Poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke in 2007
- Authors: Ntamo, Precious Nomatende
- Date: 2011
- Subjects: Physiotherapy -- Medical care Stroke Mthatha -- South Africa
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18424 , http://hdl.handle.net/11260/d1006933
- Description: Background: Stroke is a major cause of disability in the world and its long term effects require good adherence to treatment protocols of physiotherapy. This will ensure optimal rehabilitation and reduce the burden of care in the society and the health service. Superficial analysis of existing data from the Physiotherapy Department of Mthatha General Hospital (MGH) revealed that there was poor attendance of outpatient physiotherapy by patients discharged from MGH with stroke and this had negative effects on outcomes and health care costs. Aim: To identify factors that influence poor attendance for outpatient physiotherapy by patients discharged from MGH with a stroke. Methods: Following approval from the Research Ethics Committee to conduct the study, an observational descriptive study design was used. The study population was 139 patients with stroke who attended for physiotherapy in MGH from January 2007 to December 2007. From a sample size of 103 randomly selected patients, 85 patients participated in the study with a response rate of 82%. Data collection was done using structured interviews and SPSS was used for data analysis. Results: The majority (86%) of patients did not attend physiotherapy until discharge from physiotherapy department. The major factors that influenced poor attendance were movement of patients to other areas (36%) and long distance from MGH (29%). Conclusion: The majority of stroke patients who attended for rehabilitation in MGH Physiotherapy Department lived in rural areas which were distant from Mthatha and could not attend physiotherapy at MGH as required by the physiotherapists. Recommendation: Development of a Provincial Rehabilitation Policy to address the unavailability of physiotherapy services at clinics and health care centers and ensure creation and filling of vacant physiotherapy positions at these levels of care.
- Full Text:
- Date Issued: 2011
- Authors: Ntamo, Precious Nomatende
- Date: 2011
- Subjects: Physiotherapy -- Medical care Stroke Mthatha -- South Africa
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18424 , http://hdl.handle.net/11260/d1006933
- Description: Background: Stroke is a major cause of disability in the world and its long term effects require good adherence to treatment protocols of physiotherapy. This will ensure optimal rehabilitation and reduce the burden of care in the society and the health service. Superficial analysis of existing data from the Physiotherapy Department of Mthatha General Hospital (MGH) revealed that there was poor attendance of outpatient physiotherapy by patients discharged from MGH with stroke and this had negative effects on outcomes and health care costs. Aim: To identify factors that influence poor attendance for outpatient physiotherapy by patients discharged from MGH with a stroke. Methods: Following approval from the Research Ethics Committee to conduct the study, an observational descriptive study design was used. The study population was 139 patients with stroke who attended for physiotherapy in MGH from January 2007 to December 2007. From a sample size of 103 randomly selected patients, 85 patients participated in the study with a response rate of 82%. Data collection was done using structured interviews and SPSS was used for data analysis. Results: The majority (86%) of patients did not attend physiotherapy until discharge from physiotherapy department. The major factors that influenced poor attendance were movement of patients to other areas (36%) and long distance from MGH (29%). Conclusion: The majority of stroke patients who attended for rehabilitation in MGH Physiotherapy Department lived in rural areas which were distant from Mthatha and could not attend physiotherapy at MGH as required by the physiotherapists. Recommendation: Development of a Provincial Rehabilitation Policy to address the unavailability of physiotherapy services at clinics and health care centers and ensure creation and filling of vacant physiotherapy positions at these levels of care.
- Full Text:
- Date Issued: 2011
Pre and post computerized radiography film reject analysis in a private hospital in Kenya
- Authors: Batuka, Nabawesi Jennifer
- Date: 2011
- Subjects: Radiography, Medical -- Digital techniques
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10075 , http://hdl.handle.net/10948/1574 , Radiography, Medical -- Digital techniques
- Description: The production of good quality radiographs is a complex process, given the high level of image quality required (Sniureviciute & Adliene, 2005: 260). Exposure of patients to x-rays, a factor in the production of quality radiographs also entails a risk of radiation injury. In 2006, computerized radiography (CR) was introduced at The Nairobi Hospital to try and reduce the film reject rate, decrease repeats, reduce financial costs of consumables like x-ray films and processing chemicals. However, to date, no formal film reject analysis has been conducted at The Nairobi Hospital. Four years after the incorporation of CR, there is apparently, still a significant number of film rejects, implying operational costs may still be high. The cause of film rejects and overall reject cost is not known. This has led to the research question: “Has the film reject rate in the A & E x-ray unit at The Nairobi Hospital reduced following incorporation of CR?” A quantitative, retrospective, descriptive study involving a reject film analysis of rejected radiographs in the Accident and Emergency (A&E) x-ray unit in the Nairobi Hospital, Kenya was conducted. The researcher collected data for a period of 6 months between 2/12/07 and 28/05/08 using a purpose-designed data collection form. All rejected x-ray films during the study period were included. Capture and analysis of the collected data was completed by the researcher using SPSS 10 and EPINFO computer packages. Permission to conduct the study was obtained from The Nairobi Hospital Education Committee and due consideration to patient and radiographer confidentiality was maintained throughout the study. A total of 851(2.5 percent) x-ray films were collected during the study period. Four hundred and fourteen (2.6 percent) radiographs and 437 (2.5 percent) radiographs were rejected prior to and after the incorporation of CR respectively. Chest radiographs were the most frequently rejected accounting for 277(66.9 percent) and 123 (28.1 percent) prior to and after the incorporation of CR respectively. The most frequently rejected film size was 35x35cm prior to the incorporation of CR (61.6 percent) and 26x35cm film size after the incorporation of CR (91.3 percent). The most frequent cause of film rejects was radiographer causes both prior to and after the incorporation of CR accounting for 496 (58.3 percent). The film reject rate did not significantly reduce after the incorporation of CR, suggesting that there are other factors which contribute to reject rate, other than CR. The study also shows that higher film consumption does not necessarily lead to high reject rates. The percentage value on annual rejects did not change after the incorporation of CR and a demonstrated increase in the annual cost of purchasing x-ray films was attributed to an increase in annual consumption after the incorporation of CR, and also to the higher cost of digital x-ray films. Despite some identified limitations to this study, some recommendations, which included conduction of regular reject analyses and regular continuing professional development with respect to radiographic technique amongst others, were suggested.
- Full Text:
- Date Issued: 2011
- Authors: Batuka, Nabawesi Jennifer
- Date: 2011
- Subjects: Radiography, Medical -- Digital techniques
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10075 , http://hdl.handle.net/10948/1574 , Radiography, Medical -- Digital techniques
- Description: The production of good quality radiographs is a complex process, given the high level of image quality required (Sniureviciute & Adliene, 2005: 260). Exposure of patients to x-rays, a factor in the production of quality radiographs also entails a risk of radiation injury. In 2006, computerized radiography (CR) was introduced at The Nairobi Hospital to try and reduce the film reject rate, decrease repeats, reduce financial costs of consumables like x-ray films and processing chemicals. However, to date, no formal film reject analysis has been conducted at The Nairobi Hospital. Four years after the incorporation of CR, there is apparently, still a significant number of film rejects, implying operational costs may still be high. The cause of film rejects and overall reject cost is not known. This has led to the research question: “Has the film reject rate in the A & E x-ray unit at The Nairobi Hospital reduced following incorporation of CR?” A quantitative, retrospective, descriptive study involving a reject film analysis of rejected radiographs in the Accident and Emergency (A&E) x-ray unit in the Nairobi Hospital, Kenya was conducted. The researcher collected data for a period of 6 months between 2/12/07 and 28/05/08 using a purpose-designed data collection form. All rejected x-ray films during the study period were included. Capture and analysis of the collected data was completed by the researcher using SPSS 10 and EPINFO computer packages. Permission to conduct the study was obtained from The Nairobi Hospital Education Committee and due consideration to patient and radiographer confidentiality was maintained throughout the study. A total of 851(2.5 percent) x-ray films were collected during the study period. Four hundred and fourteen (2.6 percent) radiographs and 437 (2.5 percent) radiographs were rejected prior to and after the incorporation of CR respectively. Chest radiographs were the most frequently rejected accounting for 277(66.9 percent) and 123 (28.1 percent) prior to and after the incorporation of CR respectively. The most frequently rejected film size was 35x35cm prior to the incorporation of CR (61.6 percent) and 26x35cm film size after the incorporation of CR (91.3 percent). The most frequent cause of film rejects was radiographer causes both prior to and after the incorporation of CR accounting for 496 (58.3 percent). The film reject rate did not significantly reduce after the incorporation of CR, suggesting that there are other factors which contribute to reject rate, other than CR. The study also shows that higher film consumption does not necessarily lead to high reject rates. The percentage value on annual rejects did not change after the incorporation of CR and a demonstrated increase in the annual cost of purchasing x-ray films was attributed to an increase in annual consumption after the incorporation of CR, and also to the higher cost of digital x-ray films. Despite some identified limitations to this study, some recommendations, which included conduction of regular reject analyses and regular continuing professional development with respect to radiographic technique amongst others, were suggested.
- Full Text:
- Date Issued: 2011
Professional nurses experiences of a team nursing care framework in critical care units in a private healthcare group
- Authors: Dunsdon, Jeananne
- Date: 2011
- Subjects: Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10022 , http://hdl.handle.net/10948/1444 , Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Description: A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.
- Full Text:
- Date Issued: 2011
- Authors: Dunsdon, Jeananne
- Date: 2011
- Subjects: Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10022 , http://hdl.handle.net/10948/1444 , Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Description: A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.
- Full Text:
- Date Issued: 2011
Professional nurses' knowledge regarding weaning the critically ill patient from the mechanical ventilation
- Authors: Demingo, Xavier Preston
- Date: 2011
- Subjects: Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10026 , http://hdl.handle.net/10948/1323 , Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Description: Mechanical ventilation (MV) is one of the most frequently used treatment modalities in the intensive care unit (ICU) (Burns, 2005:14). Up to 90% of critically ill patients in ICUs globally are connected to a mechanical ventilator. Although mechanical ventilation is a lifesaving intervention, it is expensive and is associated with diverse complications (Mclean, Jensen, Schroeder, Gibney & Skjodt, 2006: 299). Ventilator-associated pneumonia (VAP) accounts for 25% of all infections in ICU, with global crude mortality figures estimated at 20-70% (Craven, 2006:251). Minimising the time that a patient is connected to a mechanical ventilator to the absolute minimum can have considerable benefits in terms of decreased mortality and morbidity, as well as a decreased length of ICU stay and lower hospital costs. Critically ill patients therefore need to be weaned from the mechanical ventilator as soon as their condition that warranted the need for mechanical ventilation is stabilized. The process of weaning the critically ill patient from mechanical ventilation constitutes a significant proportion of total ventilator time. As professional nurses attend to the mechanically ventilated patient 24 hours a day, they have a vital role to play in the collaborative management of the patient requiring weaning from mechanical ventilation. The objectives of this study were to explore and describe the professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. Based on the results, recommendations in the form of a protocol were made in order to improve the professional nurses’ knowledge and enhance the care of the mechanically ventilated patient. A quantitative design, which was exploratory, descriptive and contextual in nature, was utilised for the study. The data collection instrument of choice was a self-administered questionnaire. Convenience, non-probability sampling was the sampling method chosen for the purpose of this study. Collected data were analysed with the assistance of a statistician using descriptive and inferential statistics. Results were displayed in the form of graphs and tables. The results obtained in the study, combined with data from the literature review, were used to develop recommendations to enhance vi professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. The recommendations were presented in the form of a protocol based on the available evidence. Ethical principles as they relate to conducting research were adhered to throughout the study.
- Full Text:
- Date Issued: 2011
- Authors: Demingo, Xavier Preston
- Date: 2011
- Subjects: Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10026 , http://hdl.handle.net/10948/1323 , Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Description: Mechanical ventilation (MV) is one of the most frequently used treatment modalities in the intensive care unit (ICU) (Burns, 2005:14). Up to 90% of critically ill patients in ICUs globally are connected to a mechanical ventilator. Although mechanical ventilation is a lifesaving intervention, it is expensive and is associated with diverse complications (Mclean, Jensen, Schroeder, Gibney & Skjodt, 2006: 299). Ventilator-associated pneumonia (VAP) accounts for 25% of all infections in ICU, with global crude mortality figures estimated at 20-70% (Craven, 2006:251). Minimising the time that a patient is connected to a mechanical ventilator to the absolute minimum can have considerable benefits in terms of decreased mortality and morbidity, as well as a decreased length of ICU stay and lower hospital costs. Critically ill patients therefore need to be weaned from the mechanical ventilator as soon as their condition that warranted the need for mechanical ventilation is stabilized. The process of weaning the critically ill patient from mechanical ventilation constitutes a significant proportion of total ventilator time. As professional nurses attend to the mechanically ventilated patient 24 hours a day, they have a vital role to play in the collaborative management of the patient requiring weaning from mechanical ventilation. The objectives of this study were to explore and describe the professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. Based on the results, recommendations in the form of a protocol were made in order to improve the professional nurses’ knowledge and enhance the care of the mechanically ventilated patient. A quantitative design, which was exploratory, descriptive and contextual in nature, was utilised for the study. The data collection instrument of choice was a self-administered questionnaire. Convenience, non-probability sampling was the sampling method chosen for the purpose of this study. Collected data were analysed with the assistance of a statistician using descriptive and inferential statistics. Results were displayed in the form of graphs and tables. The results obtained in the study, combined with data from the literature review, were used to develop recommendations to enhance vi professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. The recommendations were presented in the form of a protocol based on the available evidence. Ethical principles as they relate to conducting research were adhered to throughout the study.
- Full Text:
- Date Issued: 2011
Psychofortology of adults recovering from substance-use disorders
- Authors: Bubb, Tanielle Carmen
- Date: 2011
- Subjects: Substance-related disorders -- Therapy , Substance abuse -- Treatment , Substance abuse
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9870 , http://hdl.handle.net/10948/d1008117 , Substance-related disorders -- Therapy , Substance abuse -- Treatment , Substance abuse
- Description: Evaluating the psychofortology of adults recovering from a substance-use disorder has been identified as a research priority in South Africa. This is in line with calls from researchers in diverse fields of psychology for more attention to the resilience, strengths, resources and capacities of people. This study therefore aimed to explore and describe the coping resources, sense of coherence, happiness and satisfaction with life of adults recovering from a substance-use disorder within the Nelson Mandela Metropole. The sample consisted of 99 voluntary participants from various managed recovery centres within the Nelson Mandela Metropole. Participants were given a package of questionnaires to complete under the supervision of the researcher. The assessment consisted of a biographical questionnaire and four standardized paper and pencil measures namely; the Coping Resources Inventory (CRI), the Sense of Coherence Scale (SOC-29), the Affectometer 2 (AFM-2) and the Satisfaction with Life Scale (SWLS). A quantitative, non-experimental exploratory-descriptive research method was used. Data was analysed using descriptive statistics and the Pearson product-moment correlation coefficient. Key findings include the following: Results on the CRI revealed low average mean scores on both the Coping Resources Inventory and within all the five subscales. Results of the SOC-29 revealed a high average mean score for sense of coherence. Results of the AFM-2 revealed that more positive affect than negative affect is present, resulting in happiness. Results of the SWLS revealed an average level of satisfaction with life, with most participants’ reporting neutral levels of satisfaction with life. There were significant positive correlations between the coping resources, sense of coherence, happiness and satisfaction with life of the sample. This implies that these constructs can be categorized under the subdiscipline of psychofortology. Overall, these findings emphasized the need for more research into adults recovering from a substance-use disorder.
- Full Text:
- Date Issued: 2011
- Authors: Bubb, Tanielle Carmen
- Date: 2011
- Subjects: Substance-related disorders -- Therapy , Substance abuse -- Treatment , Substance abuse
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9870 , http://hdl.handle.net/10948/d1008117 , Substance-related disorders -- Therapy , Substance abuse -- Treatment , Substance abuse
- Description: Evaluating the psychofortology of adults recovering from a substance-use disorder has been identified as a research priority in South Africa. This is in line with calls from researchers in diverse fields of psychology for more attention to the resilience, strengths, resources and capacities of people. This study therefore aimed to explore and describe the coping resources, sense of coherence, happiness and satisfaction with life of adults recovering from a substance-use disorder within the Nelson Mandela Metropole. The sample consisted of 99 voluntary participants from various managed recovery centres within the Nelson Mandela Metropole. Participants were given a package of questionnaires to complete under the supervision of the researcher. The assessment consisted of a biographical questionnaire and four standardized paper and pencil measures namely; the Coping Resources Inventory (CRI), the Sense of Coherence Scale (SOC-29), the Affectometer 2 (AFM-2) and the Satisfaction with Life Scale (SWLS). A quantitative, non-experimental exploratory-descriptive research method was used. Data was analysed using descriptive statistics and the Pearson product-moment correlation coefficient. Key findings include the following: Results on the CRI revealed low average mean scores on both the Coping Resources Inventory and within all the five subscales. Results of the SOC-29 revealed a high average mean score for sense of coherence. Results of the AFM-2 revealed that more positive affect than negative affect is present, resulting in happiness. Results of the SWLS revealed an average level of satisfaction with life, with most participants’ reporting neutral levels of satisfaction with life. There were significant positive correlations between the coping resources, sense of coherence, happiness and satisfaction with life of the sample. This implies that these constructs can be categorized under the subdiscipline of psychofortology. Overall, these findings emphasized the need for more research into adults recovering from a substance-use disorder.
- Full Text:
- Date Issued: 2011
Response and adherence of HIV positive women to cervical cancer treatment
- Authors: Ngugi, Pearl
- Date: 2011
- Subjects: HIV infections -- Chemotherapy -- South Africa , Patient compliance -- South Africa , Cervix uteri -- Cancer -- Treatment , HIV-positive women -- South Africa , Antiretroviral agents -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10162 , http://hdl.handle.net/10948/d1014129
- Description: It is estimated that 6742 South African women are diagnosed with cervical cancer and 3681 women die from the disease every year. In 1993, The Centers for Disease Control declared cervical cancer an Acquired Immunodeficiency Syndrome defining illness. Apart from persistent human papillomavirus infection, HIV infection is the most common co-factor contributing to cervical cancer in South Africa. Studies have noted that in HIV positive women, there has been an occurrence of faster progression to more advanced stages of cervical cancer with high cases of treatment failure and recurrence. There is limited literature available regarding the prognosis of HIV positive women who suffer from cervical cancer. Women who are HIV positive and have cervical cancer have not been evaluated in detail regarding their response and adherence to cervical cancer treatment. Standard treatment protocols for this set of patients have not been defined. The aim of this study was to assess how HIV positive women who have been diagnosed with cervical cancer responded and adhered to cervical cancer therapy which includes: curative radiotherapy; curative chemotherapy; concurrent chemoradiation or palliative radiotherapy. The study also evaluated the effects of the concurrent use of antiretrovirals and cervical cancer treatment. This was done to determine whether invasive cervical cancer in women who were HIV positive could be managed using the same treatment protocols as patients who were HIV negative. A historical cohort design was employed for the study. The study was conducted at the Oncology Department of a tertiary level hospital located in the Eastern Cape Province, South Africa. The total sample consisted of 196 medical records of women diagnosed with cervical cancer between 2005 and 2008. One hundred women were HIV negative, 83 were HIV positive and the HIV status of 13 women could not be determined. The records were audited over a period of two years from the date of diagnosis. The term „complete response‟ referred to patients who had no recurrence of cervical cancer and no evidence of metastases after undergoing treatment. At one month following treatment there was a significant difference in the incidence of complete response between the HIV positive patients and the HIV negative patients (Chi2 = 16.4, d.f. = 1, p = 0.00005, Cramer‟s V = 0.31). The significant difference in response to treatment between the HIV positive patients and the HIV negative patients was maintained at six months after treatment (Chi2 = 15, d.f. = 1, p = 0.00011, Cramer‟s V = 0.34), 12 months after treatment (Chi2 = 20.5, d.f. = 1, p = 0.00001, Cramer‟s V = 0.37), 18 months after treatment (Chi2 = 9.8, d.f. = 1, p = 0.00173, Cramer‟s V = 0.28) and 24 months after treatment (Chi2 = 5.0, d.f. = 1, p = 0.02571, Cramer‟s V = 0.26). At each of these intervals, cases of treatment failure and metastases were significantly higher in the HIV positive women than in the HIV negative women. Although there was no significant difference in the incidence of adherence between the HIV negative women, the HIV positive women who were on HAART and the HIV positive women who were not on HAART, there was a significant difference in the incidence of the various reasons for non adherence between the various groups. These reasons included: missed scheduled appointments (Chi2 = 2.9, d.f. = 2, p = 0.02385, Cramer‟s V = 0.31); low blood count (Chi2 = 4.0, d.f. = 2, p = 0.01327, Cramer‟s V = 0.15); radiotherapy induced skin breakdown (Chi2 = 0.6, d.f. = 2, p = 0.04581, Cramer‟s V = 0.16) and radiotherapy induced diarrhoea (Chi2 = 6.9, d.f. = 2, p = 0.03118, Cramer‟s V = 0.19). According to the 2004 National Antiretroviral Treatment Guidelines, cervical cancer patients would fall into the WHO stage IV category of HIV disease thus all patients with confirmed diagnosis of invasive cervical cancer should be commenced on antiretrovirals as soon as the cancer diagnosis is made regardless of their CD4 count. However, in the current study, 13 percent (n= 83) of the HIV positive women were not on antiretrovirals. The study concluded that HIV positive women had a higher incidence of both treatment failure and metastases to cervical cancer treatment. Standard radiotherapy and concurrent chemoradiation cervical cancer treatment protocols should be still be used in both HIV negative patients and HIV positive patients so as not to compromise tumour control. Furthermore, in accordance with the antiretroviral treatment guidelines, all HIV positive patients with cervical cancer should receive antiretrovirals irrespective of their CD4 count.
- Full Text:
- Date Issued: 2011
- Authors: Ngugi, Pearl
- Date: 2011
- Subjects: HIV infections -- Chemotherapy -- South Africa , Patient compliance -- South Africa , Cervix uteri -- Cancer -- Treatment , HIV-positive women -- South Africa , Antiretroviral agents -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10162 , http://hdl.handle.net/10948/d1014129
- Description: It is estimated that 6742 South African women are diagnosed with cervical cancer and 3681 women die from the disease every year. In 1993, The Centers for Disease Control declared cervical cancer an Acquired Immunodeficiency Syndrome defining illness. Apart from persistent human papillomavirus infection, HIV infection is the most common co-factor contributing to cervical cancer in South Africa. Studies have noted that in HIV positive women, there has been an occurrence of faster progression to more advanced stages of cervical cancer with high cases of treatment failure and recurrence. There is limited literature available regarding the prognosis of HIV positive women who suffer from cervical cancer. Women who are HIV positive and have cervical cancer have not been evaluated in detail regarding their response and adherence to cervical cancer treatment. Standard treatment protocols for this set of patients have not been defined. The aim of this study was to assess how HIV positive women who have been diagnosed with cervical cancer responded and adhered to cervical cancer therapy which includes: curative radiotherapy; curative chemotherapy; concurrent chemoradiation or palliative radiotherapy. The study also evaluated the effects of the concurrent use of antiretrovirals and cervical cancer treatment. This was done to determine whether invasive cervical cancer in women who were HIV positive could be managed using the same treatment protocols as patients who were HIV negative. A historical cohort design was employed for the study. The study was conducted at the Oncology Department of a tertiary level hospital located in the Eastern Cape Province, South Africa. The total sample consisted of 196 medical records of women diagnosed with cervical cancer between 2005 and 2008. One hundred women were HIV negative, 83 were HIV positive and the HIV status of 13 women could not be determined. The records were audited over a period of two years from the date of diagnosis. The term „complete response‟ referred to patients who had no recurrence of cervical cancer and no evidence of metastases after undergoing treatment. At one month following treatment there was a significant difference in the incidence of complete response between the HIV positive patients and the HIV negative patients (Chi2 = 16.4, d.f. = 1, p = 0.00005, Cramer‟s V = 0.31). The significant difference in response to treatment between the HIV positive patients and the HIV negative patients was maintained at six months after treatment (Chi2 = 15, d.f. = 1, p = 0.00011, Cramer‟s V = 0.34), 12 months after treatment (Chi2 = 20.5, d.f. = 1, p = 0.00001, Cramer‟s V = 0.37), 18 months after treatment (Chi2 = 9.8, d.f. = 1, p = 0.00173, Cramer‟s V = 0.28) and 24 months after treatment (Chi2 = 5.0, d.f. = 1, p = 0.02571, Cramer‟s V = 0.26). At each of these intervals, cases of treatment failure and metastases were significantly higher in the HIV positive women than in the HIV negative women. Although there was no significant difference in the incidence of adherence between the HIV negative women, the HIV positive women who were on HAART and the HIV positive women who were not on HAART, there was a significant difference in the incidence of the various reasons for non adherence between the various groups. These reasons included: missed scheduled appointments (Chi2 = 2.9, d.f. = 2, p = 0.02385, Cramer‟s V = 0.31); low blood count (Chi2 = 4.0, d.f. = 2, p = 0.01327, Cramer‟s V = 0.15); radiotherapy induced skin breakdown (Chi2 = 0.6, d.f. = 2, p = 0.04581, Cramer‟s V = 0.16) and radiotherapy induced diarrhoea (Chi2 = 6.9, d.f. = 2, p = 0.03118, Cramer‟s V = 0.19). According to the 2004 National Antiretroviral Treatment Guidelines, cervical cancer patients would fall into the WHO stage IV category of HIV disease thus all patients with confirmed diagnosis of invasive cervical cancer should be commenced on antiretrovirals as soon as the cancer diagnosis is made regardless of their CD4 count. However, in the current study, 13 percent (n= 83) of the HIV positive women were not on antiretrovirals. The study concluded that HIV positive women had a higher incidence of both treatment failure and metastases to cervical cancer treatment. Standard radiotherapy and concurrent chemoradiation cervical cancer treatment protocols should be still be used in both HIV negative patients and HIV positive patients so as not to compromise tumour control. Furthermore, in accordance with the antiretroviral treatment guidelines, all HIV positive patients with cervical cancer should receive antiretrovirals irrespective of their CD4 count.
- Full Text:
- Date Issued: 2011
Teenage pregnancy among high school girls in Mthatha, South Africa
- Meel, A
- Authors: Meel, A
- Date: 2011
- Subjects: Teenage pregnancy -- Prevention , Teenage pregnancy -- Social aspects , South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18428 , http://hdl.handle.net/11260/d1006969
- Description: Teenage pregnancy is an important health and social problem in South Africa. Despite declining trends of fertility rates in last two decades, the pregnancy among school girls remains steadily high in South Africa. Teenage pregnancy had negative impacts on various aspects of socio-economic well being of school girls. Aim: To determine the proportion of teenage pregnancy among high school girls and to identify the possible factors that influence teenage pregnancy in Mthatha region during the year 2009. Materials and Methods: This is an observational cross sectional, analytic study of teenage pregnancy conducted among high school teenage girls in the Mthatha region of South Africa. Result: A total of 1150 teenage girls from 15 to 19 years of ages responded from seven high schools in the Mthatha region of South Africa. In total 113 (10%) of teenage high school girls were currently mothers or had previously been pregnant. The proportions of those who had ever been pregnant increased significantly with age. The risk of falling pregnant among public high school teenage girls had two times higher compared to private high school teenage girls. Condoms were the most common method of contraception whereas the oral pills were the least common in practice. About half of teenage girls who had ever been pregnant had an abortion and of this one-third had had a backstreet/illegal abortion. The frequency of substance use was significantly higher among teenage girls who had ever been pregnant. A significant correlation was found between low socio-economic status, public schools and teenage pregnancy in this study. Conclusion: Teenage pregnancy is common among high school girls from 15 to 19 years of age in the Mthatha Region, South Africa. Poor socio-economic family conditions, lack of contraceptive use, early sexual maturation, risky behaviour, lack of knowledge about sexuality and reproductive health, multiple sexual partners and substance use were the common contributing factors of teenage pregnancy.
- Full Text:
- Date Issued: 2011
- Authors: Meel, A
- Date: 2011
- Subjects: Teenage pregnancy -- Prevention , Teenage pregnancy -- Social aspects , South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: vital:18428 , http://hdl.handle.net/11260/d1006969
- Description: Teenage pregnancy is an important health and social problem in South Africa. Despite declining trends of fertility rates in last two decades, the pregnancy among school girls remains steadily high in South Africa. Teenage pregnancy had negative impacts on various aspects of socio-economic well being of school girls. Aim: To determine the proportion of teenage pregnancy among high school girls and to identify the possible factors that influence teenage pregnancy in Mthatha region during the year 2009. Materials and Methods: This is an observational cross sectional, analytic study of teenage pregnancy conducted among high school teenage girls in the Mthatha region of South Africa. Result: A total of 1150 teenage girls from 15 to 19 years of ages responded from seven high schools in the Mthatha region of South Africa. In total 113 (10%) of teenage high school girls were currently mothers or had previously been pregnant. The proportions of those who had ever been pregnant increased significantly with age. The risk of falling pregnant among public high school teenage girls had two times higher compared to private high school teenage girls. Condoms were the most common method of contraception whereas the oral pills were the least common in practice. About half of teenage girls who had ever been pregnant had an abortion and of this one-third had had a backstreet/illegal abortion. The frequency of substance use was significantly higher among teenage girls who had ever been pregnant. A significant correlation was found between low socio-economic status, public schools and teenage pregnancy in this study. Conclusion: Teenage pregnancy is common among high school girls from 15 to 19 years of age in the Mthatha Region, South Africa. Poor socio-economic family conditions, lack of contraceptive use, early sexual maturation, risky behaviour, lack of knowledge about sexuality and reproductive health, multiple sexual partners and substance use were the common contributing factors of teenage pregnancy.
- Full Text:
- Date Issued: 2011
The experiences of pregnant teenagers as related to ante-natal care
- Authors: Pienaar, Nadine
- Date: 2011
- Subjects: Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10028 , http://hdl.handle.net/10948/1321 , Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Description: The experiences of pregnant teenagers as related to ante-natal care were researched. The primary objective of the study was to explore and describe the experiences pregnant teenagers had of their ante-natal care. The researcher recommended measures based on the findings of the study to midwives to encourage ante-natal care clinic attendance amongst pregnant teenagers. The recommendations were such that even nurses at Primary Health Care clinics could utilise them as they also come into contact with pregnant teenagers. An increasing number of pregnant teenagers in the Nelson Mandela Metropolitan Municipality area are admitted to referral hospitals with complications during pregnancy and labour. Some of these teenagers are un-booked or had only a few ante-natal clinic visits. The researcher therefore wanted to obtain first hand information related to the reluctance of pregnant teenagers to attend ante-natal care clinics. Attendance at ante-natal care clinics plays an important part in enabling the staff to screen pregnant mothers for health problems and so limit complications. Hence the concern and need to develop measures to motivate pregnant teenagers to attend ante-natal clinics.
- Full Text: false
- Date Issued: 2011
- Authors: Pienaar, Nadine
- Date: 2011
- Subjects: Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10028 , http://hdl.handle.net/10948/1321 , Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Description: The experiences of pregnant teenagers as related to ante-natal care were researched. The primary objective of the study was to explore and describe the experiences pregnant teenagers had of their ante-natal care. The researcher recommended measures based on the findings of the study to midwives to encourage ante-natal care clinic attendance amongst pregnant teenagers. The recommendations were such that even nurses at Primary Health Care clinics could utilise them as they also come into contact with pregnant teenagers. An increasing number of pregnant teenagers in the Nelson Mandela Metropolitan Municipality area are admitted to referral hospitals with complications during pregnancy and labour. Some of these teenagers are un-booked or had only a few ante-natal clinic visits. The researcher therefore wanted to obtain first hand information related to the reluctance of pregnant teenagers to attend ante-natal care clinics. Attendance at ante-natal care clinics plays an important part in enabling the staff to screen pregnant mothers for health problems and so limit complications. Hence the concern and need to develop measures to motivate pregnant teenagers to attend ante-natal clinics.
- Full Text: false
- Date Issued: 2011
The experiences of professional nurses regarding the management of health services rendered to tuberculosis patients
- Authors: Jantjies, Leigh-Anne Rene
- Date: 2011
- Subjects: Tuberculosis -- Nursing -- South Africa -- Port Elizabeth , Health services administration -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10025 , http://hdl.handle.net/10948/1399 , Tuberculosis -- Nursing -- South Africa -- Port Elizabeth , Health services administration -- South Africa -- Port Elizabeth
- Description: The World Health Organisation (WHO) declared tuberculosis (TB) a global emergency, and this infectious disease remains a health threat by being the leading cause of death amongst adults (Naidoo, Dick & Cooper, 2008:55). In 2005, South Africa was ranked seventh in the world for having the highest TB rate and the lowest TB success rate in the world. As a professional nurse involved in the tuberculosis programme at a clinic in the Nelson Mandela Bay Municipality at local government level for approximately three years, the researcher observed that the morale of professional nurses who provide TB services appeared to be low. They also appeared to be frustrated because they feel that they are not winning the battle with regard to the TB epidemic in their communities irrespective of their efforts to try and curb the spread of the disease. The extent of the workload per person also appeared to add to the low morale and frustration of the professional nurses rendering TB health services because they feel that they are unable to manage everything. The objectives of the study were therefore to explore and describe how professional nurses experienced the management of health services being rendered to TB patients in Sub district B of the Nelson Mandela Bay Municipality (NMBM) in order to make recommendations that could be used by the district manager to address the research findings. The research study was based on a qualitative, explorative, descriptive and contextual research design. The research population consisted of all professional nurses who worked in the TB services of Sub district B. Non-probability, purposive sampling was used to select the participants for the study. Seven in-depth and three follow-up interviews were conducted before data saturation was achieved. The data gathered during the interview process by the researcher were transcribed and coded by an independent coder using Tech’s model for data analysis. Ethical considerations were adhered to throughout the research study. The aspect of trustworthiness according to Guba’s model was implemented in the research study and included credibility, applicability, consistency and neutrality. iii One theme, two sub themes and categories were identified relating to the diverse experiences expressed by the participants relating to the management of health services being rendered to TB patients. The experiences expressed by the professional nurses included both negative and positive experiences. The negative experiences expressed by the participants were for example, a lack of resources as hampering adequate service delivery, a concern regarding the number of staff contracting TB due to a lack of infection control measures, a difference in conditions of service between the two local authorities and the DOTS supporters as being a threat to patient confidentiality. The positive experiences expressed by the participants included experiences relating to job satisfaction in rendering TB health services, the DOTS supporters as being supportive to the staff, the TB meetings serving as an appropriate platform for problem solving and the audits conducted by managers as being remedial. The study concludes with recommendations made with regard to the areas of nursing practice, education and research.
- Full Text:
- Date Issued: 2011
- Authors: Jantjies, Leigh-Anne Rene
- Date: 2011
- Subjects: Tuberculosis -- Nursing -- South Africa -- Port Elizabeth , Health services administration -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10025 , http://hdl.handle.net/10948/1399 , Tuberculosis -- Nursing -- South Africa -- Port Elizabeth , Health services administration -- South Africa -- Port Elizabeth
- Description: The World Health Organisation (WHO) declared tuberculosis (TB) a global emergency, and this infectious disease remains a health threat by being the leading cause of death amongst adults (Naidoo, Dick & Cooper, 2008:55). In 2005, South Africa was ranked seventh in the world for having the highest TB rate and the lowest TB success rate in the world. As a professional nurse involved in the tuberculosis programme at a clinic in the Nelson Mandela Bay Municipality at local government level for approximately three years, the researcher observed that the morale of professional nurses who provide TB services appeared to be low. They also appeared to be frustrated because they feel that they are not winning the battle with regard to the TB epidemic in their communities irrespective of their efforts to try and curb the spread of the disease. The extent of the workload per person also appeared to add to the low morale and frustration of the professional nurses rendering TB health services because they feel that they are unable to manage everything. The objectives of the study were therefore to explore and describe how professional nurses experienced the management of health services being rendered to TB patients in Sub district B of the Nelson Mandela Bay Municipality (NMBM) in order to make recommendations that could be used by the district manager to address the research findings. The research study was based on a qualitative, explorative, descriptive and contextual research design. The research population consisted of all professional nurses who worked in the TB services of Sub district B. Non-probability, purposive sampling was used to select the participants for the study. Seven in-depth and three follow-up interviews were conducted before data saturation was achieved. The data gathered during the interview process by the researcher were transcribed and coded by an independent coder using Tech’s model for data analysis. Ethical considerations were adhered to throughout the research study. The aspect of trustworthiness according to Guba’s model was implemented in the research study and included credibility, applicability, consistency and neutrality. iii One theme, two sub themes and categories were identified relating to the diverse experiences expressed by the participants relating to the management of health services being rendered to TB patients. The experiences expressed by the professional nurses included both negative and positive experiences. The negative experiences expressed by the participants were for example, a lack of resources as hampering adequate service delivery, a concern regarding the number of staff contracting TB due to a lack of infection control measures, a difference in conditions of service between the two local authorities and the DOTS supporters as being a threat to patient confidentiality. The positive experiences expressed by the participants included experiences relating to job satisfaction in rendering TB health services, the DOTS supporters as being supportive to the staff, the TB meetings serving as an appropriate platform for problem solving and the audits conducted by managers as being remedial. The study concludes with recommendations made with regard to the areas of nursing practice, education and research.
- Full Text:
- Date Issued: 2011
The experiences of professional nurses working in outpatient departments of the introduction of the Batho Pele Principles in state hospitals
- Authors: Miza, Thenjiwe Mildred
- Date: 2011
- Subjects: Nurse and patient -- South Africa -- Port Elizabeth , Hospitals -- Outpatient services -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10023 , http://hdl.handle.net/10948/1421 , Nurse and patient -- South Africa -- Port Elizabeth , Hospitals -- Outpatient services -- South Africa -- Port Elizabeth
- Description: After 1994 with the inception of the South African Democratic Government, the health care delivery system was one of the areas that had to be reviewed. The vehicle for a comprehensive health care system was based on primary health care which encouraged people and patients to take responsibility for their health by being involved in all aspects of their care. For this purpose the Batho Pele principles were introduced, a concept which is informed by 8 principles, namely: consultation, service standards, access, courtesy, information, openness and transparency, redress and value for money. These principles are meant to restore the dignity and the rights of patients which are paramount in the Constitution of South Africa. (Constitution of South Africa 108 of 1996 Chapter 2) The nurses claim that since the introduction of the Batho Pele Principles, patients and their families have been “impossible” towards nurses, making unnecessary and sometimes impossible demands. The nurses also experience patients and their families as being informed of their “rights” but not of their responsibilities as patients. They were also unaware of the rights of the nurses. The objectives of the study were:- To explore and describe the experiences of professional nurses working in the outpatient departments of the introduction of the Batho Pele principles in state hospitals, and to Recommend guidelines that will enhance better understanding and implementation of the Batho Pele principles by the professional nurses. The study is founded on a qualitative research paradigm based on explorative, descriptive and contextual framework. The data was collected from focus groups from each hospital of the Port Elizabeth Hospital Complex. Each group consisted of four to six willing participants all of them were professional nurses who have worked at least five or more years in the outpatient department of the Port Elizabeth Hospital Complex. Data was collected via semi-structured audio-taped interviews together with the researcher’s field notes. Data analysis was done using Tesch’s data analysis spiral. The assistance of independent coder reinforced the truth value of the findings. Themes and subthemes emerged from the data that was collected and revealed that the professional nurses experienced that the Batho Pele Principles as a good policy, but that it was difficulty to uphold due to inadequate planning of health services prior to implementation of the Batho Pele Principles. They experience not getting from their management and they also experience that there was lack of discipline in their institutions. Based on these findings, guidelines that will recommend better implementation of the Batho Pele Principles by nurses were compiled by the researcher and future research in this regard was recommended.
- Full Text:
- Date Issued: 2011
- Authors: Miza, Thenjiwe Mildred
- Date: 2011
- Subjects: Nurse and patient -- South Africa -- Port Elizabeth , Hospitals -- Outpatient services -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10023 , http://hdl.handle.net/10948/1421 , Nurse and patient -- South Africa -- Port Elizabeth , Hospitals -- Outpatient services -- South Africa -- Port Elizabeth
- Description: After 1994 with the inception of the South African Democratic Government, the health care delivery system was one of the areas that had to be reviewed. The vehicle for a comprehensive health care system was based on primary health care which encouraged people and patients to take responsibility for their health by being involved in all aspects of their care. For this purpose the Batho Pele principles were introduced, a concept which is informed by 8 principles, namely: consultation, service standards, access, courtesy, information, openness and transparency, redress and value for money. These principles are meant to restore the dignity and the rights of patients which are paramount in the Constitution of South Africa. (Constitution of South Africa 108 of 1996 Chapter 2) The nurses claim that since the introduction of the Batho Pele Principles, patients and their families have been “impossible” towards nurses, making unnecessary and sometimes impossible demands. The nurses also experience patients and their families as being informed of their “rights” but not of their responsibilities as patients. They were also unaware of the rights of the nurses. The objectives of the study were:- To explore and describe the experiences of professional nurses working in the outpatient departments of the introduction of the Batho Pele principles in state hospitals, and to Recommend guidelines that will enhance better understanding and implementation of the Batho Pele principles by the professional nurses. The study is founded on a qualitative research paradigm based on explorative, descriptive and contextual framework. The data was collected from focus groups from each hospital of the Port Elizabeth Hospital Complex. Each group consisted of four to six willing participants all of them were professional nurses who have worked at least five or more years in the outpatient department of the Port Elizabeth Hospital Complex. Data was collected via semi-structured audio-taped interviews together with the researcher’s field notes. Data analysis was done using Tesch’s data analysis spiral. The assistance of independent coder reinforced the truth value of the findings. Themes and subthemes emerged from the data that was collected and revealed that the professional nurses experienced that the Batho Pele Principles as a good policy, but that it was difficulty to uphold due to inadequate planning of health services prior to implementation of the Batho Pele Principles. They experience not getting from their management and they also experience that there was lack of discipline in their institutions. Based on these findings, guidelines that will recommend better implementation of the Batho Pele Principles by nurses were compiled by the researcher and future research in this regard was recommended.
- Full Text:
- Date Issued: 2011
The general and emotional development of a sample of South African children in residential care
- Authors: Wills, Nicolene
- Date: 2011
- Subjects: Children -- Institutional care -- South Africa , Child psychopathology -- Residential treatment -- South Africa , Children -- Services for -- South Africa , Child welfare -- South Africa , Child care services -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9856 , http://hdl.handle.net/10948/1578 , Children -- Institutional care -- South Africa , Child psychopathology -- Residential treatment -- South Africa , Children -- Services for -- South Africa , Child welfare -- South Africa , Child care services -- South Africa
- Description: The main aim of this study was to explore and describe the general and emotional development of a sample of South African children between the age of five and eight years in residential care. More specifically, the study aimed to explore and describe the general level of development of a sample of children in residential care; to explore and describe the development of a sample of children in residential care in six areas of development; and to describe the emotional wellbeing of children in residential care. A non-probability, purposive sampling method was applied as the participants were comprised of children between the ages of 5 and 8 years housed at the residential care facility. The sample consisted of 11 children. The multiple case study method was used to achieve the aim of the study, using both qualitative and quantitative data. The quantitative data consisted of scores obtained from the administration of the Griffiths Mental Development Scales - Extended Revised (GMDS-ER). The qualitative data was obtained from the Human Figure Drawing (HFD), participants’ scholastic progress reports, case reports from the residential care facility and clinical observations during the assessment period. The data was analysed according to thematic analysis. The results highlighted the pervasiveness of delays in all domains of child development of children housed in residential care, specifically that of language, social and emotional development. An important finding of the study was that decrements in these domains of development underpinned delays in the other domains of development since they form the foundation of learning and relating to the world. The study served to emphasize the importance of consistent developmental assessment in order to ascertain whether these children present with developmental delays and, if so, to xv identify which areas of development are most affected. Information from the developmental assessments could assist in the early identification of developmental delays and allow for individually tailored interventions to overcome such delays.
- Full Text:
- Date Issued: 2011
- Authors: Wills, Nicolene
- Date: 2011
- Subjects: Children -- Institutional care -- South Africa , Child psychopathology -- Residential treatment -- South Africa , Children -- Services for -- South Africa , Child welfare -- South Africa , Child care services -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9856 , http://hdl.handle.net/10948/1578 , Children -- Institutional care -- South Africa , Child psychopathology -- Residential treatment -- South Africa , Children -- Services for -- South Africa , Child welfare -- South Africa , Child care services -- South Africa
- Description: The main aim of this study was to explore and describe the general and emotional development of a sample of South African children between the age of five and eight years in residential care. More specifically, the study aimed to explore and describe the general level of development of a sample of children in residential care; to explore and describe the development of a sample of children in residential care in six areas of development; and to describe the emotional wellbeing of children in residential care. A non-probability, purposive sampling method was applied as the participants were comprised of children between the ages of 5 and 8 years housed at the residential care facility. The sample consisted of 11 children. The multiple case study method was used to achieve the aim of the study, using both qualitative and quantitative data. The quantitative data consisted of scores obtained from the administration of the Griffiths Mental Development Scales - Extended Revised (GMDS-ER). The qualitative data was obtained from the Human Figure Drawing (HFD), participants’ scholastic progress reports, case reports from the residential care facility and clinical observations during the assessment period. The data was analysed according to thematic analysis. The results highlighted the pervasiveness of delays in all domains of child development of children housed in residential care, specifically that of language, social and emotional development. An important finding of the study was that decrements in these domains of development underpinned delays in the other domains of development since they form the foundation of learning and relating to the world. The study served to emphasize the importance of consistent developmental assessment in order to ascertain whether these children present with developmental delays and, if so, to xv identify which areas of development are most affected. Information from the developmental assessments could assist in the early identification of developmental delays and allow for individually tailored interventions to overcome such delays.
- Full Text:
- Date Issued: 2011
The general development and cognitive ability of a sample of children in specialized education
- Authors: Andrews, Samantha Lee
- Date: 2011
- Subjects: Special education -- South Africa -- Eastern Cape , Children with disabilities -- Education -- South Africa -- Eastern Cape , Child development -- Study and teaching -- South Africa , Griffiths Development Scales
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9951 , http://hdl.handle.net/10948/d1015714
- Description: The main aim of this study was to explore and describe the development and cognitive ability of a sample of children aged six to eight enrolled in specialised education, in the category of specific learning disability (SLD). This was achieved through the utilization of the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition and input from the trans-disciplinary team. A non-probability, purposive sampling method was employed and the sample consisted of eight participants. The multiple case study method was used in order to achieve the aim of the study. Both qualitative and quantitative data were incorporated to provide a holistic description of the participants. Quantitative data was obtained from the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition while qualitative data was obtained from the Biographical Questionnaire, input from members of the trans-disciplinary team, data from the participants‟ archives as well as clinical observations made during the assessment process. The data was analysed according to the domains of childhood development.The results obtained revealed that the general development of the sample as measured by the Griffiths-Mental Development Scales – Extended Revised was average. The Eye and Hand Co-ordination Subscale was the most problematic for the participants. The majority of the sample obtained below average scores on the Wechsler Intelligence Scales for Children – Fourth Edition‟s full scale IQ (FSIQ). The Verbal Reasoning Index and the Working Memory Index yielded the lowest scores amongst the sample. The results indicated that the majority of the participants are stronger with non-verbal as opposed to verbal reasoning. The study revealed that the two measures, the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition complement one another. The developmental and intellectual nature of the measures allow for gaps left by the one measure to be filled by the other. The study highlighted the importance of gaining information from the trans-disciplinary team and not relying purely on psychometric measures. It was made clear through the study that deficits often exist that are not picked up by assessment measures alone. In order to gain a comprehensive, holistic picture of a child, one needs to consult a variety of sources. Questions regarding the classification system of high needs learners as well as the current system of specialised education were raised.
- Full Text:
- Date Issued: 2011
- Authors: Andrews, Samantha Lee
- Date: 2011
- Subjects: Special education -- South Africa -- Eastern Cape , Children with disabilities -- Education -- South Africa -- Eastern Cape , Child development -- Study and teaching -- South Africa , Griffiths Development Scales
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9951 , http://hdl.handle.net/10948/d1015714
- Description: The main aim of this study was to explore and describe the development and cognitive ability of a sample of children aged six to eight enrolled in specialised education, in the category of specific learning disability (SLD). This was achieved through the utilization of the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition and input from the trans-disciplinary team. A non-probability, purposive sampling method was employed and the sample consisted of eight participants. The multiple case study method was used in order to achieve the aim of the study. Both qualitative and quantitative data were incorporated to provide a holistic description of the participants. Quantitative data was obtained from the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition while qualitative data was obtained from the Biographical Questionnaire, input from members of the trans-disciplinary team, data from the participants‟ archives as well as clinical observations made during the assessment process. The data was analysed according to the domains of childhood development.The results obtained revealed that the general development of the sample as measured by the Griffiths-Mental Development Scales – Extended Revised was average. The Eye and Hand Co-ordination Subscale was the most problematic for the participants. The majority of the sample obtained below average scores on the Wechsler Intelligence Scales for Children – Fourth Edition‟s full scale IQ (FSIQ). The Verbal Reasoning Index and the Working Memory Index yielded the lowest scores amongst the sample. The results indicated that the majority of the participants are stronger with non-verbal as opposed to verbal reasoning. The study revealed that the two measures, the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition complement one another. The developmental and intellectual nature of the measures allow for gaps left by the one measure to be filled by the other. The study highlighted the importance of gaining information from the trans-disciplinary team and not relying purely on psychometric measures. It was made clear through the study that deficits often exist that are not picked up by assessment measures alone. In order to gain a comprehensive, holistic picture of a child, one needs to consult a variety of sources. Questions regarding the classification system of high needs learners as well as the current system of specialised education were raised.
- Full Text:
- Date Issued: 2011
The lived experience of meaning in life and satisfaction with life among older adults
- Authors: Cooper, Holly
- Date: 2011
- Subjects: Meaning (Psychology) , Satisfaction , Old age , Old age homes
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/4398 , vital:20595
- Description: The purpose of the study was to explore and describe the meaning in life and satisfaction with life of the elderly living in the old age institutions.
- Full Text:
- Date Issued: 2011
- Authors: Cooper, Holly
- Date: 2011
- Subjects: Meaning (Psychology) , Satisfaction , Old age , Old age homes
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/4398 , vital:20595
- Description: The purpose of the study was to explore and describe the meaning in life and satisfaction with life of the elderly living in the old age institutions.
- Full Text:
- Date Issued: 2011
The medicinal chemistry of cyclo(D-Phe-2Cl-Pro) and cyclo(Phe-4F-Pro)
- Authors: Ndung'u, Susan Wanjiru
- Date: 2011
- Subjects: Peptide drugs , Cyclic peptides , Pharmaceutical chemistry , Peptides -- Synthesis
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/7083 , vital:21223
- Description: Although peptides and proteins are considered as lead compounds for the discovery and development of new therapeutic agents, poor metabolic and physical properties have limited their optimisation as drug candidates (Adessi & Soto, 2002). Research by medicinal chemists however, generated the discovery of structural similarities between some peptides and diketopiperazines and the common occurrence of such compounds in natural products. This discovery initiated the synthesis of diketopiperazines from amino acids in an attempt to bypass the previously mentioned limitations of using peptides as drug candidates (Dinsmore & Beshore, 2002). Diketopiperazines (DKPs) are the simplest form of cyclic dipeptides, and a class of unexplored bioactive peptides that have great potential for the future. The compounds are relatively simple to synthesise and are prevalent in nature (Prasad, 1995). The DKP backbone is rigid and therefore poses conformational constraint on the compounds. This rigidity allows for simple conformational analysis of the compounds and also gives insight into the conformational requirements for interaction with the targets involved in their biological activity. The reduced conformational freedom also increases the receptor specificity and thus the compounds are proposed to have less unfavourable effects (Anteunis, 1978). The aim of the study was to synthesise compounds that would exhibit metabolic stability, receptor specificity and enhanced lipophilicity which would increase the bioavailability of the compounds. This was to be achieved by the introduction of fluorine and chlorine elements into the DKPs. The structure of the DKPs would be altered which in turn would improve the physicochemical properties and the biological activity of the compounds (Naumann, 1999). Cyclo(D-Phe-2Cl-Pro) and cyclo(Phe-4F-Pro) were synthesised using the method of Milne et al. (1992) and by boiling the linear counterparts under reflux in sec-butanol-toluene. The structures of the synthesised DKPs were elucidated using mass spectrometry, nuclear magnetic resonance spectroscopy, infrared spectroscopy and molecular modeling. Qualitative analysis and evaluation of the physicochemical properties of the DKPs were performed using high-performance liquid chromatography, scanning electron microscopy, thermogravimetric analysis, differential scanning calorimetry and x-ray powder diffraction. The study aimed to determine the biological activity of cyclo(D-Phe-2Cl-Pro) and cyclo(Phe-4F-Pro) with respect to their anticancer, antimicrobial, haematological and antidiabetic effects. The anticancer results obtained indicated that the percentage inhibition produced by both DKPs were lower than those proposed by Graz et al. (2000) for proline-containing DKPs where, a greater than 50% inhibition was observed for cyclo(Phe-Pro). Antimicrobial studies revealed that both DKPs demonstrated marginal effects on Gram-positive and Gram-negative organisms but showed significant effects against C. albicans. The haematological studies revealed that cyclo(D-Phe-2Cl-Pro) at a screening concentration of 12.5 mM, significantly decreased the levels of D-dimer (P < 0.0001). The antidiabetics studies showed limited activity of the DKPs in inhibiting the activity of α-glucosidase and α-amylase enzymes.
- Full Text:
- Date Issued: 2011
- Authors: Ndung'u, Susan Wanjiru
- Date: 2011
- Subjects: Peptide drugs , Cyclic peptides , Pharmaceutical chemistry , Peptides -- Synthesis
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/7083 , vital:21223
- Description: Although peptides and proteins are considered as lead compounds for the discovery and development of new therapeutic agents, poor metabolic and physical properties have limited their optimisation as drug candidates (Adessi & Soto, 2002). Research by medicinal chemists however, generated the discovery of structural similarities between some peptides and diketopiperazines and the common occurrence of such compounds in natural products. This discovery initiated the synthesis of diketopiperazines from amino acids in an attempt to bypass the previously mentioned limitations of using peptides as drug candidates (Dinsmore & Beshore, 2002). Diketopiperazines (DKPs) are the simplest form of cyclic dipeptides, and a class of unexplored bioactive peptides that have great potential for the future. The compounds are relatively simple to synthesise and are prevalent in nature (Prasad, 1995). The DKP backbone is rigid and therefore poses conformational constraint on the compounds. This rigidity allows for simple conformational analysis of the compounds and also gives insight into the conformational requirements for interaction with the targets involved in their biological activity. The reduced conformational freedom also increases the receptor specificity and thus the compounds are proposed to have less unfavourable effects (Anteunis, 1978). The aim of the study was to synthesise compounds that would exhibit metabolic stability, receptor specificity and enhanced lipophilicity which would increase the bioavailability of the compounds. This was to be achieved by the introduction of fluorine and chlorine elements into the DKPs. The structure of the DKPs would be altered which in turn would improve the physicochemical properties and the biological activity of the compounds (Naumann, 1999). Cyclo(D-Phe-2Cl-Pro) and cyclo(Phe-4F-Pro) were synthesised using the method of Milne et al. (1992) and by boiling the linear counterparts under reflux in sec-butanol-toluene. The structures of the synthesised DKPs were elucidated using mass spectrometry, nuclear magnetic resonance spectroscopy, infrared spectroscopy and molecular modeling. Qualitative analysis and evaluation of the physicochemical properties of the DKPs were performed using high-performance liquid chromatography, scanning electron microscopy, thermogravimetric analysis, differential scanning calorimetry and x-ray powder diffraction. The study aimed to determine the biological activity of cyclo(D-Phe-2Cl-Pro) and cyclo(Phe-4F-Pro) with respect to their anticancer, antimicrobial, haematological and antidiabetic effects. The anticancer results obtained indicated that the percentage inhibition produced by both DKPs were lower than those proposed by Graz et al. (2000) for proline-containing DKPs where, a greater than 50% inhibition was observed for cyclo(Phe-Pro). Antimicrobial studies revealed that both DKPs demonstrated marginal effects on Gram-positive and Gram-negative organisms but showed significant effects against C. albicans. The haematological studies revealed that cyclo(D-Phe-2Cl-Pro) at a screening concentration of 12.5 mM, significantly decreased the levels of D-dimer (P < 0.0001). The antidiabetics studies showed limited activity of the DKPs in inhibiting the activity of α-glucosidase and α-amylase enzymes.
- Full Text:
- Date Issued: 2011
The relationship between self-efficacy and ways of coping of first-year university students
- Authors: Goss, Joanne Kate
- Date: 2011
- Subjects: Self-efficacy , Control (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9860 , http://hdl.handle.net/10948/1555 , Self-efficacy , Control (Psychology)
- Description: This is a quantitative, exploratory study focusing on self-efficacy and ways of coping of male and female first-year psychology students at a university in the Nelson Mandela Metropole. The study aimed to explore and describe the relationship between The General Perceived Self- Efficacy Scale and the Ways of Coping Questionnaire of first-year university psychology students. A non-probability convenience sampling technique was employed. The sample consisted of 34 males and 94 females between the ages of 18 and 21 years, who were registered for a first-year psychology module. Descriptive and inferential statistics were used to analyse the data. The results showed moderate correlations between general perceived self-efficacy and problem-focused and focusing on the positive as ways of coping. In addition, the results showed significant relationships between general perceived self-efficacy and problem-focused coping, seeking social support and focusing on the positive as ways of coping. Gender differences with regards to the constructs of coping and self-efficacy were also explored. Limitations of the present research were noted and recommendations for future research were proposed.
- Full Text:
- Date Issued: 2011
- Authors: Goss, Joanne Kate
- Date: 2011
- Subjects: Self-efficacy , Control (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9860 , http://hdl.handle.net/10948/1555 , Self-efficacy , Control (Psychology)
- Description: This is a quantitative, exploratory study focusing on self-efficacy and ways of coping of male and female first-year psychology students at a university in the Nelson Mandela Metropole. The study aimed to explore and describe the relationship between The General Perceived Self- Efficacy Scale and the Ways of Coping Questionnaire of first-year university psychology students. A non-probability convenience sampling technique was employed. The sample consisted of 34 males and 94 females between the ages of 18 and 21 years, who were registered for a first-year psychology module. Descriptive and inferential statistics were used to analyse the data. The results showed moderate correlations between general perceived self-efficacy and problem-focused and focusing on the positive as ways of coping. In addition, the results showed significant relationships between general perceived self-efficacy and problem-focused coping, seeking social support and focusing on the positive as ways of coping. Gender differences with regards to the constructs of coping and self-efficacy were also explored. Limitations of the present research were noted and recommendations for future research were proposed.
- Full Text:
- Date Issued: 2011
Traditional, complementary and alternative medicine use in HIV-positive patients
- Authors: Lunat, Imran
- Date: 2011
- Subjects: HIV infections -- Alternative treatment -- South Africa -- Nelson Mandela Metropolitan Municipality
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10137 , http://hdl.handle.net/10948/1388 , HIV infections -- Alternative treatment -- South Africa -- Nelson Mandela Metropolitan Municipality
- Description: The standard anti-retroviral drugs (ARVs) used for the treatment of HIV/AIDS have significant side effects resulting in a lack of adherence and the emergence of multidrug resistant viral strains. These drugs are also expensive, making it essential to investigate all alternatives to classical HIV/AIDS treatment. A wide variety of nonconventional medicines are used by patients for the treatment HIV and for symptoms associated with HIV. So long as they are safe and effective, traditional, complementary and alternative medicines (TCAMs) may be considered more advantageous for developing countries as they are relatively cheap, more accessible and widely accepted by local populations. The aim of this study was to determine the prevalence of TCAM use in HIV-positive patients, prior to, and during ARV therapy. The study was exploratory, cross sectional and observational in nature. Participants were selected via convenience sampling from the Nelson Mandela Bay Municipality, and included 244 HIV-positive patients, 29 health care professionals (HCPs) and 30 traditional, complementary and alternative practitioners (TCAMPs). A wide variety of TCAMs were used by the sample population. These medicines were more commonly used by non-ARV patients (36 percent) compared with ARV patients (22 percent). A significant statistical difference in TCAM use between the ARV and non- ARV population was found in relation to education, employment, period of status awareness, patient opinion of personal health and the reasons for TCAM use. Amongst the HCPs, 24 percent recommended TCAM use prior to ARVs, and 55 percent were aware of patients self-prescribing before and during ARV treatment. Amongst the TCAMPs, 90 percent provided a wide range of TCAMs for HIV, with some giving consideration to conventional management. TCAMs are commonly used by HIV-positive patients on ARVs, as well as by those not on ARVs. These medicines are also the preferred form of treatment for those not seeking conventional treatment. TCAMs are widely available and recommended by TCAMPs as well as some HCPs. Due to public health concerns, clinical trials of the widely used TCAMs are crucial in order to establish the safety and efficacy of these medicines in HIV.
- Full Text:
- Date Issued: 2011
- Authors: Lunat, Imran
- Date: 2011
- Subjects: HIV infections -- Alternative treatment -- South Africa -- Nelson Mandela Metropolitan Municipality
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10137 , http://hdl.handle.net/10948/1388 , HIV infections -- Alternative treatment -- South Africa -- Nelson Mandela Metropolitan Municipality
- Description: The standard anti-retroviral drugs (ARVs) used for the treatment of HIV/AIDS have significant side effects resulting in a lack of adherence and the emergence of multidrug resistant viral strains. These drugs are also expensive, making it essential to investigate all alternatives to classical HIV/AIDS treatment. A wide variety of nonconventional medicines are used by patients for the treatment HIV and for symptoms associated with HIV. So long as they are safe and effective, traditional, complementary and alternative medicines (TCAMs) may be considered more advantageous for developing countries as they are relatively cheap, more accessible and widely accepted by local populations. The aim of this study was to determine the prevalence of TCAM use in HIV-positive patients, prior to, and during ARV therapy. The study was exploratory, cross sectional and observational in nature. Participants were selected via convenience sampling from the Nelson Mandela Bay Municipality, and included 244 HIV-positive patients, 29 health care professionals (HCPs) and 30 traditional, complementary and alternative practitioners (TCAMPs). A wide variety of TCAMs were used by the sample population. These medicines were more commonly used by non-ARV patients (36 percent) compared with ARV patients (22 percent). A significant statistical difference in TCAM use between the ARV and non- ARV population was found in relation to education, employment, period of status awareness, patient opinion of personal health and the reasons for TCAM use. Amongst the HCPs, 24 percent recommended TCAM use prior to ARVs, and 55 percent were aware of patients self-prescribing before and during ARV treatment. Amongst the TCAMPs, 90 percent provided a wide range of TCAMs for HIV, with some giving consideration to conventional management. TCAMs are commonly used by HIV-positive patients on ARVs, as well as by those not on ARVs. These medicines are also the preferred form of treatment for those not seeking conventional treatment. TCAMs are widely available and recommended by TCAMPs as well as some HCPs. Due to public health concerns, clinical trials of the widely used TCAMs are crucial in order to establish the safety and efficacy of these medicines in HIV.
- Full Text:
- Date Issued: 2011