physical inactivity was observed among student nurses in East London. Screening for cardio-metabolic risk factors (CMRFs) among nursing students and implementation of intervention programs are recommended. Programs to raise awareness about CMRFs, encourage young adult students to adopt a healthy dietary behaviour and promote physical exercise should be initiated.
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