Barriers to exclusive breastfeeding for mothers in the Tswelopele Municipality
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding , Infants -- Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27209 , vital:66466
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32 percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding , Infants -- Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27209 , vital:66466
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32 percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
Barriers to exclusive breastfeeding for mothers in the Tswelopele Municipality
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23589 , vital:58192
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
- Authors: Quebu, Simthandile Rebecca
- Date: 2020-03
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23589 , vital:58192
- Description: The purpose of the study was to assess the barriers to exclusive breastfeeding (EBF) of mothers in the Tswelopele Municipality. The South Africa Demographic and Health survey reported the country’s EBF rates among children below six months of age to be at 32percent for the year 2016. The World Health Organisation endorses the promotion and protection of the practice of EBF throughout the first six months of life, and the addition of complementary foods at six months coupled with breastfeeding up to two years of age. This feeding practise is recommended as the most efficient feeding practice to save infants from various illnesses and mortality across the globe, irrespective of their mother’s HIV status and economic class. A qualitative, contextual, explorative and descriptive research design was employed for this study to achieve the research objectives. The researcher incorporated both purposive and convenience sampling in this study. Purposive sampling was used to select the clinics, and convenience sampling was used to select the participants. Mothers who had infants 6-12 months old who were accessing infant and child health services in the three public health care facilities in the Tswelopele Municipality were a target population. Individual semi-structured interviews were administered, and an audio recorder was utilized to record the interviews with the participants' consent. The researcher throughout this study verbatim transcribed the interview audio tapes, and ethical principles and trustworthiness standards were adhered to. The University of Fort Hare (Ref # 2021=06=12 QuebuS) granted ethical clearance and all participants gave formal consent to voluntarily participate in this research. Tesch's approach for data analysis to open coding in qualitative research was used to analyse the data. Sixteen (16) participants in total took part in this study and the research study was conducted during the whole month of October 2021.During the data analysis, four main themes and thirteen sub-themes emerged, all of which were thoroughly examined. The findings suggest that maternal factors such as extreme pain in the breast, maternal sickness, belief that milk supply is insufficient, lack of EBF knowledge and cultural influences are the key contributors to the success or failure of EBF practice. When mothers have difficulties with breastfeeding, their difficulties can become barriers to EBF. Furthermore, a noteworthy finding is that some participants in this study were eager to breastfeed their babies and maintain EBF for six months; however, their infants had problems that prohibited them from doing so. These issues primarily included infants who refused to breastfeed and breast milk not being tolerated by some infants, as seen by baby vomiting after feeds. It was recommended that breastfeeding education and counselling should be available to mothers and their families from prenatal to postnatal so that they have enough time to make informed infant feeding decisions. Furthermore, an open dialogue with mothers and their families on a realistic understanding of what to expect when they first breastfeed, as well as the exploration of myths, inaccurate information, and concerns can be addressed during the counselling sessions. In conclusion, health professionals should also take into account the culture of mothers, respect cultural customs linked with breastfeeding, and respectfully educate them and their families about traditions that may affect breast-feeding. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
Exploring knowledge, attitudes and psychosocial experiences of health care workers regarding covid-19 in Bufalo City Municipality
- Authors: Notununu, Zintle
- Date: 2020-03
- Subjects: Medical personnel and patient , Health services administration , COVID-19 (Disease)
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23545 , vital:58122
- Description: The purpose of this study was to explore and describe the knowledge, attitude and psychosocial experiences of health care workers regarding Covid-19 in Buffalo City Municipality. Covid-19 is a disease that attacks the respiratory system and functions. It is a highly infectious disease with a lengthy 5-6 sometimes even 14-day incubation period. It is very serious condition and has killed a lot of people including the Health Care Workers A qualitative descriptive explorative contextual design was employed in this research study. The design was relevant for this study to explore and describe the knowledge, attitude, and psychosocial experiences of health workers regarding Covid-19 in Buffalo City Municipality. The non-probability sampling method was used and a convenient sampling technique was used to select the participants. Professional nurses who met the criteria and who were on duty on the day of data collection were included in the study. The researcher interviewed 15 professional nurses and stopped as the data was saturated. A semi-structured Interview guide was used as an instrument to collect data containing open-ended questions. The researcher maintained ethical principles throughout the study. Concepts of trustworthiness of the study were applied throughout the research. Tech’s eight steps approach was used to guide the data analysis process. The findings of this study indicate that health care workers have a high level of knowledge about Covid-19. They know what Covid-19 is, how it started, its signs and symptoms, how to protect themselves from it and its complications. Negative attitudes, fears were noticed from the HCWs and thus the need for psychological support was identified. Feelings of neglect and lack of motivation were also identified. Psychological support for health care workers must be provided to prevent staff burnout. Personal Protective Equipment used in the hospital premises must be left and washed in the hospital laundry to prevent the spread of infection to the families of the HCWs. It was indicated that there are health care workers who experienced chronic illnesses after being diagnosed with Covid-19. These chronic illnesses include diabetes and high blood pressure. It was brought to light that myths circulating on the social media about Covid-19 vaccines are delaying the end of Covid-19 epidemic by putting the health care workers at risk of being infected with it as they will be expected to treat patients diagnosed with Covid-19; therefore, government should develop a policy that will limit people from spreading things that they are not true and cannot prove. In conclusion, community awareness and forced vaccination are recommended to end the Covid-19 virus. Monitory incentives should be provided to motivate health care workers. Their overtime that they have worked during Covid-19 must be paid. The Department of Health and hospital managers must make sure that working conditions are improved. This includes the availability of machines to test for Covid-19. More research needs to be done to find out why some people who were diagnosed with Covid-19 end up having chronic illnesses that they never had previously. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
- Authors: Notununu, Zintle
- Date: 2020-03
- Subjects: Medical personnel and patient , Health services administration , COVID-19 (Disease)
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23545 , vital:58122
- Description: The purpose of this study was to explore and describe the knowledge, attitude and psychosocial experiences of health care workers regarding Covid-19 in Buffalo City Municipality. Covid-19 is a disease that attacks the respiratory system and functions. It is a highly infectious disease with a lengthy 5-6 sometimes even 14-day incubation period. It is very serious condition and has killed a lot of people including the Health Care Workers A qualitative descriptive explorative contextual design was employed in this research study. The design was relevant for this study to explore and describe the knowledge, attitude, and psychosocial experiences of health workers regarding Covid-19 in Buffalo City Municipality. The non-probability sampling method was used and a convenient sampling technique was used to select the participants. Professional nurses who met the criteria and who were on duty on the day of data collection were included in the study. The researcher interviewed 15 professional nurses and stopped as the data was saturated. A semi-structured Interview guide was used as an instrument to collect data containing open-ended questions. The researcher maintained ethical principles throughout the study. Concepts of trustworthiness of the study were applied throughout the research. Tech’s eight steps approach was used to guide the data analysis process. The findings of this study indicate that health care workers have a high level of knowledge about Covid-19. They know what Covid-19 is, how it started, its signs and symptoms, how to protect themselves from it and its complications. Negative attitudes, fears were noticed from the HCWs and thus the need for psychological support was identified. Feelings of neglect and lack of motivation were also identified. Psychological support for health care workers must be provided to prevent staff burnout. Personal Protective Equipment used in the hospital premises must be left and washed in the hospital laundry to prevent the spread of infection to the families of the HCWs. It was indicated that there are health care workers who experienced chronic illnesses after being diagnosed with Covid-19. These chronic illnesses include diabetes and high blood pressure. It was brought to light that myths circulating on the social media about Covid-19 vaccines are delaying the end of Covid-19 epidemic by putting the health care workers at risk of being infected with it as they will be expected to treat patients diagnosed with Covid-19; therefore, government should develop a policy that will limit people from spreading things that they are not true and cannot prove. In conclusion, community awareness and forced vaccination are recommended to end the Covid-19 virus. Monitory incentives should be provided to motivate health care workers. Their overtime that they have worked during Covid-19 must be paid. The Department of Health and hospital managers must make sure that working conditions are improved. This includes the availability of machines to test for Covid-19. More research needs to be done to find out why some people who were diagnosed with Covid-19 end up having chronic illnesses that they never had previously. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-03
Leadership competencies of primary health care facility managers at Buffalo City Metropolitan District in the Eastern Cape Province
- Authors: Makinana, Noxolo Beauty
- Date: 2020-02
- Subjects: Primary health care -- Leadership , Facility management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22033 , vital:51954
- Description: The study explored and described the perceptions and experiences of Primary Health Care facility managers regarding their leadership and management competencies in the Buffalo City Metro Health District in the Eastern Cape Province. The objectives of this study were to explore and describe the leadership competencies required for facility managers to exercise their leadership in Primary Health Care facilities and to bring about the recommendation. The population of this study comprised of facility managers who are appointed in facility management position permanently or on acting basis during the time of the study, in rural, urban, and semi-urban Primary Health Care facilities (clinics) in Buffalo City Health District. Non-probability convenience sampling was used to select the participants. Two focus group interviews with 10 participants per group were held to collect data. Thematic data analysis was used to analyze the data. The findings were discussed according to themes and subthemes. Four themes and 9 subthemes were identified from the data. Themes include departmental factors, individual factors, and political factors. The subthemes include managers lack of support, need for capacitation of staff, lack of uniformity in exercising leadership, work positions, infrastructure, staff shortages, lack of involvement in decision making, lack of resources, feeling of being a failure, not meeting expectation (workload) role of managers, pressure, the resistance of staff members to change, absenteeism, teamwork, compliance to policies, the 80/20 principle, nurse-patient ratio, and consultation. The trustworthiness of the findings was ensured by focussing on dependability, confirmability, transferability, and credibility. The study concluded that facility managers receive very limited supervision to perform their management duties in their facilities. They also need adequate resources, induction, training and a habitable work environment to ensure that quality care is provided. The study recommended that the Department of Health should have a program for supervision, mentorship, and guiding the facility managers in the Primary Health Care facilities. It should also establish a training and development program on leadership, finance management and technology. Lastly, there should be more accountability by facility managers at the different departmental levels i.e. national, province, district subdistrict, and other internal and external stakeholders. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-02
- Authors: Makinana, Noxolo Beauty
- Date: 2020-02
- Subjects: Primary health care -- Leadership , Facility management
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22033 , vital:51954
- Description: The study explored and described the perceptions and experiences of Primary Health Care facility managers regarding their leadership and management competencies in the Buffalo City Metro Health District in the Eastern Cape Province. The objectives of this study were to explore and describe the leadership competencies required for facility managers to exercise their leadership in Primary Health Care facilities and to bring about the recommendation. The population of this study comprised of facility managers who are appointed in facility management position permanently or on acting basis during the time of the study, in rural, urban, and semi-urban Primary Health Care facilities (clinics) in Buffalo City Health District. Non-probability convenience sampling was used to select the participants. Two focus group interviews with 10 participants per group were held to collect data. Thematic data analysis was used to analyze the data. The findings were discussed according to themes and subthemes. Four themes and 9 subthemes were identified from the data. Themes include departmental factors, individual factors, and political factors. The subthemes include managers lack of support, need for capacitation of staff, lack of uniformity in exercising leadership, work positions, infrastructure, staff shortages, lack of involvement in decision making, lack of resources, feeling of being a failure, not meeting expectation (workload) role of managers, pressure, the resistance of staff members to change, absenteeism, teamwork, compliance to policies, the 80/20 principle, nurse-patient ratio, and consultation. The trustworthiness of the findings was ensured by focussing on dependability, confirmability, transferability, and credibility. The study concluded that facility managers receive very limited supervision to perform their management duties in their facilities. They also need adequate resources, induction, training and a habitable work environment to ensure that quality care is provided. The study recommended that the Department of Health should have a program for supervision, mentorship, and guiding the facility managers in the Primary Health Care facilities. It should also establish a training and development program on leadership, finance management and technology. Lastly, there should be more accountability by facility managers at the different departmental levels i.e. national, province, district subdistrict, and other internal and external stakeholders. , Thesis (MPH) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-02
A best practice guideline for screening and managing chorioamnionitis
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
A psychobiographical case study: Amelia Dyer in a search for glory
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
A psychobiographical study of Maya Angelo
- Authors: De Waal, Leandra
- Date: 2020
- Subjects: Angelou, Maya
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46341 , vital:39569
- Description: Psychobiographies aim to gain a deeper understanding into the lives of notable or notorious individuals through the lens of a psychological theory. Thisstudy aimedto gain insight into the personality development of Maya Angelou through the useof Erikson’s Theory of PsychosocialDevelopment. The study exploresand describesher life experiences in terms of this theory, and understandsher life within her socio-historical context. Angelou is a renowned literary figure. Herjourney to becoming a writer was an arduous one, marked by great hardships from an early age. Despite early parental abandonment, childhood rape, exposure to racism, and difficulties in romantic relationships, she developed into a healthy adult who achieved much literary success and inspired individuals worldwide.Nonprobability purposive sampling was used to selectAngelou as the subjectand was madeon the basis of the researcher’s interest in Angelou’s life history.Datawas collected by triangulating multiple sources of informationand analysed using the approach developed by Miles and Huberman, which involves threesteps: data reduction, data display, and conclusion drawing and verification.The main findings suggest that Angelou progressed through Erikson’s eight stages successfully, despite some delays in negotiations of crises.
- Full Text:
- Date Issued: 2020
- Authors: De Waal, Leandra
- Date: 2020
- Subjects: Angelou, Maya
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46341 , vital:39569
- Description: Psychobiographies aim to gain a deeper understanding into the lives of notable or notorious individuals through the lens of a psychological theory. Thisstudy aimedto gain insight into the personality development of Maya Angelou through the useof Erikson’s Theory of PsychosocialDevelopment. The study exploresand describesher life experiences in terms of this theory, and understandsher life within her socio-historical context. Angelou is a renowned literary figure. Herjourney to becoming a writer was an arduous one, marked by great hardships from an early age. Despite early parental abandonment, childhood rape, exposure to racism, and difficulties in romantic relationships, she developed into a healthy adult who achieved much literary success and inspired individuals worldwide.Nonprobability purposive sampling was used to selectAngelou as the subjectand was madeon the basis of the researcher’s interest in Angelou’s life history.Datawas collected by triangulating multiple sources of informationand analysed using the approach developed by Miles and Huberman, which involves threesteps: data reduction, data display, and conclusion drawing and verification.The main findings suggest that Angelou progressed through Erikson’s eight stages successfully, despite some delays in negotiations of crises.
- Full Text:
- Date Issued: 2020
A psychobiography of Viktor Emil Frankl
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
A stunting profile of children under the age of five visiting Bhisho hospital clinic, part of the umbrella project: a profile of stunting in children under the age of five in food insecure villages in Mqanduli, Ngqushwa and Bhisho hospital, Eastern Cape, South Africa
- Authors: Beyleveld, Janine
- Date: 2020
- Subjects: Children -- growth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/50201 , vital:42066
- Description: Introduction and Background: Stunting is the most prevalent form of childhood malnutrition where about 149 million children under the age of five can be classified as stunted globally. South Africa has one of the highest stunting rates in the world at 27%, causing devastating effects on economic productivity as well as on an individual’s nutritional status. The presence of stunted growth in children is a strong indicator of chronic undernutrition and highlights injustices experienced within communities. Aims and Objectives: The aim of this study is to develop a stunning profile of children under the age of five, visiting BhishoHospital’s gateway clinic in the Eastern Cape, South Africa. The objectives were to determine the prevalence of stunting of the children visiting Bhisho Hospital’s clinic and to identify the drivers of stunting in the area. Methodology: A quantitative study with a descriptive, cross-sectional design was used. The study population included all children under the age of five visiting Bhisho Hospital’s clinic. Data was collected by means of an interview-administered questionnaire. Results: The prevalence of stunting in the area was 47.5%. A significant association was found between the participants' main form of sanitation and stunting category in the group of infants younger than six months (p = 0.007) and the group older than six months(p = 0.040). Discussion: The prevalence of stunting in the area was far higher than the national average of 27%, although the majority of the sample had a normal weight. The use of non-flush toilets was found to be a risk factor for childhood stunting. Recommendation: Financial and political investment in child health needs to be placed as a top priority in South Africa to reduce stunting rates.
- Full Text:
- Date Issued: 2020
- Authors: Beyleveld, Janine
- Date: 2020
- Subjects: Children -- growth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/50201 , vital:42066
- Description: Introduction and Background: Stunting is the most prevalent form of childhood malnutrition where about 149 million children under the age of five can be classified as stunted globally. South Africa has one of the highest stunting rates in the world at 27%, causing devastating effects on economic productivity as well as on an individual’s nutritional status. The presence of stunted growth in children is a strong indicator of chronic undernutrition and highlights injustices experienced within communities. Aims and Objectives: The aim of this study is to develop a stunning profile of children under the age of five, visiting BhishoHospital’s gateway clinic in the Eastern Cape, South Africa. The objectives were to determine the prevalence of stunting of the children visiting Bhisho Hospital’s clinic and to identify the drivers of stunting in the area. Methodology: A quantitative study with a descriptive, cross-sectional design was used. The study population included all children under the age of five visiting Bhisho Hospital’s clinic. Data was collected by means of an interview-administered questionnaire. Results: The prevalence of stunting in the area was 47.5%. A significant association was found between the participants' main form of sanitation and stunting category in the group of infants younger than six months (p = 0.007) and the group older than six months(p = 0.040). Discussion: The prevalence of stunting in the area was far higher than the national average of 27%, although the majority of the sample had a normal weight. The use of non-flush toilets was found to be a risk factor for childhood stunting. Recommendation: Financial and political investment in child health needs to be placed as a top priority in South Africa to reduce stunting rates.
- Full Text:
- Date Issued: 2020
An educational intervention for professional nurses on the use of surgical attire in the prevention of surgical site infections in the operating theatres
- Authors: Alayemi, Joshua
- Date: 2020
- Subjects: Surgical wound infections -- Prevention , Surgical nursing Operating room nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/47937 , vital:40454
- Description: Infection control and prevention is an issue that is of utmost importance to every health practitioner, including professional nurses, as patients who undergo surgeries could develop sepsis, leading to failure of multiple organs and possibly death. Surgical site infections acquired from operating theatres are often introduced when there is lack of application of and adherence to the necessary control measures, sterile principles and techniques, including the appropriate use of surgical attire. This study aimed to contextualize, implement and evaluate an existing educational intervention regarding the use of surgical attire in operating theatres, in order to establish whether the educational intervention enhanced the practices of professional nurses in operating theatres regarding the use of surgical attire. A quantitative research design, using a quasi-experimental two-group pre-test, post-test intervention approach was employed for the study. The study consisted of three phases. Phase 1 consisted of the administration of the pre-test questionnaire relating to Objective One: “To explore and describe the practices of professional nurses on the use of surgical attire in the prevention of surgical site infections in operating theatres”. Phase 2 consisted of the contextualization and implementation of the educational intervention, which related to Objective Two: “To contextualize and implement an educational intervention for professional nurses on the use of surgical attire in the prevention of surgical site infections in operating theatres”. Phase 3 consisted of the administration of the posttest questionnaire, which related to Objective Three: “To evaluate whether an educational intervention regarding the use of surgical attire in the prevention of surgical site infections in operating theatres enhanced professional nurses’ practices”. The study is underpinned by the Promoting Action on Research Implementation (PARiHS) framework. The research sample consisted of all professional nurses working in the public and private operating theatres in the Nelson Mandela Bay Municipality. Purposive sampling was used to select the hospitals in control (Hospitals 2 and 3) and intervention groups (Hospitals 4 and 5), ensuring an equal number of public and private hospitals in each group. Data was collected through self-administered pre- and post-questionnaires. An existing educational intervention based on the Association of Perioperative Registered Nurses (AORN’s) guidelines was contextualized through review by three professional nurses with a specialty in operating theatre. The educational intervention was implemented for the intervention group, while the control group only received the summary of the AORN guidelines. Reliability and validity were ensured through the conduct of a pilot study, and expert review by three professional nurses with a specialty in operating theatre in order to check the validity and reliability of the data collection instrument and educational intervention. The data collection instrument was also reviewed by a statistician. Ethical clearance and permission was obtained from the relevant institutions. The following ethical principles were adhered to during the study: justice, respect and beneficence. The overall score of pre-test and post-test questionnaires for the control group revealed means of 3.96 and 4.01, with a standard deviation of 0.40 and 0.38, with a difference of -0.06 and a degree of freedom of 59. The overall score of the pre-test and post-test of the intervention group revealed means of 3.68 and 4.22, a standard deviation of 0.47 and 0.36, with a difference of -0.53, degree of freedom of 61 and a large significance difference of Cohen’s d= 1.26. This means that the educational intervention had a positive effect in terms of improving the professional nurses’ practices on the use of surgical attire to prevent surgical site infections in operating theatres. Recommendations for education, practice as well as future research were provided.
- Full Text:
- Date Issued: 2020
- Authors: Alayemi, Joshua
- Date: 2020
- Subjects: Surgical wound infections -- Prevention , Surgical nursing Operating room nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/47937 , vital:40454
- Description: Infection control and prevention is an issue that is of utmost importance to every health practitioner, including professional nurses, as patients who undergo surgeries could develop sepsis, leading to failure of multiple organs and possibly death. Surgical site infections acquired from operating theatres are often introduced when there is lack of application of and adherence to the necessary control measures, sterile principles and techniques, including the appropriate use of surgical attire. This study aimed to contextualize, implement and evaluate an existing educational intervention regarding the use of surgical attire in operating theatres, in order to establish whether the educational intervention enhanced the practices of professional nurses in operating theatres regarding the use of surgical attire. A quantitative research design, using a quasi-experimental two-group pre-test, post-test intervention approach was employed for the study. The study consisted of three phases. Phase 1 consisted of the administration of the pre-test questionnaire relating to Objective One: “To explore and describe the practices of professional nurses on the use of surgical attire in the prevention of surgical site infections in operating theatres”. Phase 2 consisted of the contextualization and implementation of the educational intervention, which related to Objective Two: “To contextualize and implement an educational intervention for professional nurses on the use of surgical attire in the prevention of surgical site infections in operating theatres”. Phase 3 consisted of the administration of the posttest questionnaire, which related to Objective Three: “To evaluate whether an educational intervention regarding the use of surgical attire in the prevention of surgical site infections in operating theatres enhanced professional nurses’ practices”. The study is underpinned by the Promoting Action on Research Implementation (PARiHS) framework. The research sample consisted of all professional nurses working in the public and private operating theatres in the Nelson Mandela Bay Municipality. Purposive sampling was used to select the hospitals in control (Hospitals 2 and 3) and intervention groups (Hospitals 4 and 5), ensuring an equal number of public and private hospitals in each group. Data was collected through self-administered pre- and post-questionnaires. An existing educational intervention based on the Association of Perioperative Registered Nurses (AORN’s) guidelines was contextualized through review by three professional nurses with a specialty in operating theatre. The educational intervention was implemented for the intervention group, while the control group only received the summary of the AORN guidelines. Reliability and validity were ensured through the conduct of a pilot study, and expert review by three professional nurses with a specialty in operating theatre in order to check the validity and reliability of the data collection instrument and educational intervention. The data collection instrument was also reviewed by a statistician. Ethical clearance and permission was obtained from the relevant institutions. The following ethical principles were adhered to during the study: justice, respect and beneficence. The overall score of pre-test and post-test questionnaires for the control group revealed means of 3.96 and 4.01, with a standard deviation of 0.40 and 0.38, with a difference of -0.06 and a degree of freedom of 59. The overall score of the pre-test and post-test of the intervention group revealed means of 3.68 and 4.22, a standard deviation of 0.47 and 0.36, with a difference of -0.53, degree of freedom of 61 and a large significance difference of Cohen’s d= 1.26. This means that the educational intervention had a positive effect in terms of improving the professional nurses’ practices on the use of surgical attire to prevent surgical site infections in operating theatres. Recommendations for education, practice as well as future research were provided.
- Full Text:
- Date Issued: 2020
Associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in ECD centres in the Nelson Mandela Bay Municipality
- Authors: Wilson, Teresa Margaret
- Date: 2020
- Subjects: Nutrition--Evaluation
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46344 , vital:39602
- Description: Introduction: Childhood overweight and obesity is an escalating global health issue. In Africa, overweight and obesity prevalence in children has nearly doubled since 2000(World Health Organisation, 2018).TheSANHANES-1 study (2013) identified that overweight and obesity in were most prevalent in urban informal areas of South Africa, with approximately a quarter of the children classified as overweight or obese (Shisana et al., 2013).In the Nelson Mandela Bay Municipality(NMBM), a double burden of disease was identified in the lower socio-economic population (Phekana et al., 2016). This study and others recommended further study into the contributing factors and behaviours which play a role in the development of overweight and obesity in children. These include household dietary intake, family history of lifestyle diseases, as well as the children’s and parental physical activity and sedentary time (Zhang et al.,2016).Aim: The aim of the study was to determine the associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in NMBM to describe underlying causes of childhood overweight and obesity.Methods: A cross-sectional design, using a quantitative approach, was used for this study(Ethics approval: H18-HEA-DIET-004). The study population included adult parents and/or caregivers of children from urban areas of Nelson Mandela Bay Municipality attending crèches and schools in these areas, in the age group from birth to 96 months (8 years). Randomised cluster sampling of crèches and schools from an existing database of anthropometrical data of children attending these crèches and schools in the area was done and a final sample of n=155obtained. With the assistance of a trained fieldworker, respondents completed a questionnaire detailing the family history of lifestyle diseases, physical activity levels and sedentary screen time behaviours, and a graphical adjusted version of a household dietary diversity questionnaire. Data about children’s activity levels in the preschool/creche environment was collected by the fieldworker by assessing the ECD centres’daily activity schedules. The anthropometric data of the children of the respondents was accessed from an existing database of these measurements. The data was described using means and standard deviations. Inferential statistics determined any existing associations between these underlying influences of childhood obesity.Results: Only 2% (n=3) of the children were underweight and 12% (n=9) were at risk of becoming underweight as classified by WAZ. HAZ scores identified26% (n=40) of the children at risk of becoming stunted, and 6% (n=9) of the children were already stunted. WHZ classified5% (n=8)of the children as overweight and 5% (n=8)as obese. A further 22% (n=34) of the children were at risk of becoming overweight.BMI/age classificationidentified25% (n=38) of the children as overweight and a further 12% (n=19) as obese. Out of the sample, 12%(n=17) of mothers and 8% (n=7) of fathers were categorised as overweight-to-obese according to the SA specific waist circumference(WC)cut-offs. Out of the children, 15% (n=22) have at least one parent who was overweight-to-obese. Traditional WC categories were classified48% (n=67) of the mothers as overweight-to-obese and at high risk for metabolic syndrome. Of all the lifestyle diseases, hypertension was the most prevalent with 29% (n=41) of households having at least one parent with hypertension. Parental physical activity was grossly overestimated, and the results found to be invalid. The Diet Variety and Frequency score resulted in a mean of 65.00 (n=154, SD=27.37) out of a possible 100 for the households in this sample, and junk food was consumed on three to four occasions per day in 32% (n=49) of households. There were no significant associations found between the parents’ variables and underweight children. Statistically small to medium effect associations were found between parental weight (both SA specific and traditional categories) and overweight children (classified by WHZ and BMI/age). Conclusions and recommendations: The prevalence of overweight and obesity among children in the NMBM was high. The only possible underlying cause of childhood overweight and obesity in pre-school children in the NMBM that could be determined by this study was parents’ weight classified by WC. However, it must be reiterated that due to the cross-sectional nature of the study, an association does not immediately mean causation, and the results are not adequate to rule out other underlying factors influencing childhood obesity. It is recommended that the results of the study are used to incentivise the final implementation of all the intervention targets laid out in the Strategic Plan for the Prevention and Control of Obesity in South Africa 2015-2020 in NMB, and for the development of the future obesity strategy after 2020. The results have shown the necessity for future health interventions to be targeted at the family as a unit.
- Full Text:
- Date Issued: 2020
- Authors: Wilson, Teresa Margaret
- Date: 2020
- Subjects: Nutrition--Evaluation
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46344 , vital:39602
- Description: Introduction: Childhood overweight and obesity is an escalating global health issue. In Africa, overweight and obesity prevalence in children has nearly doubled since 2000(World Health Organisation, 2018).TheSANHANES-1 study (2013) identified that overweight and obesity in were most prevalent in urban informal areas of South Africa, with approximately a quarter of the children classified as overweight or obese (Shisana et al., 2013).In the Nelson Mandela Bay Municipality(NMBM), a double burden of disease was identified in the lower socio-economic population (Phekana et al., 2016). This study and others recommended further study into the contributing factors and behaviours which play a role in the development of overweight and obesity in children. These include household dietary intake, family history of lifestyle diseases, as well as the children’s and parental physical activity and sedentary time (Zhang et al.,2016).Aim: The aim of the study was to determine the associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in NMBM to describe underlying causes of childhood overweight and obesity.Methods: A cross-sectional design, using a quantitative approach, was used for this study(Ethics approval: H18-HEA-DIET-004). The study population included adult parents and/or caregivers of children from urban areas of Nelson Mandela Bay Municipality attending crèches and schools in these areas, in the age group from birth to 96 months (8 years). Randomised cluster sampling of crèches and schools from an existing database of anthropometrical data of children attending these crèches and schools in the area was done and a final sample of n=155obtained. With the assistance of a trained fieldworker, respondents completed a questionnaire detailing the family history of lifestyle diseases, physical activity levels and sedentary screen time behaviours, and a graphical adjusted version of a household dietary diversity questionnaire. Data about children’s activity levels in the preschool/creche environment was collected by the fieldworker by assessing the ECD centres’daily activity schedules. The anthropometric data of the children of the respondents was accessed from an existing database of these measurements. The data was described using means and standard deviations. Inferential statistics determined any existing associations between these underlying influences of childhood obesity.Results: Only 2% (n=3) of the children were underweight and 12% (n=9) were at risk of becoming underweight as classified by WAZ. HAZ scores identified26% (n=40) of the children at risk of becoming stunted, and 6% (n=9) of the children were already stunted. WHZ classified5% (n=8)of the children as overweight and 5% (n=8)as obese. A further 22% (n=34) of the children were at risk of becoming overweight.BMI/age classificationidentified25% (n=38) of the children as overweight and a further 12% (n=19) as obese. Out of the sample, 12%(n=17) of mothers and 8% (n=7) of fathers were categorised as overweight-to-obese according to the SA specific waist circumference(WC)cut-offs. Out of the children, 15% (n=22) have at least one parent who was overweight-to-obese. Traditional WC categories were classified48% (n=67) of the mothers as overweight-to-obese and at high risk for metabolic syndrome. Of all the lifestyle diseases, hypertension was the most prevalent with 29% (n=41) of households having at least one parent with hypertension. Parental physical activity was grossly overestimated, and the results found to be invalid. The Diet Variety and Frequency score resulted in a mean of 65.00 (n=154, SD=27.37) out of a possible 100 for the households in this sample, and junk food was consumed on three to four occasions per day in 32% (n=49) of households. There were no significant associations found between the parents’ variables and underweight children. Statistically small to medium effect associations were found between parental weight (both SA specific and traditional categories) and overweight children (classified by WHZ and BMI/age). Conclusions and recommendations: The prevalence of overweight and obesity among children in the NMBM was high. The only possible underlying cause of childhood overweight and obesity in pre-school children in the NMBM that could be determined by this study was parents’ weight classified by WC. However, it must be reiterated that due to the cross-sectional nature of the study, an association does not immediately mean causation, and the results are not adequate to rule out other underlying factors influencing childhood obesity. It is recommended that the results of the study are used to incentivise the final implementation of all the intervention targets laid out in the Strategic Plan for the Prevention and Control of Obesity in South Africa 2015-2020 in NMB, and for the development of the future obesity strategy after 2020. The results have shown the necessity for future health interventions to be targeted at the family as a unit.
- Full Text:
- Date Issued: 2020
Audit of intravenous antifungal therapy used for Candida infections at a South African private hospital
- Authors: Van Dyk, Jacklyn Kate
- Date: 2020
- Subjects: Candidiasis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46380 , vital:39600
- Description: The epidemiological landscape of the candida species has changed with the emergence of MDR strains globally and in South Africa. The aim of this study was to critically evaluate the compliance to guidelines in the use of intravenous antifungal therapy when treating invasive Candidainfections in a South African private hospital.Objective One was to determine the prevalence of Candida auris(C.auris) in the sample. Objective Two examined the relationship between high-risk patients and positive microbiological cultures. Objective Three studied the prescribing utilisation of the intravenous antifungalsin the form of a clinical audit. Objective Four compared these prescribing patternsto current guidelines by evaluating whether the antifungal course was non-compliant, of suboptimal compliance or compliant. Objective Five was to design a protocol for ward pharmacists to use when assessing antifungal treatment for candidiasis. The research design consisted of a retrospective, non-experimental, cross-sectional analysis of intravenous antifungal use in the management of systemic Candida infections in a private sector hospital in the Gauteng province, South Africa.A positive research paradigm with a quantitative clinical audit was used in this study. The most prevalent species cultured was C.auris with 31 of the 77 positive cultures. Risk stratifying patients was validated with 70% of high risk patients (Candida Score >2.5 and positive β-D-glucan) having a corresponding positive culture. Echinocandins were the most frequently utilised antifungal class, with caspofungin being the most used antifungal in the sample. The average duration of therapy for the echinocandins ranged between 11 and 16 days. Compliance to guidelines was evaluated accordingto: reason for initiation; drug choice and drug dose. Three levels of compliance were determined: non-compliant, sub-optimal compliance and compliant. xivThe overall compliance,according to recommended treatment guidelines,was found to be suboptimal, with anidentified need foranintervention which targets thedosing of the antifungals used. In conclusion, the research findings highlight the importance of reviewing antifungal prescribing habits and the need for antifungal stewardship programmes.
- Full Text:
- Date Issued: 2020
- Authors: Van Dyk, Jacklyn Kate
- Date: 2020
- Subjects: Candidiasis
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46380 , vital:39600
- Description: The epidemiological landscape of the candida species has changed with the emergence of MDR strains globally and in South Africa. The aim of this study was to critically evaluate the compliance to guidelines in the use of intravenous antifungal therapy when treating invasive Candidainfections in a South African private hospital.Objective One was to determine the prevalence of Candida auris(C.auris) in the sample. Objective Two examined the relationship between high-risk patients and positive microbiological cultures. Objective Three studied the prescribing utilisation of the intravenous antifungalsin the form of a clinical audit. Objective Four compared these prescribing patternsto current guidelines by evaluating whether the antifungal course was non-compliant, of suboptimal compliance or compliant. Objective Five was to design a protocol for ward pharmacists to use when assessing antifungal treatment for candidiasis. The research design consisted of a retrospective, non-experimental, cross-sectional analysis of intravenous antifungal use in the management of systemic Candida infections in a private sector hospital in the Gauteng province, South Africa.A positive research paradigm with a quantitative clinical audit was used in this study. The most prevalent species cultured was C.auris with 31 of the 77 positive cultures. Risk stratifying patients was validated with 70% of high risk patients (Candida Score >2.5 and positive β-D-glucan) having a corresponding positive culture. Echinocandins were the most frequently utilised antifungal class, with caspofungin being the most used antifungal in the sample. The average duration of therapy for the echinocandins ranged between 11 and 16 days. Compliance to guidelines was evaluated accordingto: reason for initiation; drug choice and drug dose. Three levels of compliance were determined: non-compliant, sub-optimal compliance and compliant. xivThe overall compliance,according to recommended treatment guidelines,was found to be suboptimal, with anidentified need foranintervention which targets thedosing of the antifungals used. In conclusion, the research findings highlight the importance of reviewing antifungal prescribing habits and the need for antifungal stewardship programmes.
- Full Text:
- Date Issued: 2020
Awareness, knowledge and practices with regards to alcohol use of pregnant women in the Missionvale area
- Authors: Du Preez, Mingon
- Date: 2020
- Subjects: Pregnant women -- Alcohol use
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46404 , vital:39572
- Description: South African statistics, when compared to global statistics, has an above-average occurrence of Fetal Alcohol Spectrum Disorder(FASD). Alcohol use during pregnancy is on the rise globally and has far-reaching consequences. FASD is an umbrella term that describes the range of effects that can occur in an individual whose mother consumed alcohol during pregnancy.FASDnot only has an abiological, social and emotional negative impact on the individual, but also creates an added burden on the family caring for such an individual. When this condition occurs in a third world country, like South Africa, there is an economic impact as this country has limited physical and human resources to deal with the multitude of repercussions associated with this condition. This study was conducted in the Missionvale Community, an impoverished area of Port Elizabeth in the Eastern Cape. Participants were selected from this community, as clients attending the psychology clinic in the area frequently present with diagnosed FASD and co-concurring conditions, such as scholastic underachievement and behavioural conditions. These factors perpetuate an individuals inability to rise above their current circumstances as they are frequently unable to complete their schooling and are consequently unable to find unemployment. Prevention of FASD is a social, public and personal health issue that requires a multifaceted approach to intervention. The present study aimed to determine participants’ awareness, knowledge levels and practices with regard to alcohol use during pregnancy. Previous studies conducted in the Eastern Cape have primarily focused on the outcomes of prenatal alcohol exposure rather than the contributing factors, thus making this study the first of its kind to be conducted in the Eastern Cape. The study was quantitative in nature and participants were obtained through purposive sampling. A questionnaire, comprising of four different sections was used to obtain the necessary information. The sections in the questionnaire tapped information about the following concepts: Demographics, awareness, knowledge, and practices of alcohol use by pregnant women. The statistical results and additional comments by the participants assisted the researcher to gain a better understanding of the awareness levels, knowledge, and practices with regard to alcohol use of pregnant women residing in the Missionvale area. The results from the study indicate that participants have a general awareness that alcohol use during pregnancy could be harmful to an unborn baby but lack in-depth specific knowledge of the adverse effects of prenatal alcohol exposure.
- Full Text:
- Date Issued: 2020
- Authors: Du Preez, Mingon
- Date: 2020
- Subjects: Pregnant women -- Alcohol use
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46404 , vital:39572
- Description: South African statistics, when compared to global statistics, has an above-average occurrence of Fetal Alcohol Spectrum Disorder(FASD). Alcohol use during pregnancy is on the rise globally and has far-reaching consequences. FASD is an umbrella term that describes the range of effects that can occur in an individual whose mother consumed alcohol during pregnancy.FASDnot only has an abiological, social and emotional negative impact on the individual, but also creates an added burden on the family caring for such an individual. When this condition occurs in a third world country, like South Africa, there is an economic impact as this country has limited physical and human resources to deal with the multitude of repercussions associated with this condition. This study was conducted in the Missionvale Community, an impoverished area of Port Elizabeth in the Eastern Cape. Participants were selected from this community, as clients attending the psychology clinic in the area frequently present with diagnosed FASD and co-concurring conditions, such as scholastic underachievement and behavioural conditions. These factors perpetuate an individuals inability to rise above their current circumstances as they are frequently unable to complete their schooling and are consequently unable to find unemployment. Prevention of FASD is a social, public and personal health issue that requires a multifaceted approach to intervention. The present study aimed to determine participants’ awareness, knowledge levels and practices with regard to alcohol use during pregnancy. Previous studies conducted in the Eastern Cape have primarily focused on the outcomes of prenatal alcohol exposure rather than the contributing factors, thus making this study the first of its kind to be conducted in the Eastern Cape. The study was quantitative in nature and participants were obtained through purposive sampling. A questionnaire, comprising of four different sections was used to obtain the necessary information. The sections in the questionnaire tapped information about the following concepts: Demographics, awareness, knowledge, and practices of alcohol use by pregnant women. The statistical results and additional comments by the participants assisted the researcher to gain a better understanding of the awareness levels, knowledge, and practices with regard to alcohol use of pregnant women residing in the Missionvale area. The results from the study indicate that participants have a general awareness that alcohol use during pregnancy could be harmful to an unborn baby but lack in-depth specific knowledge of the adverse effects of prenatal alcohol exposure.
- Full Text:
- Date Issued: 2020
Change of perspectives and behaviour regarding lifestyle, with emphasis on dietary habits, in a rural community
- Authors: Barnard, Mariska
- Date: 2020
- Subjects: Food habits
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46384 , vital:39565
- Description: Background: The steady increase in deaths due to non-communicable diseases (NCDs) in South Africa is raising concern, as 63% of all deaths worldwide are attributed to NCDs and these diseases cause 36 million deaths each year, with 80 % of incidences occurring in low-and middle-income countries. In rural communities where income is increasing, the prevalence of NCDs are increasing as well. Due to the lack of NCD prevention and treatment in rural communities, it is expected that, if health promotion strategies are not implemented and socio-economic development in South Africa continues, there will soon be an uncontrollable NCD epidemic. It has been found that dietary risks affected people’s healthirrespective of their age, gender or residential sociodemographic development and that dietary improvement might prevent one in every five deaths worldwide.Aim:The aim of this study was to determine the factors that influence the perceptions and behaviour in a rural community with a low socio-economic status regarding dietary habits and to use the knowledge to formulate an effective dietary modification strategy.Designand methodology:For this study,action research with a quantitative and qualitative component was followed.The quantitative component focuses on measureable aspects, and the qualitative component focuses on meaning. Data was collected following the standard operating procedure for anthropometry, blood pressure and blood glucose. Further methods used were questionnaires, 24-hour dietary recalls and focus group discussions. Data were analysed using Microsoft Excel, FoodFinder3 and other calculations.Sample and setting:A convenience sample (n = 16) wasused and this study was undertaken on request of the non-governmental organization, Karoo Angels and included all participants who earn an income and who do not work for themselves, that were willing to participate and living in Rietbron and Vondeling, in the Sarah BaartmanDistrict in the Eastern Cape. Results:Weight changes took place, both the crafters in the mild thinness category gained weight, one gained 3.9 kg and the other 0.5 kg. The three crafters in the normal category did not have to gain or lose weight, but all three ofthem gained an average of 3.6 kg. For the group who had to lose weight, no statistically significant weight change took place from before the intervention (76.08 ±17.67 kg) to after the intervention (75.81 ± 17.81 kg, t(10) = 0.692, p = 0.505). The maximum weight lost ivwas 3.1 kg and the maximum weight gained was 3.2 kg. Changes took place regarding BMI, waist circumference, waist-to-hip ratio and neck circumference. Some positively changed their BMI status.After the implementation of the intervention, there was a slight decrease in frequency of alcohol consumption, but smoking and physical activity remained mostly the same. Hypertension was the most prevalent NCD and is linked to smoking and alcohol consumption which is prevalent in this study. Fruit and vegetable consumption is low, and a slight increase in consumption was evident. A maximum dietary diversityscore of seven and minimum of two, where the mean was 3.81was found. The crafters’ diet did not meet the DASH diet recommendation,the mean energy distribution is of all macronutrients differ with ±4% and none of the participants’ mean micronutrients intake met the recommendations of the DASH diet or RDA. Factors that prevent them from reaching their goals included low income, low availability of fruit, vegetables and transport and no storage for food.Conclusion:It is important to consider the individuals’ living conditions, resources, knowledge, motivation and social group. The environment and resources available have a significant impact on the lifestyle of the individuals. Directing efforts of behaviour change to increase dietary diversity as the main objective, might be a more efficient way to change behaviour.Recommendations:Future studies should consider doing this study over a longer time period. The involvement of a psychologist would also be beneficial to assist the process of behaviour change.
- Full Text:
- Date Issued: 2020
- Authors: Barnard, Mariska
- Date: 2020
- Subjects: Food habits
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46384 , vital:39565
- Description: Background: The steady increase in deaths due to non-communicable diseases (NCDs) in South Africa is raising concern, as 63% of all deaths worldwide are attributed to NCDs and these diseases cause 36 million deaths each year, with 80 % of incidences occurring in low-and middle-income countries. In rural communities where income is increasing, the prevalence of NCDs are increasing as well. Due to the lack of NCD prevention and treatment in rural communities, it is expected that, if health promotion strategies are not implemented and socio-economic development in South Africa continues, there will soon be an uncontrollable NCD epidemic. It has been found that dietary risks affected people’s healthirrespective of their age, gender or residential sociodemographic development and that dietary improvement might prevent one in every five deaths worldwide.Aim:The aim of this study was to determine the factors that influence the perceptions and behaviour in a rural community with a low socio-economic status regarding dietary habits and to use the knowledge to formulate an effective dietary modification strategy.Designand methodology:For this study,action research with a quantitative and qualitative component was followed.The quantitative component focuses on measureable aspects, and the qualitative component focuses on meaning. Data was collected following the standard operating procedure for anthropometry, blood pressure and blood glucose. Further methods used were questionnaires, 24-hour dietary recalls and focus group discussions. Data were analysed using Microsoft Excel, FoodFinder3 and other calculations.Sample and setting:A convenience sample (n = 16) wasused and this study was undertaken on request of the non-governmental organization, Karoo Angels and included all participants who earn an income and who do not work for themselves, that were willing to participate and living in Rietbron and Vondeling, in the Sarah BaartmanDistrict in the Eastern Cape. Results:Weight changes took place, both the crafters in the mild thinness category gained weight, one gained 3.9 kg and the other 0.5 kg. The three crafters in the normal category did not have to gain or lose weight, but all three ofthem gained an average of 3.6 kg. For the group who had to lose weight, no statistically significant weight change took place from before the intervention (76.08 ±17.67 kg) to after the intervention (75.81 ± 17.81 kg, t(10) = 0.692, p = 0.505). The maximum weight lost ivwas 3.1 kg and the maximum weight gained was 3.2 kg. Changes took place regarding BMI, waist circumference, waist-to-hip ratio and neck circumference. Some positively changed their BMI status.After the implementation of the intervention, there was a slight decrease in frequency of alcohol consumption, but smoking and physical activity remained mostly the same. Hypertension was the most prevalent NCD and is linked to smoking and alcohol consumption which is prevalent in this study. Fruit and vegetable consumption is low, and a slight increase in consumption was evident. A maximum dietary diversityscore of seven and minimum of two, where the mean was 3.81was found. The crafters’ diet did not meet the DASH diet recommendation,the mean energy distribution is of all macronutrients differ with ±4% and none of the participants’ mean micronutrients intake met the recommendations of the DASH diet or RDA. Factors that prevent them from reaching their goals included low income, low availability of fruit, vegetables and transport and no storage for food.Conclusion:It is important to consider the individuals’ living conditions, resources, knowledge, motivation and social group. The environment and resources available have a significant impact on the lifestyle of the individuals. Directing efforts of behaviour change to increase dietary diversity as the main objective, might be a more efficient way to change behaviour.Recommendations:Future studies should consider doing this study over a longer time period. The involvement of a psychologist would also be beneficial to assist the process of behaviour change.
- Full Text:
- Date Issued: 2020
Compliance with good distribution practice guidelines for cold chain products among pharmaceutical wholesalers in South Africa
- Authors: Masebe, Zandisile
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46390 , vital:39581
- Description: Background: The South African pharmaceutical cold chain distribution industry is highly regulated. Cold chain pharmaceutical products require storage in a cold room, in a temperature-controlled environment between (2°C-8°C) and the cold chain must be maintained at all times throughout the distribution process. The incorrect handling, storage, transport and distribution of cold chain products may reduce the potency and therapeutic effectiveness of the product which in turn may result in treatment failure. The research was aimed at determining the level of compliance to current Good Distribution Practice guidelines for cold chain products among pharmaceutical wholesalers and distributors in South Africa. Methodology: The study made use of quantitative research techniques. A purpose designed online questionnaire was used as a data collection tool from the study participants. The judgmental sampling technique was used in this study as it was found to be the most appropriate method for the research question. Phase one of the study was to conduct a pilot study at two Port Elizabeth pharmaceutical wholesalers. The data was analysed using Microsoft Excel®, chi-square test for goodness of fit and content analysis. The data was further analysed using a descriptive and inferential statistics approach to determine the level of compliance to regulatory guidelines for cold chain products.Results:The results obtained from the empirical study revealed that less than 50% of the study respondents indicated compliance to the factors listed in the regulatory guidelines for cold chain products distribution.These factors include cold chain monitoring, alternative power sources, validation of cold chain boxes and route transport validation.Conclusion:The wholesale pharmaceutical industry is experiencing challenges to comply with factors necessary to ensure compliance with GDP guidelines for cold chain products. Through the study it was proven that there is evidence of commitment by the industry to implement the GWP and GPP amendment guidelines, despite less than 50% of the respondents reporting compliance to the guidelines. Recommendations were provided to improve the level of compliance to guidelines for cold chain products by pharmaceutical wholesalers in South Africa.
- Full Text:
- Date Issued: 2020
- Authors: Masebe, Zandisile
- Date: 2020
- Subjects: Pharmaceutical industry
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/46390 , vital:39581
- Description: Background: The South African pharmaceutical cold chain distribution industry is highly regulated. Cold chain pharmaceutical products require storage in a cold room, in a temperature-controlled environment between (2°C-8°C) and the cold chain must be maintained at all times throughout the distribution process. The incorrect handling, storage, transport and distribution of cold chain products may reduce the potency and therapeutic effectiveness of the product which in turn may result in treatment failure. The research was aimed at determining the level of compliance to current Good Distribution Practice guidelines for cold chain products among pharmaceutical wholesalers and distributors in South Africa. Methodology: The study made use of quantitative research techniques. A purpose designed online questionnaire was used as a data collection tool from the study participants. The judgmental sampling technique was used in this study as it was found to be the most appropriate method for the research question. Phase one of the study was to conduct a pilot study at two Port Elizabeth pharmaceutical wholesalers. The data was analysed using Microsoft Excel®, chi-square test for goodness of fit and content analysis. The data was further analysed using a descriptive and inferential statistics approach to determine the level of compliance to regulatory guidelines for cold chain products.Results:The results obtained from the empirical study revealed that less than 50% of the study respondents indicated compliance to the factors listed in the regulatory guidelines for cold chain products distribution.These factors include cold chain monitoring, alternative power sources, validation of cold chain boxes and route transport validation.Conclusion:The wholesale pharmaceutical industry is experiencing challenges to comply with factors necessary to ensure compliance with GDP guidelines for cold chain products. Through the study it was proven that there is evidence of commitment by the industry to implement the GWP and GPP amendment guidelines, despite less than 50% of the respondents reporting compliance to the guidelines. Recommendations were provided to improve the level of compliance to guidelines for cold chain products by pharmaceutical wholesalers in South Africa.
- Full Text:
- Date Issued: 2020
Continuous professional development for medical sales representatives: a needs assessment
- Authors: Heleta, Jade Lana
- Date: 2020
- Subjects: Career development -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/46366 , vital:39576
- Description: Employees in any industry need to continuously update their skills in order to be knowledgeable and competitive. Conducting a needs assessment plays an instrumental role in ensuring that continuous professional development (CPD) training is relevant to the target audience. In many organisations, however, CPD training programmes are often planned and delivered without a comprehensive needs assessment first being undertaken. This was a quantitative study that used a descriptive survey design and an online survey tool for data collection and analysis. Using an all-inclusive sample, the purpose of this study was to explore and describe CPD needs of medical sales representatives at an international medical devices company that operates in South Africa. Descriptive and inferential statistics were used to analyse the data. Research findings are depicted in frequencies, percentages, tables and figures. The findings of the study reveal specific training needs of the respondents and the shortcomings of the existing CPD offerings. The findings show that the CPD training offered by the company under study is mostly product specific and about sales. The respondents have highlighted that they would like to see more practical training to be incorporated into the CPD training programmes. It was also noted that the respondents would like to provide more input into the training programmes that are being offered by the company under study. The study has also identified areas where the company can improve in order to make these CPD training opportunities a more satisfying, educational and developmental experience for the employees. While the study focuses on one company, findings are relevant for other similar companies, as well as companies in other industries, since CPD at the workplace is a necessity in any competitive business environment or industry in order to increase productivity, sales, staff retention and customer satisfaction.
- Full Text:
- Date Issued: 2020
- Authors: Heleta, Jade Lana
- Date: 2020
- Subjects: Career development -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/46366 , vital:39576
- Description: Employees in any industry need to continuously update their skills in order to be knowledgeable and competitive. Conducting a needs assessment plays an instrumental role in ensuring that continuous professional development (CPD) training is relevant to the target audience. In many organisations, however, CPD training programmes are often planned and delivered without a comprehensive needs assessment first being undertaken. This was a quantitative study that used a descriptive survey design and an online survey tool for data collection and analysis. Using an all-inclusive sample, the purpose of this study was to explore and describe CPD needs of medical sales representatives at an international medical devices company that operates in South Africa. Descriptive and inferential statistics were used to analyse the data. Research findings are depicted in frequencies, percentages, tables and figures. The findings of the study reveal specific training needs of the respondents and the shortcomings of the existing CPD offerings. The findings show that the CPD training offered by the company under study is mostly product specific and about sales. The respondents have highlighted that they would like to see more practical training to be incorporated into the CPD training programmes. It was also noted that the respondents would like to provide more input into the training programmes that are being offered by the company under study. The study has also identified areas where the company can improve in order to make these CPD training opportunities a more satisfying, educational and developmental experience for the employees. While the study focuses on one company, findings are relevant for other similar companies, as well as companies in other industries, since CPD at the workplace is a necessity in any competitive business environment or industry in order to increase productivity, sales, staff retention and customer satisfaction.
- Full Text:
- Date Issued: 2020
Coping and support needs of midwives caring for women with perinatal loss in the Nelson Mandela Bay health district
- Authors: Kave, Yekiswa Victoria
- Date: 2020
- Subjects: Perinatal death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/46365 , vital:39573
- Description: Midwives are part of the multidisciplinary team in maternal units and have the bulk of the obstetrical and midwifery responsibilities. The responsibilities being referred to include provision of perinatal care and support to grieving women who have lost their babies at birth and to their families. The care referred to in this study is focused mainly on the grieving women and not on the midwife. By virtue of midwives being present in the event of perinatal loss or caring for a woman who experienced perinatal loss, midwives are compelled to be involved and are bound to experience deep emotions. Furthermore, there is little formal support available for midwives caring for women with perinatal loss in Nelson Mandela Bay Health District (NMBHD) and South Africa at large. The purpose of this study was to obtain a deeper understanding of coping and support needs of midwives caring for women with perinatal loss in the NMBHD. The objectives developed for this study were: explore and describe the facilitating conditions that will enable midwives to care for women with perinatal loss in the in NMBHD; explore and describe the inhibitory conditions that prevent midwives from caring for women with perinatal loss in the NMBHD; identify and describe support needs for midwives caring for women with perinatal loss in the NMBHD and develop coping and support recommendations for midwives caring for women with perinatal loss in the NMBHD. After permission had been granted by the Nelson Mandela university and approval from other relevant authorities had been received data collection was conducted between November 2018 and January 2019, using qualitative research design and interviews. The research population included all midwives working in Midwife Obstetric units (MOUs) and referral hospitals in NMBHD. Purposive sampling was used, and the data collection method was semi-structured and audio-taped in one-on-one interviews with midwives. Sample size was determined by data saturation. The number of participants was thirteen and two of these participants formed part of the pilot study. The collected data was analysed using the seven steps of Framework Analysis from which three themes emerged namely: Midwives rely on their own coping mechanisms vi to deal with perinatal loss; Midwives expressed how management influenced the way they coped with perinatal loss events; Midwives expressed the need for psychological and emotional support. Trustworthiness was maintained by observing Lincoln and Guba’s principles of credibility, transferability, dependability and confirmability. The researcher ensured that the Belmont Report ethical principles were maintained throughout the study. Three main coping and support recommendations for midwives caring for women with perinatal loss in the NMBHD were developed using an adapted version of the AGREE II Tool. The recommendations were: Recommendation 1: Facilitate various forms of peer assistance to prepare and support midwives caring for women with perinatal loss; Recommendation 2: Provide formal support systems in the labour unit to assist midwives to care for women with perinatal loss; and Recommendation 3: Strengthen existing EAPs and provide unit-based psychological and emotional support in order to accommodate the needs of midwives caring for women with perinatal loss.
- Full Text:
- Date Issued: 2020
- Authors: Kave, Yekiswa Victoria
- Date: 2020
- Subjects: Perinatal death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/46365 , vital:39573
- Description: Midwives are part of the multidisciplinary team in maternal units and have the bulk of the obstetrical and midwifery responsibilities. The responsibilities being referred to include provision of perinatal care and support to grieving women who have lost their babies at birth and to their families. The care referred to in this study is focused mainly on the grieving women and not on the midwife. By virtue of midwives being present in the event of perinatal loss or caring for a woman who experienced perinatal loss, midwives are compelled to be involved and are bound to experience deep emotions. Furthermore, there is little formal support available for midwives caring for women with perinatal loss in Nelson Mandela Bay Health District (NMBHD) and South Africa at large. The purpose of this study was to obtain a deeper understanding of coping and support needs of midwives caring for women with perinatal loss in the NMBHD. The objectives developed for this study were: explore and describe the facilitating conditions that will enable midwives to care for women with perinatal loss in the in NMBHD; explore and describe the inhibitory conditions that prevent midwives from caring for women with perinatal loss in the NMBHD; identify and describe support needs for midwives caring for women with perinatal loss in the NMBHD and develop coping and support recommendations for midwives caring for women with perinatal loss in the NMBHD. After permission had been granted by the Nelson Mandela university and approval from other relevant authorities had been received data collection was conducted between November 2018 and January 2019, using qualitative research design and interviews. The research population included all midwives working in Midwife Obstetric units (MOUs) and referral hospitals in NMBHD. Purposive sampling was used, and the data collection method was semi-structured and audio-taped in one-on-one interviews with midwives. Sample size was determined by data saturation. The number of participants was thirteen and two of these participants formed part of the pilot study. The collected data was analysed using the seven steps of Framework Analysis from which three themes emerged namely: Midwives rely on their own coping mechanisms vi to deal with perinatal loss; Midwives expressed how management influenced the way they coped with perinatal loss events; Midwives expressed the need for psychological and emotional support. Trustworthiness was maintained by observing Lincoln and Guba’s principles of credibility, transferability, dependability and confirmability. The researcher ensured that the Belmont Report ethical principles were maintained throughout the study. Three main coping and support recommendations for midwives caring for women with perinatal loss in the NMBHD were developed using an adapted version of the AGREE II Tool. The recommendations were: Recommendation 1: Facilitate various forms of peer assistance to prepare and support midwives caring for women with perinatal loss; Recommendation 2: Provide formal support systems in the labour unit to assist midwives to care for women with perinatal loss; and Recommendation 3: Strengthen existing EAPs and provide unit-based psychological and emotional support in order to accommodate the needs of midwives caring for women with perinatal loss.
- Full Text:
- Date Issued: 2020
Coping mechanisms of unemployed registered counsellors in the South African context
- Authors: Mogatosi, Ntsako Emmah
- Date: 2020
- Subjects: Counselors--Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46375 , vital:39585
- Description: ivABSTRACTThe Registered Counsellorcategory has been a developing profession since its inception in 2003. There havebeen few studies done on the coping mechanisms of unemployed Registered Counsellors in the South African context. This field of study is particularly important as Registered Counsellors are the primarymentalhealth care professionals;therefore,their role in psychology is of utmost importance. This study focused on exploring the coping mechanisms of unemployed Registered Counsellors. A qualitative research approach was followed in order to gaina comprehensive understanding regardingthe perceived coping strategies. A combination of purposive,non-probability and snowball sampling techniques was employedto select participants and semi-structured interviews were conducted with them to explore and describe their coping mechanisms. Lazarus and Folkman’stheorywas utilised to provide a theoretical understanding of the coping mechanisms. Unemployment is perceived to cause stress and may lead to maladaptive coping strategies. It was perceived to have an impact on the professional’s goalsand increased financial strain in their lives. However, communication, social and family support, positive attitudes, availability to opportunities and advocacy for the profession were identified as effective coping mechanisms. The majority of the participants perceived good communication about the situation and supportive relationships to be the most effective strategies to be utilised in their lives.
- Full Text:
- Date Issued: 2020
- Authors: Mogatosi, Ntsako Emmah
- Date: 2020
- Subjects: Counselors--Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46375 , vital:39585
- Description: ivABSTRACTThe Registered Counsellorcategory has been a developing profession since its inception in 2003. There havebeen few studies done on the coping mechanisms of unemployed Registered Counsellors in the South African context. This field of study is particularly important as Registered Counsellors are the primarymentalhealth care professionals;therefore,their role in psychology is of utmost importance. This study focused on exploring the coping mechanisms of unemployed Registered Counsellors. A qualitative research approach was followed in order to gaina comprehensive understanding regardingthe perceived coping strategies. A combination of purposive,non-probability and snowball sampling techniques was employedto select participants and semi-structured interviews were conducted with them to explore and describe their coping mechanisms. Lazarus and Folkman’stheorywas utilised to provide a theoretical understanding of the coping mechanisms. Unemployment is perceived to cause stress and may lead to maladaptive coping strategies. It was perceived to have an impact on the professional’s goalsand increased financial strain in their lives. However, communication, social and family support, positive attitudes, availability to opportunities and advocacy for the profession were identified as effective coping mechanisms. The majority of the participants perceived good communication about the situation and supportive relationships to be the most effective strategies to be utilised in their lives.
- Full Text:
- Date Issued: 2020
Cultural position and the development of posttraumatic stress disorder
- Authors: Dorfling, Inge-Louise
- Date: 2020
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46371 , vital:39564
- Description: Trauma exposure and PTSD are widespread health concerns in South Africa. This country is also extremely culturally diverse. The effects of cultural position on PTSD development are unknown. The objective was to explore these possibilities in detail. Individuals eighteen years or older with a stable pre-existing PTSD diagnosis participated in semi-structured voice recorded interviews. Both participants displayed clear conscious changes in cultural position following trauma exposure, some of which are believed to be due to a failure of support and acknowledgement from their collective. This would have contributed to PTSD development. Main themes identified were reactions of others and a paradigm shift. Further, more detailed research is required in this field.
- Full Text:
- Date Issued: 2020
- Authors: Dorfling, Inge-Louise
- Date: 2020
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46371 , vital:39564
- Description: Trauma exposure and PTSD are widespread health concerns in South Africa. This country is also extremely culturally diverse. The effects of cultural position on PTSD development are unknown. The objective was to explore these possibilities in detail. Individuals eighteen years or older with a stable pre-existing PTSD diagnosis participated in semi-structured voice recorded interviews. Both participants displayed clear conscious changes in cultural position following trauma exposure, some of which are believed to be due to a failure of support and acknowledgement from their collective. This would have contributed to PTSD development. Main themes identified were reactions of others and a paradigm shift. Further, more detailed research is required in this field.
- Full Text:
- Date Issued: 2020
Differences in swimming stroke mechanics and kinematics derived from tri-axial accelerometers during a 200-IM event in South African national swimmers
- Authors: Musson, Courtney Ruth
- Date: 2020
- Subjects: Swimming
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46337 , vital:39588
- Description: Context: Swimming is a highly competitive sport, with elite swimmers and coaches constantly looking for ways to improve and challenge themselves to meet new performance goals. The implementation of technology in swimming has proven to be a vital tool in athlete monitoring and in providing coaches with additional information on the swimmer’s performance. Example of this technology is the use of inertial sensory devices such as tri-axial accelerometers. The accelerometers can be used to provide kinematic information with regards to the swimmer’s stroke rate, stroke length and stroke mechanics. In a typical training session, coaches would have to manually time and count their swimmer’s strokes to be able to gain the kinematic information they require. Hence, the use ofinertial sensory technology, such as accelerometers, would provide the necessary information coaches require, allowing them to concentrate on other performance aspects such as theirswimmer’s technique.Aim and objectives: The aim of this study was to determine the kinematic parameters and swimming stroke mechanics that could be derived from tri-axial accelerometers, during a 200-m individual medley (IM) event in South African national level swimmers. Three objectives were set to meet the aim of the study. The first was to identify and differentiate each of the stroking styles using tri-axial accelerometers. The second was to identify and differentiate the kinematic parametersand stroke mechanicsfor all four strokes using tri-axial accelerometers. The third objective was to implement machine learning to automate the identification and interpretation of the accelerometer data. Method:A quantitative, non-experimental descriptive one group post-test only design was used, in which 15 national level swimmers, of which seven male and eight female (mean ±SD: age: 20.9 ± 2.90 years; height: 173.28 ± 10.61 cm; weight: 67.81 ± 8.09 kg; arm span: 178.21 ± 12.15 cm) were tested. Three anthropometric measures were taken (height, weight and arm span) prior to testing, with two tri-axial accelerometers and Polar V800watch and heart rate belt attached to the swimmers left wrist, upper-back and chest, respectively. All swimmerswere required to perform three main swimming sets: 50-m IM, 100-m variation and 200-mIM. Variousdescriptivestatisticsincluding mean, standard deviation and confidence intervals (95%)were used to describe the data. with further inferential statistics including paired t-test, intra-class correlation and Bland Altman analysis wereused to describe the relationship ivbetween the accelerometer and the manually estimated parameters. Additionally, arepeated measures one-way ANOVA (with post-hoc Tukey HSD test) werealso used in an inter-comparison of the stroke parameters between each of the stroking styles. A confusion matrix wasused to measure the classification accuracy of the machine learning model implemented on the accelerometer data.Results:The accelerometers proved successful in identifyingand discerningthe stroke mechanics for each of the four stroking styles, with the use of video footage to validatethe findings. In the stroke kinematic differentiation, theBland Altman analysisresultsshowed an agreement between themanual method and accelerometer-derived estimates, although a discrepancy was evident for several of the kinematic parameters, with a significant difference found with the estimated lap time, average swimming velocity and stroke rate (paired t-test: p <0.001 for all swim sets). The inter-comparison between the stroke parameters per stroking style showed a significant difference with average swimming velocity (repeated one-way ANOVA: F = 1789.37, p <0.001), averages stroke rate (repeated one-way ANOVA: F = 671.70, p <0.001) and average stroke length (repeated one-way ANOVA: F = 346.46, p<0.001) for the population group tested. Furtheranalysis with post-hoc Tukey HSD test showed no significant difference wereevident for the average swimming velocity(Tukey: p > 0.05for all strokes)andbetween freestyle and backstroke for the average stroke rate and stroke length (Tukey:p = 0.0968 andp = 0.997, respectively).Lastly, the machine learning model found a classification accuracy of 96.6% in identifyingand labelling the stroking styles fromthe accelerometer data.Conclusion: It was shown that the tri-axial accelerometers were successful in the identification and differentiation of all the stroking styles, stroke mechanics and kinematics, although a discrepancy was found with the average swimming velocity, stroke rate and lap time estimations. The machine learning model implemented proved the benefits of using artificial intelligence to ease the data process and interpretation by automatically labelling the accelerometer data. Therefore, the use of tri-axial accelerometers as a coaching aid has major potential in the swimming community. However, further research is required to eliminate the time-consuming data processingand to increasetheaccuracy of the accelerometer in the measurement of all the stroke kinematics.
- Full Text:
- Date Issued: 2020
- Authors: Musson, Courtney Ruth
- Date: 2020
- Subjects: Swimming
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46337 , vital:39588
- Description: Context: Swimming is a highly competitive sport, with elite swimmers and coaches constantly looking for ways to improve and challenge themselves to meet new performance goals. The implementation of technology in swimming has proven to be a vital tool in athlete monitoring and in providing coaches with additional information on the swimmer’s performance. Example of this technology is the use of inertial sensory devices such as tri-axial accelerometers. The accelerometers can be used to provide kinematic information with regards to the swimmer’s stroke rate, stroke length and stroke mechanics. In a typical training session, coaches would have to manually time and count their swimmer’s strokes to be able to gain the kinematic information they require. Hence, the use ofinertial sensory technology, such as accelerometers, would provide the necessary information coaches require, allowing them to concentrate on other performance aspects such as theirswimmer’s technique.Aim and objectives: The aim of this study was to determine the kinematic parameters and swimming stroke mechanics that could be derived from tri-axial accelerometers, during a 200-m individual medley (IM) event in South African national level swimmers. Three objectives were set to meet the aim of the study. The first was to identify and differentiate each of the stroking styles using tri-axial accelerometers. The second was to identify and differentiate the kinematic parametersand stroke mechanicsfor all four strokes using tri-axial accelerometers. The third objective was to implement machine learning to automate the identification and interpretation of the accelerometer data. Method:A quantitative, non-experimental descriptive one group post-test only design was used, in which 15 national level swimmers, of which seven male and eight female (mean ±SD: age: 20.9 ± 2.90 years; height: 173.28 ± 10.61 cm; weight: 67.81 ± 8.09 kg; arm span: 178.21 ± 12.15 cm) were tested. Three anthropometric measures were taken (height, weight and arm span) prior to testing, with two tri-axial accelerometers and Polar V800watch and heart rate belt attached to the swimmers left wrist, upper-back and chest, respectively. All swimmerswere required to perform three main swimming sets: 50-m IM, 100-m variation and 200-mIM. Variousdescriptivestatisticsincluding mean, standard deviation and confidence intervals (95%)were used to describe the data. with further inferential statistics including paired t-test, intra-class correlation and Bland Altman analysis wereused to describe the relationship ivbetween the accelerometer and the manually estimated parameters. Additionally, arepeated measures one-way ANOVA (with post-hoc Tukey HSD test) werealso used in an inter-comparison of the stroke parameters between each of the stroking styles. A confusion matrix wasused to measure the classification accuracy of the machine learning model implemented on the accelerometer data.Results:The accelerometers proved successful in identifyingand discerningthe stroke mechanics for each of the four stroking styles, with the use of video footage to validatethe findings. In the stroke kinematic differentiation, theBland Altman analysisresultsshowed an agreement between themanual method and accelerometer-derived estimates, although a discrepancy was evident for several of the kinematic parameters, with a significant difference found with the estimated lap time, average swimming velocity and stroke rate (paired t-test: p <0.001 for all swim sets). The inter-comparison between the stroke parameters per stroking style showed a significant difference with average swimming velocity (repeated one-way ANOVA: F = 1789.37, p <0.001), averages stroke rate (repeated one-way ANOVA: F = 671.70, p <0.001) and average stroke length (repeated one-way ANOVA: F = 346.46, p<0.001) for the population group tested. Furtheranalysis with post-hoc Tukey HSD test showed no significant difference wereevident for the average swimming velocity(Tukey: p > 0.05for all strokes)andbetween freestyle and backstroke for the average stroke rate and stroke length (Tukey:p = 0.0968 andp = 0.997, respectively).Lastly, the machine learning model found a classification accuracy of 96.6% in identifyingand labelling the stroking styles fromthe accelerometer data.Conclusion: It was shown that the tri-axial accelerometers were successful in the identification and differentiation of all the stroking styles, stroke mechanics and kinematics, although a discrepancy was found with the average swimming velocity, stroke rate and lap time estimations. The machine learning model implemented proved the benefits of using artificial intelligence to ease the data process and interpretation by automatically labelling the accelerometer data. Therefore, the use of tri-axial accelerometers as a coaching aid has major potential in the swimming community. However, further research is required to eliminate the time-consuming data processingand to increasetheaccuracy of the accelerometer in the measurement of all the stroke kinematics.
- Full Text:
- Date Issued: 2020