32 results
Search Results
2. COVID-19 and Immigrant Status: A Qualitative Study of Malawian Immigrants Living in South Africa.
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David, Ifeolu, Lembani, Martina, Tefera, Gashaye M., and Majee, Wilson
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IMMIGRANTS ,EMIGRATION & immigration ,COMMUNITY support ,QUALITATIVE research ,SOCIOECONOMIC factors ,INTERVIEWING ,UNEMPLOYMENT ,THEMATIC analysis ,RESEARCH ,RESEARCH methodology ,CONCEPTUAL structures ,DATA analysis software ,COVID-19 ,EMPLOYMENT ,COVID-19 pandemic ,RELIABILITY (Personality trait) - Abstract
Migration to South Africa is motivated by the pursuit of employment, safety, and improved living conditions. However, immigrants encounter significant challenges, such as restricted access to essential services, which were exacerbated by the COVID-19 pandemic. This paper investigates the impact of the COVID-19 pandemic on Malawian immigrants in South Africa, addressing the lack of attention given to this immigrant population by highlighting their vulnerabilities. Using a qualitative exploratory and descriptive approach, in-depth interviews were conducted with 24 Malawi immigrants who were over 18 years old and had established residency in South Africa before the onset of the COVID-19 pandemic. Five key stakeholders were also interviewed for additional perspectives and to ensure triangulation and improve data reliability. The interviews were transcribed verbatim and analyzed using thematic analysis strategies and coding with Nvivo12 software. The study highlighted the exacerbated struggles of Malawian immigrants in South Africa amid the COVID-19 pandemic, uncovering systemic discrimination in healthcare, marked by longer wait times and reluctance from health workers to treat undocumented immigrants. The study also revealed a dire security situation, with immigrants living in high-crime areas and feeling particularly targeted due to their foreign status, a situation worsened by the pandemic's economic effects. Additionally, the economic downturn induced by COVID-19 significantly impacted employment opportunities, with many immigrants facing prolonged unemployment and job losses, especially in sectors where they traditionally found work. The detailed accounts of participants highlight not only the multifaceted challenges imposed by the pandemic but also the critical need for inclusive policies and support systems that ensure healthcare access, safety, and economic resilience for immigrants, particularly during global health emergencies. Future research should focus on effective interventions for socioeconomic integration and well-being, particularly for immigrants from other African countries. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. Development of a workplace breastfeeding support practice model in South Africa.
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Daniels, Lynette Carmen, Mbhenyane, Xikombiso Gertrude, and Du Plessis, Lisanne Monica
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BREASTFEEDING ,CROSS-sectional method ,QUALITATIVE research ,RESEARCH funding ,WORK environment ,QUANTITATIVE research ,MATHEMATICAL models ,TEST validity ,RESEARCH methodology ,SOCIAL support ,THEORY ,DELPHI method - Abstract
Background: Globally, mothers have identified work as one of the main obstacles to exclusive and continued breastfeeding. The support a woman receives in her workplace in terms of workplace arrangements can be critical to enable women to continue breastfeeding. This study aimed to develop and assess the face validity of a practice model to support exclusive and continued breastfeeding in workplaces in the Western Cape, South Africa. Methods: An explanatory, sequential, mixed-method research design, was conducted (June 2017 to March 2019) in three distinct phases. Phase one employed a quantitative, descriptive, cross-sectional study design. Phase 2 used a qualitative, multiple case study. Phase three involved the development and face validity of a practice model to support exclusive breastfeeding in workplaces. The face validity included two Delphi rounds for experts to provide input on the draft practice model. This paper will only report on phase 3 of the study. The practice model was developed, drawing on the analysis of data from phases one and two and using programme theory approaches and a logic model. Results: The practice model was positively perceived. Participants viewed it as informative, well designed and easy to follow, even for those not knowledgeable about the subject. It was viewed as an ideal tool, if accompanied by some training. Participants were positive that the model would be feasible and most commended the tiered approach to implementation. They felt that workplaces would be more open to a step-by-step approach to implementation and if only a few activities are implemented it would be a start to make the work environment more conducive for breastfeeding employees. There were mixed opinions regarding commitment; a few participants mentioned commitment as a challenge they anticipated in the male-dominant environments in which they worked. The provision of space for breastfeeding at the workplace was also highlighted as a potential challenge. Conclusions: Advocacy around creating an enabling workplace environment for breastfeeding is needed. The practice model has the potential to be internationally relevant, locally applied and may be of particular use to workplaces that want to initiate and/or strengthen breastfeeding support. [ABSTRACT FROM AUTHOR]
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- 2024
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4. A community service doctor's experiences of mental healthcare provision in rural Eastern Cape.
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Rall, Divan and Swartz, Leslie
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WORK ,HEALTH services accessibility ,MEDICAL quality control ,COMMUNITY health nurses ,SOCIAL workers ,HEALTH facility administration ,INTERVIEWING ,JUDGMENT sampling ,RURAL health services ,SOUND recordings ,THEMATIC analysis ,HEALTH services administrators ,ATTITUDES of medical personnel ,RESEARCH methodology ,PUBLIC health ,CASE studies ,PHYSICIANS ,EXPERIENTIAL learning - Abstract
Background: Literature shows that in South Africa there are insufficient resources to meet mental healthcare needs. At general or district hospital level, the non-specialist doctor is often responsible for the holistic assessment and management of mental health service users. Such situations inevitably increase doctors' care load as they are required to treat across disciplines. We highlight the particular challenges faced by a community service (CS) doctor in this context. Methods: The presented case study formed part of a larger project that investigated public mental healthcare provision in the Eastern Cape province. Data were collected through a once-off semi-structured interview with the participant. The interview was transcribed and data analysed by utilising thematic analysis to yield results. Results: The study suggests that the CS doctor experiences being overloaded with duties, and feels overwhelmed in a healthcare context that lacks resources needed for service provision, which may lead to inadequate mental healthcare provision to public health service users. Conclusion: Healthcare facilities in rural parts of the Eastern Cape province are in need of assistance. This in-depth account highlighted the consequences of working on the front line of a disadvantaged and under-resourced health system. The presented account can be interpreted as a cry for help by CS doctors for relevant authorities to improve access and provision of mental healthcare in the area. Contribution: The paper provides an exploration of the circumstances wherein mental healthcare is provided in rural parts of South Africa. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Girls, sexuality and playground‐assemblages in a South African primary school.
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Janak, Raksha and Bhana, Deevia
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SOCIALIZATION , *HUMAN sexuality , *RESEARCH methodology , *SELF-perception , *INTERVIEWING , *PSYCHOLOGY of women , *SCHOOLS , *PLAY , *RESEARCH funding , *PSYCHOLOGY of school children , *STUDENT attitudes - Abstract
Inspired by new feminist materialism, this paper seeks to reimagine existing knowledge of girls, sexuality and playgrounds by considering how the socio‐material reality may unlock girls' capacities for what is possible through play. Focusing on semi‐structured interviews of girls (aged 12–13), the paper draws attention to the playground as an 'assemblage' of human and non‐human matter that connect to illuminate other ways of being, feeling and doing. We argue that the assemblage not only creates spaces for girls to disrupt hetero‐patriarchal ideologies but simultaneously serves to reinforce them. Interventions require attention to the oppressive materialities that underpin play. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Towards the development of culturally responsive marriage interventions: traditional and modern perceptions.
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Neswiswa, Kabaro Grace and Jacobs, Susanne
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MARRIAGE ,QUALITATIVE research ,FOCUS groups ,SOCIAL workers ,INTERVIEWING ,JUDGMENT sampling ,COMMUNITIES ,BLACK people ,RESEARCH methodology ,CULTURAL pluralism - Abstract
Traditional marriage systems reinforce positive marital outcomes, but modernization, neglecting core values of indigenous practices, upsurges divorce. Here described are perceptions of two influential groups, leaders, and practitioners, involved in mediating traditional marital systems in the community of the Royal Bafokeng Nation in South Africa. Qualitative face-to-face interviews with 12 leaders reveal the necessity to restore non-negotiable traditions to preserve marriages. A focus group discussion with ten social services practitioners shows practices as biased and outdated, articulating negotiation and integration of strengths of traditional and modern systems. Findings point to the first steps key to growing theory and approaching the development of culturally appropriate interventions for Black African couples, for instance, identifying evidence-based interventions, conducting baseline research, and expanding or adapting interventions to meet current needs. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Transitioning between the EQ-5D youth and adult descriptive systems in a group of adolescents.
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Verstraete, Janine, Kind, Paul, Janssen, Mathieu F., Yang, Zhihao, Stolk, Elly, and Gebregziabiher, Abraham
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COMPETENCY assessment (Law) ,DIAGNOSIS of mental depression ,ANXIETY diagnosis ,CROSS-sectional method ,HEALTH status indicators ,RESEARCH funding ,SCIENTIFIC observation ,QUESTIONNAIRES ,CHI-squared test ,MANN Whitney U Test ,SURVEYS ,THEMATIC analysis ,QUALITY of life ,RESEARCH methodology ,PSYCHOMETRICS ,ANALYSIS of variance ,DATA analysis software ,ADOLESCENCE - Abstract
Purpose: To investigate whether the same health state results in the same distribution of responses on the EQ-5D youth and adult descriptive systems. Methods: Adolescents aged 13–18 years with a range of health conditions and from the general school going population were recruited in South Africa (ZA) and Ethiopia (ET). In ZA participants completed the English EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L in parallel. Whereas in ET participants completed the Amharic EQ-5D-5L and EQ-5D-Y-5L in parallel. Analysis aimed to describe the transition between youth and adult instruments and not differences between countries. Results: Data from 592 adolescents completing the EQ-5D-3L, EQ-5D-Y-3L and EQ-5D-5L (ZA) and 693 completing the EQ-5D-5L and EQ-5D-Y-5L (ET) were analysed. Adolescents reported more problems on the youth versions compared to the adult version for the dimension of mental health. 13% and 4% of adolescents who reported no problems on the EQ-5D-3L and EQ-5D-5L reported some problems on the EQ-5D-Y-3L respectively. This was less notable with transition between the five level versions with 4% of adolescents reporting more problems on the EQ-5D-Y-5L than the EQ-5D-5L. Very few adolescents reported severe problems (level 3 on the EQ-5D-3L or EQ-5D-Y-3L and level 4 and level 5 on the EQ-5D-5L or EQ-5D-5L) thus there was little variation between responses between the versions. In ZA, discriminatory power, measured on the Shannon's Index, was higher for Y-3L compared to 3L for pain/discomfort (ΔH′=0.11) and anxiety/depression (ΔH′=0.04) and across all dimensions for Y-3L compared to 5L. Similarly, in ET discriminatory power was higher for Y-5L than 5L (ΔH′ range 0.05–0.09). Gwet's AC showed good to very good agreement across all paired (ZA) 3L and (ET) 5L dimensions. The summary score of all EQ-5D versions were able to differentiate between known disease groups. Conclusion: Despite the overall high levels of agreement between EQ-5D instruments for youth and for adults, they do not provide identical results in terms of health state, from the same respondent. The differences were most notable for anxiety/depression. These differences in the way individuals respond to the various descriptive systems need to be taken into consideration for descriptive analysis, when transitioning between instruments, and when comparing preference-weighted scores. [ABSTRACT FROM AUTHOR]
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- 2024
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8. First-in-human infection imaging with 89Zr-labelled leukocytes and comparison of scan quality with [99mTc]Tc-HMPAO-labelled leukocytes.
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Kahts, Maryke, Summers, Beverley, Ndlela, Akhona Nkokheli, Gutta, Aadil, Nemutaduni, Phumudzo, More, Andrew, Parsoo, Aman, Ebenhan, Thomas, Zeevaart, Jan Rijn, Aras, Omer, and Sathekge, Mike Machaba
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LEUCOCYTES ,HEAVY metals ,SINGLE-photon emission computed tomography ,RADIOPHARMACEUTICALS ,RESEARCH funding ,CHELATING agents ,POSITRON emission tomography ,TERTIARY care ,DESCRIPTIVE statistics ,LONGITUDINAL method ,RESEARCH methodology ,COMPARATIVE studies ,RADIONUCLIDE imaging - Abstract
Introduction: Nuclear medicine infection imaging is routinely performed with the use of leukocytes radiolabelled with technetium-99m hexamethylpropyleneamine oxime ([
99m Tc]Tc-HMPAO) and single-photon emission computed tomography (SPECT). Positron emission tomography (PET) is more sensitive than SPECT and results in higher-quality images. Zirconium-89 (89 Zr) is a positron emitter with a half-life of 78.4 h, which translates to the biological half-life and slow biodistribution of intact cells and allows delayed PET imaging for more accurate biodistribution of the labelled leukocytes to infection foci. A first-in-human study with [89 Zr]Zr-oxine-leukocytes in four healthy volunteers was reported in 2022. Our first-in-human study utilising the cell surface labelling approach aimed to image infection in patients with the use of89 Zr-labelled leukocytes, using p-isothiocyanatobenzyl-desferrioxamine B (Df-Bz-NCS) as a bifunctional chelating agent, and to compare the scan quality and biodistribution of [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes on PET images to SPECT images obtained with [99m Tc]Tc-HMPAO-labelled leukocytes. Methods: Leukocytes were isolated from whole-blood samples of eight patients with clinically and/or radiologically confirmed infection. Isolated leukocytes were labelled with [99m Tc]Tc-HMPAO according to standardised methods, and [89 Zr]Zr-Df-Bz-NCS according to our previously published radiolabelling method. Whole-body SPECT imaging was performed 2 and 18 h post injection of [99m Tc]Tc-HMPAO-labelled leukocytes, and whole-body PET/CT was performed 3 and 24 h post injection of [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes in seven patients. Results: Successful [89 Zr]Zr-Df-Bz-NCS-leukocyte labelling was achieved. High labelling efficiencies were obtained (81.7% ± 3.6%; n = 8). A mean high viability of [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes was observed (88.98% ± 12.51%). The [89 Zr]Zr-Df-Bz-NCS-leukocyte labelling efficiency was not significantly affected by the white blood cell count of the patient. The performance of [99m Tc]Tc-HMPAOand [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes, in terms of the ability to accurately detect infection, were similar in two out of seven patients, and [99m Tc]Tc-HMPAOlabelled leukocytes outperformed [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes in one patient with femoral osteomyelitis. However, in two cases of pulmonary pathology, [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes demonstrated improved pathological uptake. No skeletal activity was observed in any of the patients imaged with [89 Zr] Zr-Df-Bz-NCS-labelled leukocytes, illustrating the in vivo stability of the radiolabel. Discussion: Although the [89 Zr]Zr-Df-Bz-NCS-leukocyte labelling aspect of this study was noteworthy, infection imaging did not yield convincingly positive results due to the pulmonary trapping of intravenously administered [89 Zr]Zr-Df-Bz-NCS-labelled leukocytes. [ABSTRACT FROM AUTHOR]- Published
- 2024
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9. Prevention method preferences and factors influencing hypothetical choice among women in South Africa: a survey exploring opportunities for a multipurpose prevention technology implant.
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Martin, Catherine E., Kutywayo, Alison, Mataboge, Paballo, Chidumwa, Glory, Mthimkhulu, Nqaba, Bothma, Rutendo, and Mullick, Saiqa
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PREVENTION of sexually transmitted diseases ,HIV prevention ,CROSS-sectional method ,HEALTH services accessibility ,RESEARCH funding ,QUESTIONNAIRES ,HUMAN sexuality ,STATISTICAL sampling ,PSYCHOLOGY of women ,DESCRIPTIVE statistics ,DECISION making ,SEX customs ,UNPLANNED pregnancy ,ORAL contraceptives ,RESEARCH methodology ,CONTRACEPTION ,NEEDS assessment ,DATA analysis software ,PREVENTIVE health services ,PATIENTS' attitudes ,REGRESSION analysis ,ACCESS to information - Abstract
Introduction: South African women bear an intersecting burden of HIV, sexually transmitted infections (STIs) and unintended pregnancy. Multipurpose prevention technologies (MPTs) are a class of products that address multiple needs and have the potential to improve uptake and use of prevention products. Methods: Analysing survey data from 703 HIV-negative women 18--40 years in three provinces in South Africa, collected between July and November 2022, this study explores their preferences for prevention methods and factors influencing choice of hypothetical prevention methods, including MPTs. Descriptive statistics and multinomial regression analyses were conducted to determine prevention method preferences and factors associated with choosing a pill, injectable or MPT-implant type prevention method. Results: Most women wanted to prevent HIV, STIs and pregnancy. The most important factors when choosing a prevention product were whether it provided dual and long-term protection and if side effects were manageable. If choosing only one method, half of women would choose any MPT-implant and a quarter each would choose a pill or an injectable method, with method choices differing by population group. Discussion: Prevention method choices were influenced by sexual-behavioural factors and current and prior contraceptive method use. Providing a choice of prevention methods and a population specific approach to new method development and introduction with access to accurate information could enhance their ability to fill a gap in prevention needs. [ABSTRACT FROM AUTHOR]
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- 2024
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10. An Investigation of Mindfulness Training As a Self-Care Strategy for Trauma Counsellors.
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Pillay, Kanthamoney, Eagle, Gillian, and Esprey, Yvette
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JOB stress prevention ,COUNSELORS ,SELF-management (Psychology) ,T-test (Statistics) ,MINDFULNESS ,DESCRIPTIVE statistics ,MANN Whitney U Test ,CHI-squared test ,CONTROL groups ,PRE-tests & post-tests ,RESEARCH methodology ,ANALYSIS of variance ,PSYCHOSOCIAL factors ,SECONDARY traumatic stress - Abstract
Trauma counselors are vulnerable to negative impacts such as secondary traumatic stress and vicarious traumatization. This study investigated Mindfulness Training as a self-care strategy for counselors in South Africa, examining the effect of MT on negative and positive secondary trauma impacts (STI), and employing a quasi-experimental embedded mixed methods research model to investigate the impact of MT and areas of greatest post-intervention change. The study compared pre- and posttest scores across an MT intervention group and an active control group. A mixed Between-Within Subjects ANOVA was tested for mean differences between the two independent groups, while simultaneously subjecting participants to repeated measures, to establish whether mean changes in the outcome scores on the dependent variables from pretest to posttest differed significantly for individuals over time within the groups. Results indicated that MT was effective in reducing negative STI and in increasing trait mindfulness. Benefits were sustained three months post-intervention. MT was associated with variable rates of change on each outcome measure. The evidence supports the role of MT in reducing negative STIs in trauma counselors. [ABSTRACT FROM AUTHOR]
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- 2024
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11. The acceptability of a donor human milk bank and donated human milk among mothers in Limpopo Province, South Africa.
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Mampane, Tebogo and Wolvaardt, Jacqueline E.
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BREAST milk collection & preservation ,BREASTFEEDING ,INFANT mortality ,CROSS infection ,QUALITATIVE research ,HEALTH attitudes ,BREAST milk banks ,IMMUNOGLOBULINS ,NEONATAL intensive care units ,INTERVIEWING ,CULTURE ,BREAST milk ,ATTITUDES of mothers ,NUTRITIONAL requirements ,JUDGMENT sampling ,NEONATAL intensive care ,DESCRIPTIVE statistics ,INFANT nutrition ,DISEASES ,NEONATAL necrotizing enterocolitis ,ENTERAL feeding ,THEMATIC analysis ,PRENATAL care ,PSYCHOLOGY of mothers ,RESEARCH methodology ,CONCEPTUAL structures ,PARENT-infant relationships ,FOOD waste ,PUBLIC health ,PHENOMENOLOGY ,VIRUSES - Abstract
Breastfeeding is a crucial public health approach that reduces infant morbidity and mortality by providing essential nutrients and antibodies, and breast milk is easily digested. Breastfeeding and donated milk serve as a preventative measure against necrotising enterocolitis. Additionally, they protect against viruses and nosocomial sepsis. When a birthing parent's own milk is unavailable, alternative enteral nutrition for preterm or low‐birth‐weight infants is either donor human milk (DHM) or artificial formula. This study aimed to understand mothers' acceptance of the donor human milk bank (DHMB) and DHM. A qualitative phenomenological study was conducted in Limpopo Province, South Africa. The study used purposive sampling to select 23 mothers in postnatal and neonatal wards. Data collection was via in‐depth interviews using a semistructured interview guide. Manual data analysis using an interpretative phenomenological analysis (IPA) framework was used to coding. Concepts were grouped to generate themes. Three themes and nine subthemes were generated: (1) DHMBs (2) cultural perspective of DHMB, and (3) health considerations of DHM. Participants were unaware of the DHMB. Hesitancy in accepting DHM due to fear of contracting HIV was observed. Cultural beliefs are an influencing factor for use, while donation was driven by altruistic reasons, preventing waste, helping others and having previously benefited from DHM. The study found that mothers are willing to donate human milk. Willingness to donate can be increased by raising awareness about DHMB and addressing culture and safety concerns at antenatal clinics. Key messages: The study emphasises the possible willingness to accept the concept of donating and utilising donor human milk for newborns who do not have access to their mother's own milk. However, safety concerns, bonding and cultural issues should be addressed.Promoting breastfeeding and milk donation in communities requires addressing cultural and health concerns by utilising the service of community health workers.Education about safe breast milk banking before neonatal intensive care unit admission is also an important factor. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Does sugar taxation on sugar-sweetened beverages alter purchasing behaviour of South African consumers? Perspectives of dietitians and key industry role-players.
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Smit, Yolande, Ebrahim, Zarina, Marais, Maritha, Nel, Daan, and Koen, Nelene
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TAX laws ,PREVENTION of obesity ,DIETITIANS' attitudes ,CROSS-sectional method ,DIETARY sucrose ,EXECUTIVES ,SHOPPING ,NUTRITIONISTS ,PUBLIC opinion ,DESCRIPTIVE statistics ,DISEASE prevalence ,INDUSTRIES ,NON-communicable diseases ,SURVEYS ,FOOD industry ,RESEARCH methodology ,FOOD preferences ,HEALTH promotion ,HEALTH education ,BEVERAGES ,OBESITY - Abstract
The increasing prevalence of non-communicable diseases and obesity is associated with excessive consumption of sugar. To address this concern the taxation of sugar-sweetened beverages (SSBs), known as the Health Promotion Levy (HPL), was implemented in South Africa in April 2018. A study was undertaken to investigate perspectives of dietitians and key industry role-players (KIRs) on the HPL. This was a cross-sectional, descriptive study. A national study was conducted in South Africa via a virtual platform. The participants were registered dietitians (n = 138) and key industry role-players (KIRs) (n = 39) who had expertise in nutrition, food science and/or sugar taxation legislation. Electronic surveys probed participants' awareness and opinions of the HPL, perceived SSB purchasing of consumers and barriers or facilitators for implementation of the HPL. Dietitians were positive regarding the HPL (75.8%; n = 94/124) but regarded the tax as too little to affect a reduction in obesity (71.8%, n = 89/124). They reported a 19.2% reduction in their perceived clients' daily purchasing of SSBs since implementation of the HPL. The KIRs regarded the HPL as insufficient to influence consumers' purchasing behaviour (64.9%, n = 24/37). Consumers' habitual purchasing was deemed a barrier (83.8%, n = 31/37) and consumer education an enabling factor (76,9%, n = 30/39) to successful implementation. Dietitians have a positive opinion on the HPL. They agree that the HPL alone will not influence the purchasing behaviour of consumers or reduce the prevalence of obesity. KIRs regard the HPL to be insufficient to affect consumers' purchasing behaviour. The HPL should form part of a multi-pronged approach to create a supportive environment to reduce sugar consumption. It is recommended that approaches should include fiscal measures, consumer education and controlled marketing of SSBs. Trained dietitians would be able to enhance the goal of the HPL to combat the obesity pandemic. [ABSTRACT FROM AUTHOR]
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- 2024
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13. The role of community health workers in non-communicable diseases in Cape Town, South Africa: descriptive exploratory qualitative study.
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Doresha, Lize-Marie, Williams, and Mash, Robert
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WORK ,RISK assessment ,SUPPORT groups ,OCCUPATIONAL roles ,QUALITATIVE research ,PALLIATIVE treatment ,CLINICAL supervision ,INTERPROFESSIONAL relations ,EXECUTIVES ,SCIENTIFIC observation ,UNOBTRUSIVE measures ,INTERVIEWING ,STATISTICAL sampling ,PRIMARY health care ,NON-communicable diseases ,SOUND recordings ,THEMATIC analysis ,CLIENT relations ,ATTITUDES of medical personnel ,RESEARCH methodology ,RESEARCH ,COMMUNITY health workers ,HEALTH promotion ,COUNSELING ,HEALTH information systems ,PSYCHOSOCIAL factors ,EXPERIENTIAL learning ,MEDICAL referrals ,DISEASE risk factors - Abstract
Background: Community health workers (CHW) are an integral part of primary health care re-engineering in South Africa. Cape Town is developing community-orientated primary care, with a central role for CHWs. Their role in human immunodeficiency virus, tuberculosis, maternal and child health has been articulated, but is less clear for non-communicable diseases (NCDs). Non-communicable diseases are now a major contributor to the burden of disease. The aim was to explore the current role of CHWs regarding NCDs in the Eastern sub-district of Cape Town, South Africa. Methods: An exploratory descriptive qualitative study made use of non-participant observation and qualitative interviews with CHWs, their managers, and nurse coordinators. Data from nine semi-structured interviews and ten observations were analysed with the framework method and Atlas-ti. Results: The CHWs were embedded in their communities and provided services via support groups, household visits and delivery of medication. They linked people to care with assistance of nurse coordinators. They could also provide physical care in the home. They lacked the ability to counsel people on the risk factors for NCDs and their role in rehabilitation and palliative care was unclear. More nurse coordinators were needed to provide supportive supervision. Inter-sectoral collaboration was weak and hindered CHWs from addressing social issues. More standardised and comprehensive training should equip CHWs for health promotion and disease prevention during household visits. Data collected in the community needed to be analysed, reported on and integrated with data from the primary care facility. This should also contribute to a community diagnosis. Their relationship with facility-based members of the primary health care team needed to be improved. Attention needed to be given to the requirements for and conditions of employment, as well as working hours and remuneration. Some equipment was absent and hindered their services for NCDs. Conclusions: CHWs have the potential to provide a comprehensive approach to NCDs, but community-orientated primary care needs to be strengthened in many of the key areas to support their activities. In relation to NCDs, they need training in basic and brief behaviour change counselling and risk factors as well as in the areas of rehabilitation and palliative care. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Holistic Sexual-Reproductive Healthcare Services and Needs for Queer Individuals: Healthcare Providers' Perspectives.
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Seretlo, Raikane James, Smuts, Hanlie, and Mokgatle, Mathildah Mpata
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HOLISTIC medicine ,REPRODUCTIVE health ,PATIENT safety ,RESEARCH funding ,LGBTQ+ people ,MEDICAL care ,HUMAN beings ,INTERVIEWING ,CONTENT analysis ,PILOT projects ,LUBRICATION & lubricants ,JUDGMENT sampling ,DESCRIPTIVE statistics ,PROSTATE tumors ,THEMATIC analysis ,RESEARCH ,RESEARCH methodology ,ATTITUDES of medical personnel ,PAP test ,MEDICAL needs assessment ,DATA analysis software ,MEDICAL screening ,SEXUAL health - Abstract
There are ongoing debates and controversies about whether genderqueer individuals have specific sexual-reproductive healthcare services and needs (SRHSNs). This study intended to identify and explore queer-specific SRHSNs among healthcare providers (HCPs) in Gauteng Province, South Africa. This was an exploratory sequential mixed-methods study, and this article focuses on the qualitative findings of that investigation. Thirty-three HCPs were purposively sampled, and semi-structured one-on-one interviews were used to collect data between September and November 2023. The data were analyzed using thematic content analysis (TCA). The results of this study revealed nine main themes: a crucial need for inclusive healthcare facilities; a need for psychological, counseling, and therapeutic support in sexual and reproductive healthcare; access to sexual-reproductive education and integrating support; suggested reproductive health services for queer sexual wellness; improved accessibility and particular queer reproductive healthcare; optimizing services related to human immunodeficiency virus (HIV), pre-exposure prophylaxis (PrEP) access, and sexually transmitted illness (STI) treatment; genderqueer persons' parenthood aspirations and empowerment; the safe availability of intimacy tools; and navigation transitions. A holistic and inclusive healthcare approach that fits psychological support, comprehensive sexual-reproductive education, and specialized services to accommodate the unique needs of queer individuals should be implemented and made easily accessible. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Nurse perceptions of practice environment, quality of care and patient safety across four hospital levels within the public health sector of South Africa.
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Tenza, Immaculate Sabelile, Blignaut, Alwiena J., Ellis, Suria M., and Coetzee, Siedine K.
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CROSS-sectional method ,MEDICAL quality control ,PATIENT safety ,STATISTICAL significance ,RESEARCH funding ,WORK environment ,LEADERSHIP ,MEDICAL care ,NURSING ,HOSPITALS ,DESCRIPTIVE statistics ,NURSING practice ,NURSES' attitudes ,RESEARCH methodology ,ANALYSIS of variance ,MATHEMATICAL models ,CONCEPTUAL structures ,PUBLIC health ,THEORY ,DATA analysis software - Abstract
Improving the practice environment, quality of care and patient safety are global health priorities. In South Africa, quality of care and patient safety are among the top goals of the National Department of Health; nevertheless, empirical data regarding the condition of the nursing practice environment, quality of care and patient safety in public hospitals is lacking. Aim This study examined nurses' perceptions of the practice environment, quality of care and patient safety across four hospital levels (central, tertiary, provincial and district) within the public health sector of South Africa. Methods This was a cross-sectional survey design. We used multi-phase sampling to recruit all categories of nursing staff from central (n = 408), tertiary (n = 254), provincial (n = 401) and district (n = 244 [large n = 81; medium n = 83 and small n = 80]) public hospitals in all nine provinces of South Africa. After ethical approval, a self-reported questionnaire with subscales on the practice environment, quality of care and patient safety was administered. Data was collected from April 2021 to June 2022, with a response rate of 43.1%. ANOVA type Hierarchical Linear Modelling (HLM) was used to present the differences in nurses' perceptions across four hospital levels. Results Nurses rated the overall practice environment as poor (M = 2.46; SD = 0.65), especially with regard to the subscales of nurse participation in hospital affairs (M = 2.22; SD = 0.76), staffing and resource adequacy (M = 2.23; SD = 0.80), and nurse leadership, management, and support of nurses (M = 2.39; SD = 0.81). One-fifth (19.59%; n = 248) of nurses rated the overall grade of patient safety in their units as poor or failing, and more than one third (38.45%; n = 486) reported that the quality of care delivered to patient was fair or poor. Statistical and practical significant results indicated that central hospitals most often presented more positive perceptions of the practice environment, quality of care and patient safety, while small district hospitals often presented the most negative. The practice environment was most highly correlated with quality of care and patient safety outcomes. Conclusion There is a need to strengthen compliance with existing policies that enhance quality of care and patient safety. This includes the need to create positive practice environments in all public hospitals, but with an increased focus on smaller hospital settings. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Giving voice to the voiceless: Understanding the perceived needs of dementia family carers in Soweto, a South African township.
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Mahomed, Aqeela and Pretorius, Chrisma
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PSYCHOLOGICAL resilience ,HEALTH services accessibility ,HEALTH literacy ,QUALITATIVE research ,INTERPROFESSIONAL relations ,INTERVIEWING ,HEALTH policy ,DIGNITY ,PSYCHOEDUCATION ,CONFIDENCE ,SERVICES for caregivers ,THEMATIC analysis ,SOUND recordings ,METROPOLITAN areas ,RESEARCH methodology ,BLACK Africans ,ADULT education workshops ,DEMENTIA ,NEEDS assessment ,CAREGIVER attitudes - Abstract
This qualitative study aimed to provide family caregivers with an independent platform to reflect on and identify their needs in the role of dementia caregiver. Thirty caregivers were interviewed using a semi-structured approach, and data analysis followed a reflective thematic analysis method. The study revealed that Black African caregivers in townships require sufficient information and orientation to dementia-specific services, psychoeducation on dementia as a disease and its behavioural manifestations, as well as practical skills to manage the disease process. Caregivers expressed the need for in-depth, accessible education to boost their confidence and resilience in handling the challenges of dementia caregiving. They also proposed community initiatives to raise awareness, promote knowledge, and facilitate early detection and diagnosis of dementia. Additional needs included informational and educational workshops, resources like transportation services and helplines, day care facilities, media campaigns, and collaboration with the government for funding and policy change. New caregivers were advised to seek comprehensive education, support, and services while preserving the dignity of their family members with dementia. Remarkably, the identified needs and community initiatives aligned with the priority areas outlined by ADI for a National Dementia Plan, which South Africa currently lacks. The study highlights the importance of developing a National Dementia Plan in South Africa through collaboration among stakeholders, including communities, policy-makers, and multidisciplinary healthcare teams, while ensuring that individuals and families affected by dementia have a voice. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Exploring the Barriers and Facilitators in the Management of Childhood Trauma and Violence Exposure Intervention in the Vhembe District of the Limpopo Province, South Africa.
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Tsheole, Petunia, Makhado, Lufuno, Maphula, Angelina, and Sepeng, Nombulelo Veronica
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WOUND care ,PSYCHOTHERAPY ,HEALTH services accessibility ,VIOLENCE ,MENTAL health services ,QUALITATIVE research ,PSYCHOLOGISTS ,SOCIAL workers ,PROFESSIONAL ethics ,INTERVIEWING ,STATISTICAL sampling ,MEDICAL case management ,THEMATIC analysis ,RESEARCH methodology ,RESEARCH ,SOCIAL boundaries ,HEALTH education ,ADVERSE childhood experiences ,MEDICAL referrals ,CHILDREN - Abstract
Research has shown that barriers and facilitators in psychotherapy exhibit similarities. The authors of this study are of the view that to effectively address the difficulties encountered in psychotherapy for children and adolescents, it is crucial to consider the points of view of professionals who have firsthand encounters with children. The purpose of this study was to effectively explore barriers and facilitators in the treatment of children exposed to trauma and violence. Exploratory and descriptive methods, as components of a qualitative research design, were employed to investigate and articulate the barriers and facilitators involved in managing childhood trauma. An advertisement was used to recruit participants. It was developed and distributed to psychologists and social workers recommended by the Thohoyandou Victim Empowerment Programme. Seventeen professionals were individually interviewed using semi-structured interview schedules. The interviews were recorded, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). The findings of the study indicated a lack of commitment from parents in honouring appointments, financial challenges, a fear of perpetrators associated with the poor reporting of incidences, professional boundaries, and referral route challenges. Familiar facilitators in the management of childhood trauma included continuous training and workshops for all people working with childhood trauma and violence, the employment of more victim advocates, and awareness campaigns. Additionally, the referral pathway for traumatised children presents logistical, psychological, and educational hurdles, underscoring the complex nature of meeting the needs of these vulnerable populations within the healthcare system. In conclusion, even while the currently available research supports the barriers and facilitators for this population, more investigation is required to examine how these factors affect treatment outcomes, particularly in community-based settings. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Chiropractic attitude and utilisation of evidence-based practice in South Africa: a secondary analysis.
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Naidoo, Sharné, Hoenselaar, Nicole Karensa, and Yelverton, Christopher
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CROSS-sectional method ,PROFESSIONAL practice ,SECONDARY analysis ,RESEARCH funding ,QUESTIONNAIRES ,RESEARCH evaluation ,QUANTITATIVE research ,DECISION making in clinical medicine ,JUDGMENT sampling ,ATTITUDES of medical personnel ,CLINICAL competence ,RESEARCH methodology ,CHIROPRACTORS ,EVIDENCE-based medicine ,DATA analysis software ,CHIROPRACTIC ,PSYCHOSOCIAL factors - Abstract
Background: Evidence-Based Practice (EBP) is a model utilised by the majority of healthcare professionals and is a clinical framework that assists with decision-making related to patient care, to improve outcomes and patient satisfaction. The study aimed to analyse the attitudes, skills, and utilization of evidence-based practice (EBP) among South African chiropractors, focusing on perceived skill levels, training, use and identifying facilitators and barriers to EBP application. Methods: A descriptive cross-sectional quantitative secondary analysis was conducted by inviting registered chiropractors in South Africa (n = 920) to participate in an anonymous online questionnaire using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE). Results: A total of 132 chiropractors completed the survey, yielding a response rate of 14.4%. Of the respondents, 59.9% were female, 52.3% were between 26 and 35 years old, and 63.3% had graduated from the University of Johannesburg. A third of respondents stated they have poor clinical research skills. Over half of the respondents (56.8%) indicated that EBP constituted a significant part of their education except for completing systematic reviews or meta-analyses. Published clinical evidence was ranked 6th as a source of information for clinical decisions. The obstacles indicated were time constraints and a lack of clinical research in complementary and alternative medicine. Access to the internet, databases and research tools were facilitators that were deemed to be "very useful" in promoting EBP. Conclusion: The majority of South African chiropractors are generally favourable towards EBP, and this practice therefore appears to be utilised and embraced, with the requisite skills. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Critical care nurses' experiences of communication-vulnerable patients in the intensive care unit and the influence on rendering compassionate care.
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Kuyler, A., Heyns, T., and Johnson, E.
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NURSE-patient relationships ,WORK ,CORPORATE culture ,INTENSIVE care nursing ,QUALITATIVE research ,PROPRIETARY hospitals ,COMPASSION ,WORK environment ,DESCRIPTIVE statistics ,NURSING ,THEMATIC analysis ,PATIENT-centered care ,INTENSIVE care units ,NURSES' attitudes ,RESEARCH ,RESEARCH methodology ,COMMUNICATION ,COMPARATIVE studies ,SOCIAL support ,COMMUNICATION barriers ,EXPERIENTIAL learning ,CRITICAL care nurses ,CRITICALLY ill patient psychology ,SECONDARY traumatic stress - Abstract
Background. Interventions administered to critically ill patients, including mechanical ventilation, sedation or other treatments may hinder communication between patients and nurses. These communication challenges may affect critical care nurses' ability to provide compassionate, person-centred care. Objective. To identify nurses' experiences with patients who are communication-vulnerable in the intensive care unit and how they affect nurses' ability to offer compassionate care. Method. This qualitative explorative descriptive study involved nurses who worked in intensive care units from four private hospitals in Gauteng, South Africa. Focus groups were conducted with 30 critical care nurses in groups of two to six participants each. Thematic analysis was used to identify themes. Results. Five main themes were identified based on nurses' reports of their experiences with critically ill patients who experience communication difficulties and their impact on rendering compassionate care. Themes were deductively identified based on the social purposes of communication categories. Participants indicated that communication-vulnerable patients influence their ability to provide compassionate care. Generally, the physical, emotional, social and communication difficulties of assisting communication-vulnerable patients caused nurses to feel frustrated and negative towards their work environment, which added to their work stress and sometimes resulted in compassion fatigue. Conclusion. The study shows that various factors could impact the nurses' ability to provide compassionate care and that they require support to provide person-centred care. These factors can include the physical environment, the patient's alertness and awareness and institutional barriers. To support nurses in providing compassionate care, communication partner training may be warranted. [ABSTRACT FROM AUTHOR]
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- 2024
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20. The views of family physicians on National Health Insurance in Gauteng Province, South Africa.
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Murphy, Shane D., von Pressentin, Klaus, and Moosa, Shabir A.
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JOB involvement ,POLICY sciences ,WORK ,MEDICAL quality control ,QUALITATIVE research ,DECENTRALIZATION in management ,SELF-efficacy ,GENERAL practitioners ,HEALTH policy ,HEALTH insurance ,PRIMARY health care ,INTERVIEWING ,PHYSICIANS' attitudes ,JUDGMENT sampling ,STRATEGIC planning ,UNIVERSAL healthcare ,RESEARCH ,RESEARCH methodology ,HEALTH outcome assessment ,FRAUD ,SOCIAL support ,PSYCHOSOCIAL factors ,EXPERIENTIAL learning - Abstract
Background: Universal health coverage (UHC) improves national health outcomes while addressing social inequalities in access to quality healthcare services. The district health system (DHS) is critical to the success of UHC in South Africa through the National Health Insurance (NHI) scheme. Family physicians (FPs), as champions of primary care, are central to the DHS operation and implementation of NHI. Methods: This was a qualitative exploratory study that used semi-structured interviews to explore FPs views and engagement on NHI policy and implementation in their districts. Ten FPs were included through purposive sampling. Results: Most of the FPs interviewed were not engaged in either policy formulation or strategic planning. The NHI bill was seen as a theoretical ideology that lacked any clear plan. Family physicians expressed several concerns around corruption in governmental structures that could play out in NHI implementation. Family physicians felt unsupported within their district structures and disempowered to engage in rollout strategies. The FPs were able to provide useful solutions to health system challenges because of the design of their training programmes, as well as their experience at the primary care level. Conclusion: Healthcare governance in South Africa remains located in national and provincial structures. Devolution of governance to the DHS is required if NHI implementation is to succeed. The FPs need to be engaged in NHI strategies, to translate plans into actionable objectives at the primary care level. Contribution: This study highlights the need to involve FPs as key actors in implementing NHI strategies at a decentralised DHS governance level. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Registrars' experience with research in family medicine training programmes in South Africa.
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Louw, Emcy and Mash, Robert J.
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SUPERVISION of employees ,FAMILY medicine ,QUALITATIVE research ,INTERPROFESSIONAL relations ,OCCUPATIONAL roles ,GENERAL practitioners ,INTERVIEWING ,JUDGMENT sampling ,DESCRIPTIVE statistics ,TEACHING methods ,MEDICAL research ,ATTITUDES of medical personnel ,RESEARCH ,RESEARCH methodology ,DATA analysis software ,PSYCHOSOCIAL factors - Abstract
Background: Completion of a research assignment is a requirement for specialist training in South Africa. Difficulty with completion delays graduation and the supply of family physicians. The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes. Methods: An explorative descriptive qualitative study. Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes. Saturation was achieved after 12 semi-structured interviews. The framework method was used for data analysis, assisted by ATLAS.ti software. Results: The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed. Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory. Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays. The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive. The individual research experience was dependent on choosing a feasible project and having dedicated time. The balancing of personal, professional and academic responsibilities was challenging. Conclusion: Training programmes should revise the teaching of research and improve institutional processes. Supervisors need to become more responsive, with adequate expertise. Provincial support is needed for streamlined approval and dedicated research time. Contribution: The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country. [ABSTRACT FROM AUTHOR]
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- 2024
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22. Health Workers' Responses to COVID-19 Pandemic's Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study.
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Mayman, Yolanda, Crowley, Talitha, and van Wyk, Brian
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MEDICAL care for teenagers ,ANTIRETROVIRAL agents ,QUALITATIVE research ,HEALTH facility administration ,MENTAL health ,RESEARCH funding ,MEDICAL care ,HIV-positive persons ,INTERVIEWING ,HIV infections ,JUDGMENT sampling ,HEALTH services administrators ,THEMATIC analysis ,ATTITUDES of medical personnel ,RESEARCH methodology ,DATA analysis software ,SOCIAL support ,COVID-19 pandemic ,ADOLESCENCE - Abstract
Adolescents living with HIV (ALHIVs) are considered a priority population in the fight against HIV, requiring dedicated services. The COVID-19 pandemic and subsequent disruptions deprived ALHIVs on antiretroviral therapy (ART) of the care and social support essential for treatment adherence and positive treatment outcomes. This study describes health managers' and healthcare workers' responses to the impact of COVID-19 on service delivery to ALHIVs in HIV treatment in the Cape Town Metropole. A descriptive qualitative design was employed, where semi-structured individual interviews (n = 13) were conducted with senior and programme managers as well as healthcare workers between April and October 2023. Inductive thematic analysis was performed using Atlas.ti version 23. Two main themes emerged from these interviews: "HIV service delivery to adolescents during the COVID-19 pandemic" and "Lessons learnt—the way forward". The de-escalation of health services at primary health facilities and the disruption of HIV services resulted in disengagement from care by ALHIVs, increasing mental health and treatment challenges. This warrants the restoration of psychosocial support services and the re-engagement of ALHIVs. The findings from this study can function as a guide for health systems and healthcare providers to navigate future pandemics to ensure that vulnerable populations such as ALHIVs continue to receive care and treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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23. South African adolescents' lived experiences of acquired hearing loss following multidrug-resistant tuberculosis treatment.
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Sparg, Tarryn, Petersen, Lucretia, Mayers, Pat, and Rogers, Christine
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HOLISTIC medicine ,QUALITATIVE research ,INTERVIEWING ,JUDGMENT sampling ,ANTI-infective agents ,EXPERIENCE ,SOUND recordings ,THEMATIC analysis ,PATIENT-centered care ,RESEARCH methodology ,AMINOGLYCOSIDES ,HEARING disorders ,PHENOMENOLOGY ,ADOLESCENCE - Abstract
Objective: The impact of acquiring hearing loss might be exacerbated during adolescence, as this normal transition from childhood to adulthood is characterised by identity construction and social intensity. This study aimed to describe the lived experiences of South African adolescents with acquired hearing loss following aminoglycoside treatment for multidrug resistant tuberculosis. Design: The study adopted a descriptive phenomenological design and indepth, semi-structured interviews were conducted in English, isiZulu and Afrikaans. The data was managed and analysed according to a modified version of Hycner's framework. Study sample: Six participants aged 16-24 years with bilateral, mild to profound hearing loss acquired from aminoglycoside treatment were recruited from two South African provinces. Results: Three themes emerged which created a triple burden for participants. They endured socio-economic hardship encompassing limited economic and emotional support. Participants battled the consequences of life-threatening MDR-TB including illness, hospitalisation, stigma, and other challenges. Finally, participants were left with life-changing hearing loss. Conclusion: The findings indicate the necessity of holistic management of adolescents with aminoglycoside-related acquired hearing loss and serves as motivation to improve ototoxic monitoring practices and patient uptake of monitoring services and calls for the cessation, or at least cautious use, of aminoglycosides. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Key programmatic and policy considerations for introducing multipurpose prevention (MPT) methods: reflections from healthcare providers and key stakeholders in South Africa.
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Kutywayo, Alison, Mataboge, Paballo, Mthimkhulu, Nqaba, Martin, Catherine E., Muhwava, Lorrein S., Mazibuko, Mbali, Makalela, Nthabiseng, Kwatsha, Khanyiswa, Butler, Vusile, and Mullick, Saiqa
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NURSING education ,EDUCATION of executives ,HIV prevention ,HUMAN services programs ,MEDICAL technology ,ANTIRETROVIRAL agents ,RESEARCH funding ,QUALITATIVE research ,HEALTH facility administration ,EXECUTIVES ,HEALTH policy ,INTERVIEWING ,EDUCATIONAL outcomes ,REFLECTION (Philosophy) ,ORAL drug administration ,DESCRIPTIVE statistics ,MENTORING ,JUDGMENT sampling ,PRE-exposure prophylaxis ,INFORMATION needs ,THEMATIC analysis ,SOUND recordings ,HEALTH services administrators ,PROFESSIONS ,ATTITUDES of medical personnel ,UNPLANNED pregnancy ,INDUSTRIAL research ,CONTRACEPTIVES ,RESEARCH methodology ,ADULT education workshops ,STAKEHOLDER analysis ,CONTRACEPTION ,WOMEN'S health ,PREVENTIVE health services ,PROFESSIONAL competence ,PSYCHOLOGY of nurses - Abstract
Introduction: Multipurpose prevention technologies (MPTs) simultaneously prevent HIV, other sexually transmitted infections, and/or unintended pregnancy. Key gatekeepers, [healthcare providers (HCPs) and key stakeholders] require proactive engagement before product implementation. This manuscript identifies HCP demand creation strategies, key stakeholder considerations for the adoption of MPTs in South Africa. Methods: Formative research was conducted in three districts in three South African provinces (July to November 2022). Nurses initiating oral PrEP at facility and mobile study sites participated in 4-hour participatory workshops, exploring HIV prevention, including MPTs, demand creation strategies, and preferred MPTs training packages. Activities were observed, transcribed, and thematically analysed. Five online in-depth interviews (IDIs) with Key informants (KIs) (National/district programme implementers and technical leads) and one in person, exploring key programmatic and policy considerations for MPT adoption. IDIs were approximately 40 min long, audio recorded, transcribed, and thematically analysed. Results: Twenty-one Professional Nurses completed workshops: 19 female. Six IDIs were conducted with 4 Facility Managers, 1 NDoH representative and 1 DoH Provincial Deputy Director. All participants were females, aged 30-60+ years with >10 years' in SRH/HIV policy/advocacy/research. Community conversations and information at the clinic were the best MPT demand creation methods among HCPs. KIs identified five considerations for future MPT implementation: HCP training; demand creation and messaging; existing PrEP policy amendments; preparing users for additional choice; and sustaining MPT provision. Conclusion: Contraceptive implant and oral PrEP implementation lessons learned should be proactively considered when preparing for MPT introduction. HCP training and demand creation are of particular importance before MPT introduction. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners' Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa.
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Tshitangano, Takalani Grace
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INTELLECT ,INFECTION control ,QUALITATIVE research ,STERILIZATION (Disinfection) ,EXPERIMENTAL design ,PRE-tests & post-tests ,RESEARCH methodology ,HEALTH facilities - Abstract
Despite being preventable, healthcare-associated infections are known primary causes of patient mortality and morbidity, threatening global public health. Though it is believed that one competent and dedicated cleaning staff member given the right tools and enough time can prevent more health-care-associated infectious diseases than a room full of doctors and nurses can cure, it was discovered in Letaba Hospital of the Limpopo Province, South Africa, that knowledge and practices of infection control among cleaning staff were not optimal. The proposed study aims to evaluate the impact of training interventions on cleaners' knowledge levels and practices. In Phase 1, cleaners' pre-training knowledge level, practices, and perceptions regarding correct cleaning techniques will be assessed through qualitative, individual, in-depth interviews. The initial question will read, "Describe the steps you follow when cleaning at this health facility and why?" In Phase 2a, a cleaning training program will be developed based on the South African Qualification Authority ID 118730 Healthcare Cleaner: Occupational Certificate Curriculum and the Center for Diseases Control and ICAN's Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings. In Phase 2b, a cleaning training intervention will be implemented. In Phase 3, cleaners' post-training knowledge level, practices, and perceptions will be reassessed and compared to pre-training findings. The Standard Protocol Items: Recommendations for an Interventional Trial, commonly known as SPIRIT, guided the development of this protocol. This protocol received ethical clearance number FHS/22/PH/04/3005 in August 2023 from the University of Venda Human and Clinical Trials Research Ethics Committee. The protocol approval was granted by the Limpopo Provincial Department of Health (LP_2022-05-028) in October 2023. This protocol is registered with the South African National Clinical Trial Registry. The findings of this study may provide baseline data upon which healthcare facilities' cleaner training qualification curriculum may be developed. In addition, this protocol contributes to the application of qualitative methodology in an intervention trial. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Registered nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics of eThekwini Municipality in KwaZulu-Natal.
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Ngcobo, Silingene Joyce, Makhado, Lufuno, and Sehularo, Leepile Alfred
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HIV infections ,RESEARCH ,NURSES' attitudes ,ACADEMIC medical centers ,RESEARCH methodology ,MEDICAL care ,MOBILE hospitals ,INTERVIEWING ,LABOR demand ,QUALITATIVE research ,NURSES ,DESCRIPTIVE statistics ,SOUND recordings ,RESEARCH funding ,JUDGMENT sampling ,DATA analysis software ,THEMATIC analysis ,MEDICAL needs assessment - Abstract
Background: Registered nurses working in the mobile health clinics (MHCs) play an important role in enabling HIV care access to populations in remote areas through Nurse Initiated Antiretroviral Therapy program (NIMART). Aim: To explore and describe the nurses' experiences regarding operational factors influencing the implementation of HIV care services in the mobile health clinics (MHCs) of eThekwini Municipality in KwaZulu Natal. Methods: Qualitative Exploratory Descriptive (QED) method was used after permission was granted from North-West University Human Research Ethics Committee provincial and local health authorities. Data saturation informed sample size of thirteen MHCs nurses were purposefully sampled to participate. Audio-recorded, semi-structured, online, one-on-one interviews guided by open-ended questions were done for data collection, and including demographic profile. The interview transcripts were analysed using Atlas-TI and SPSS descriptive statistics was used for demographics. Results: Eleven subthemes emerged under patient-related, nurse-related, and organisational-related themes which influence the operational factors in the MHCs, namely: patient defaulting treatment, lack of privacy, unavailability of phones, stressful and demotivating MHCs, nurses feel unsafe, lack of support from management, lack of budget, unavailability of computers, shortage of medical equipment, shortage of nursing staff and absence of data capturers. Conclusion: Structured contextual coaching and support program for nurses is imperative to ensure effective and strengthened operations in MHCs, further supported by improvement in human resource for health allocation for MHCs in light of expanding health care programs Contributions: Evaluation of health care programmes, and human resource for health quality improvement needs in the clinical practice of HIV care of MHCs nurses which advocate for specific policy formulations. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Barriers and Mythical Practices of Teenagers Regarding the Prevention of Sexually Transmitted Infections in Rural Areas of Limpopo Province, South Africa.
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Damian, Jessica Uchechi, Hlungwane, Eustacia, and Tshitangano, Takalani Grace
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PREVENTION of sexually transmitted diseases ,VAGINA physiology ,RESEARCH ,YOGURT ,HIV infections ,HEALTH services accessibility ,MEDICAL care for teenagers ,FOLLICLE-stimulating hormone ,CONFIDENCE intervals ,RURAL conditions ,RESEARCH methodology ,HUMAN sexuality ,QUALITATIVE research ,SEX education ,RISK assessment ,COMPARATIVE studies ,HEALTH attitudes ,TEENAGERS' conduct of life ,SEX customs ,DESCRIPTIVE statistics ,CONDOMS ,DATA analysis ,FAMILY structure - Abstract
Sexually transmitted infections in South Africa are increasing at alarming rates. This study's setting is no. 5, with the highest STI, pregnancy, and HIV statistics in Limpopo province among 13- to 19-year-old teenagers. This study explored preventative measures against STIs practiced by teenagers in rural areas of Limpopo province, South Africa. This study was conducted at a selected rural-based clinic using an exploratory descriptive qualitative research approach. Unstructured in-depth face-to-face interviews were used to collect data from sixteen conveniently sampled teenagers aged 13–19, consisting of 13 females and 3 males, who came to Manavhela Clinic for youth-friendly services in August/September 2022. Open-coding analysis was used to identify themes and sub-themes. Measures to ensure trustworthiness were ensured. Ethical clearance (FSH/21/PH/22/2211) was obtained, and ethics principles were observed throughout this study. Two themes emerged from data analysis: STI preventive measures practiced by teenagers and factors influencing the choice of STI preventive measures practiced by teenagers. Only a few participants aged 13 and 14 years of age practiced abstinence and condom use. Most participants were sexually active and used mythical mixtures made from boiling aloe or morula tree (which they drank before and after sex), applied plain yogurt on the vagina once a week, or practiced vaginal steaming. Participants cited patriarchy, lack of sex education in rural schools, long distances to clinics, and desire to taste sex as reasons for adopting the practiced preventive measures. Risky sexual behavior among 13- to 19-year-old teenagers is still rife in rural areas. Rural clinics in Limpopo province should intensify STI school health education and youth-friendly services programs to raise awareness and improve accessibility to condoms. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Person‐centred caregiver singing for people living with dementia in South Africa: A mixed methods evaluation of acceptability, feasibility, and professional caregivers' experiences.
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Stuart‐Röhm, Karyn, Clark, Imogen N., and Baker, Felicity A.
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TREATMENT of dementia ,OCCUPATIONAL roles ,CAREGIVER attitudes ,WELL-being ,RESEARCH evaluation ,SINGING ,RESEARCH methodology ,PATIENT-centered care ,DEMENTIA patients ,MUSIC therapy ,CRONBACH'S alpha ,SELF-efficacy ,PSYCHOLOGY of caregivers ,QUESTIONNAIRES ,SCALE analysis (Psychology) ,DATA analysis software ,THEMATIC analysis - Abstract
Background: Dementia care in South Africa faces challenges including a paucity of published research, a prevalent medical model in healthcare, and inadequate caregiver training. Music is a meaningful psychosocial intervention in dementia care, yet its application is not always safe and effective. A training protocol was codesigned to enhance caregivers' delivery of person‐centred care through attuned, live singing. Objectives: This study explored the acceptability and caregivers' experiences of a person‐centred caregiver singing (PCCS) protocol in South Africa. Methods: A PCCS workshop was applied at seven aged care homes in Cape Town, South Africa. Forty‐one formal caregivers adhered to inclusion criteria and consented to attend one workshop on PCCS. Mixed methods data collection was obtained from questionnaires containing a Likert scale and written reflections. Quantitative data were analysed through nonparametric tests and narrative descriptions, and qualitative data through thematic content analysis. Findings were integrated deductively using seven components of acceptability. Results: Findings converged to show caregivers' positive experiences, highlighting observed improvements in residents' wellbeing, caregivers' capabilities, empathic connection, and person‐centred care beyond the one‐on‐one. Caregivers' limited song repertoire and residents' unpredictability hindered implementation, however, the skills acquired appeared useful and applicable. Conclusions: Integration of findings suggests the acceptability of PCCS as caregivers experienced PCCS as a helpful, easy‐to‐implement intervention that contributes to their delivery of person‐centred care. Further research focused on caregiver self‐efficacy, empathy, and caregivers' own personhood is needed as well as determining the most effective strategies to ensure maximum uptake and sustainability in the sector. Patient or Public Contribution: Formal caregivers participated in this study, both attending the training and implementing the singing protocol with residents in their care at their respective care homes. The people living with dementia residing at the care home were recipients of the singing protocol but not included as participants in the research. [ABSTRACT FROM AUTHOR]
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- 2024
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29. The influence of context on the implementation of integrated palliative care in an academic teaching hospital in South Africa.
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Krause, Rene, Gwyther, Liz, and Olivier, Jill
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ACADEMIC medical centers ,HUMAN rights ,RESEARCH methodology ,PRACTICAL politics ,LEADERSHIP ,INTERVIEWING ,QUANTITATIVE research ,HUMAN services programs ,QUALITATIVE research ,RESEARCH funding ,INTEGRATED health care delivery ,JUDGMENT sampling ,THEMATIC analysis ,DATA analysis software ,PALLIATIVE treatment - Abstract
Background: Palliative care (PC) has been integrated to a limited extent in the South African healthcare system. Contextual factors may be a pivotal influence in this integration. Objectives: This study aims to explore contextual factors that are possibly influencing the integration or lack thereof in an academic teaching hospital (ATH). Design: A mixed-method study was conducted in a large ATH in South Africa. Methods: The mixed methods were conducted in parallel and then merged. Findings were integrated to describe the contextual factors influencing PC integration, to develop a timeline of implementation and assess the probable influence of context on the integration process. The mixed-methods phases included a narrative review of published literature related to health systems, integration of health interventions and PC in teaching hospital settings; followed by interviews, documentary and routine data analyses. Semi-structured interviews with purposively sampled participants provided the qualitative data. Primary national, provincial and organizational documents expanded the contextual phenomena and corroborated findings. Routine hospital admission and mortality data was statistically analysed to expand further and corroborate findings. All qualitative data was thematically analysed using deductive coding, drawing from the aspects of the contextual dimensions of integration. Results: Enabling contextual factors for local PC integration were global and local advocacy, demonstrated need, PC being a human right, as well as the personal experiences of hospital staff. Impeding factors were numerous misconceptions, PC not valued as a healthcare priority, as well as limitations in functional elements necessary for PC integration: national and regional political support, leadership at all levels and sustainable financing. Conclusion: The normative and functional contextual aspects interplay at macro, meso and micro levels positively and negatively. How stakeholders understand and value PC directly and indirectly impacts on PC integration. Strategic interventions such as mandatory education are required to ensure PC integration. The health system is dynamic, and understanding the context in which the health system functions is core to the integration of PC. This may assist in developing integration strategies to address PC integration and the transferability of these strategies. Plain language summary: How the context influences a new palliative care intervention Palliative care is being integrated in a big hospital in South Africa. However, there are many contextual factors that influence this integration. These factors are both structural aspects like policies, but also how role players' values and understand of palliative care. It is important to know what these factors are and how these factors influence integration. This study describes the factors and how they influence palliative care integration. [ABSTRACT FROM AUTHOR]
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- 2024
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30. Exploring Mental Health Awareness: A Study on Knowledge and Perceptions of Mental Health Disorders among Residents of Matsafeni Village, Mbombela, Mpumalanga Province.
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Mboweni, Eseldah Nkhensani, Mphasha, Mabitsela Hezekiel, and Skaal, Linda
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COMPETENCY assessment (Law) ,RESEARCH ,CULTURE ,GENETICS ,SOCIAL support ,HEALTH services accessibility ,RESEARCH methodology ,INTERVIEWING ,SOCIAL stigma ,HELP-seeking behavior ,HEALTH literacy ,QUALITATIVE research ,WITCHCRAFT ,HEALTH behavior ,STATISTICAL sampling ,THEMATIC analysis ,HEALTH promotion ,MENTAL illness ,RURAL population ,EDUCATIONAL attainment ,PSYCHOLOGICAL resilience ,PSYCHOSOCIAL factors - Abstract
The global rise in mental health disorders has significant social, economic, and physical impacts. Despite advancements in support, cultural beliefs attributing mental illnesses to spiritual causes persist, fostering discrimination and stigmatization. The study aims to explore the understanding and perceptions of mental health in Matsafeni Village, acknowledging the complexity of mental health issues. A qualitative method and a descriptive exploratory design were employed, enabling the researcher to describe, examine, and explore the knowledge and perceptions regarding mental health. Data collection was conducted through unstructured, open-ended interviews, with 15 participants selected through convenience sampling. The data were analyzed through thematic analysis. Measures of rigor were ensured through credibility, transferability, confirmability, and dependability. Participants demonstrated knowledge of mental health disorders, recognizing disruptions in thought patterns and diverse symptoms. They highlighted key signs and behaviors, emphasizing the need for spotting indicators such as untidiness. Perceptions of the causes of mental illness varied, including witchcraft and genetics. Participants unanimously advocated for seeking help from traditional healers, medical facilities, and therapies. Community members shared their views of mental health, covering their understanding, recognition of signs, personal interactions, and observations of behaviors in individuals with mental health conditions. Reported symptoms align with existing research, emphasizing the complexity of managing safety concerns in severe mental illnesses. The study highlights the need for community education to reduce stigma, considering cultural factors in mental health perceptions. Recommendations include early interventions, enhanced mental health services, and collaboration between western and traditional approaches for a holistic and culturally sensitive approach to mental health. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
31. Inclusive formative assessment in work-integrated learning from the perspectives of students with disabilities.
- Author
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JOSEPH, ASA AHMED and WINBERG, CHRISTINE
- Subjects
SUCCESS ,RESEARCH funding ,RATING of students ,INTERVIEWING ,STUDENTS with disabilities ,SOUND recordings ,CONCEPTUAL structures ,RESEARCH methodology ,CONTENT mining ,STUDENT attitudes ,LEARNING strategies ,PSYCHOSOCIAL factors ,WELL-being - Abstract
The experiences of students with disabilities are the focus of the study, guided by the research question: What can we learn about inclusive formative assessment in work-integrated learning (WIL) from the experiences of students with disabilities? The capability approach was drawn on to theorize how inclusive formative assessment in WIL could contribute to students’ success and well-being. Five narrative interviews with six students were conducted over the course of their first year. The study found that students valued formative assessment tasks that combined engaged learning with preparation for working life. Formative assessment provided opportunities to showcase strengths and develop areas of weakness in a safe space. Above all, students appreciated lecturers who adapted assessment tasks to their needs. The study contributes to an understanding of inclusive formative assessment from the perspectives of students with disabilities and diverse learning needs. [ABSTRACT FROM AUTHOR]
- Published
- 2024
32. 'We are doing damage control': Government stakeholder perspectives of educational and other services for children with autism spectrum disorder in South Africa.
- Author
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Pillay, Sarosha, Duncan, Madeleine, and de Vries, Petrus J
- Subjects
FAMILIES & psychology ,MIDDLE-income countries ,STRATEGIC planning ,EDUCATION ,STAKEHOLDER analysis ,RESEARCH methodology ,PUBLIC administration ,PUBLIC health ,INTERVIEWING ,QUALITATIVE research ,AUTISM in children ,LOW-income countries ,INTERPROFESSIONAL relations ,THEMATIC analysis ,DIFFUSION of innovations - Abstract
Autism spectrum disorder is a growing public health concern in low-and middle-income countries that has prompted a World Health Organization resolution on ' comprehensive and coordinated efforts for management of autism spectrum disorder'. Despite being a signatory of the resolution, South Africa does not have any national policies to guide the management of autism spectrum disorder services. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their proposed solutions to meet the needs of autistic children and their families. The overarching theme that emerged was 'We are doing damage control'. Government stakeholders acknowledged that autism spectrum disorder services were falling between the 'cracks' caused by competing societal demands on government resources. Participants shared perspectives about autism spectrum disorder services in three categories: a cracked society, siloed service systems and gap-filling strategies. Findings from this study highlighted the need for collaborative efforts between government departments and civil society to develop a strategy for autism spectrum disorder in line with the World Health Organization resolution. Multistakeholder engagement to break down barriers, strengthen systems and develop innovative solutions to improving services for children with autism spectrum disorder and their families is recommended. Autism spectrum disorder is a growing public health concern in low- and middle-income countries like South Africa where there are no plans or policies in place for autism spectrum disorder management. Many children with autism spectrum disorder in South Africa are out of schools and waiting for school placement to become available. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their suggestion for improving services for these children and their families. Semi-structured interviews were conducted with government stakeholders from the Western Cape Department of Education, Department of Health and the Department of Social development. The main theme that emerged was 'We are doing damage control'. Government stakeholders acknowledged that autism spectrum disorder services were being overlooked because of other demands on government resources. Finding from this study highlighted the need for government departments to work together to develop a strategy for autism spectrum disorder management. Engagement between government and civil society to break down barriers, strengthen systems and develop solutions to improving access to services for children with autism spectrum disorder and their families is recommended. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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