The impact of COVID-19 on depression, anxiety, and post-traumatic stress levels in doctors and nurses at a South African health facility
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2021-12
- Authors: Finger-Motsepe, Kelebogile
- Date: 2021-12
- Subjects: COVID-19 (Disease) , Mental health
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27920 , vital:70880
- Description: Introduction: The emergence of the coronavirus disease of 2019 (Covid-19) has wrought profound and enduring transformations in global health, economic dynamics, and social interactions. However, the comprehensive quantification of the psychological repercussions of the Covid-19 pandemic remains elusive and is poised to compound the preexisting burden of mental health disorders within the general populace. Elevated transmission rates, rapid disease progression within vulnerable demographics, and the absence of definitive curative or preventive measures have collectively contributed to a heightened worldwide state of stress and anxiety. Extensive research has demonstrated that the apprehension and stress associated with Covid-19 are markedly pronounced among healthcare professionals, commonly referred to as front-line workers, in comparison to the general population. The Covid-19-related psychological distress is anticipated to act as a catalyst, exacerbating mental health conditions within high-risk groups. Aims and Objectives: This study endeavours to ascertain the prevalence and severity of depression, anxiety, and post-traumatic stress disorder (PTSD) among medical doctors and nurses employed at a regional hospital in South Africa. Methodology: A cross-sectional investigation was conducted to evaluate the presence of anxiety, depression, and stress symptoms among medical doctors and nurses working at a Regional Hospital situated in the Free State Province of South Africa. A purposive sample of 200 participants, comprising all willing doctors and nurses employed at the study site, was enrolled in the study. Findings: The participants exhibited an average age of 42 years and an average tenure of approximately 72 months at the hospital. The majority of participants were of African descent, with a male-to-female ratio of 1:2.3. Female healthcare workers reported significantly higher instances of PTSD than their male counterparts. In the aggregate, 71.4percent of doctors reported symptoms indicative of depression, 73.2percent reported anxiety-related symptoms, and 19.6percent reported PTSD-related symptoms. Among nurses, 72percent displayed clinically significant symptoms of depression, 81percent exhibited anxiety-related symptoms, and 27.7percent manifested symptoms suggestive of PTSD. A moderately robust positive correlation was discerned between PTSD and Anxiety (p = .000; r = .466) as well as PTSD and Depression (p = .000; r = .315). Additionally, a strong positive correlation was identified between Anxiety and Depression (p = .000; r = .631). A statistically significant disparity (p = .030) in anxiety levels was observed among workers in different risk-prone areas. Nurses reported substantially higher levels of anxiety (p = .039; M = 10.63, sd = 4.03) compared to doctors (M = 9.01, sd = 3.80) and administrators (M = 10.50, sd = 4.32). Moreover, both nurses (M = 27.06, sd = 13.61) and administrators (M = 33.33, sd = 14.44) exhibited significantly higher instances of PTSD (p = .003) than doctors (M = 19.96, sd = 15.03). Conclusions: The healthcare workers under scrutiny reported elevated levels of anxiety and depression attributable to the Covid-19 pandemic, although the prevalence of posttraumatic stress symptoms was comparatively lower within the hospital setting. Furthermore, this study illuminates that depressive, anxiety, and post-traumatic stress symptoms were more prevalent among nurses than doctors. Additionally, healthcare professionals operating in high-risk Covid-19 environments, such as the Covid-19 ward, demonstrated heightened levels of anxiety when juxtaposed with their counterparts stationed in low-risk Covid-19 areas within the healthcare facility. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2021-12
Assessment of compliance to the maintenance procedure of medical equipment in a selected hospital, Oliver Reginald Tambo District, Eastern Cape Province
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Knowledge, attitudes, and practices of the treatment options for dental caries among the adult patients for dental caries in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Low uptake and early removal of Implanon NXT among women of reproductive age in Limpopo
- Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Retrospective analysis of factors contributing to parasuicide among youth in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Barriers to participation in sports among urban adolescents at an International School in Cape Town, South Africa
- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
Knowledge, Attitudes and Perceptions Towards HIV Testing Among IsiXhosa-Speaking Men in The Zithulele Catchment Area of The Rural Eastern Cape Province, South Africa
- Authors: Scotcher, Philippa Claire
- Date: 2021-10
- Subjects: HIV infections
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6842 , vital:51017
- Description: BACKGROUND South Africa carries the largest burden of Human Immunodeficiency Virus (HIV) in the world, with over 7.9 million people infected and over 70 000 HIV-related deaths in 2019. Men are 25% more likely to die from Acquired Immune Deficiency Syndrome (AIDS) compared to women, even though women are more likely to be infected. Despite these numbers, only 24.1% of HIV-positive men compared to 64.8% of HIV-positive women were aware of their status. Statistics indicate that men in South Africa are not testing for HIV until it is too late. In order to focus efforts on the prevention of HIV transmission, there is a need to understand why men are not accessing HIV testing and treatment services earlier. This study aims to explore the knowledge, attitudes, and perceptions towards HIV testing of isiXhosa-speaking men in the Zithulele catchment area of the rural Eastern Cape. METHODS This was a qualitative study using the phenomenological approach. It was conducted among a purposive sample of isiXhosa-speaking men from the Zithulele catchment area, in the OR Tambo district of the Eastern Cape Province. Ten semi-structured interviews and one focus group were conducted in isiXhosa. Interviews were audiorecorded, transcribed, and translated into English. The interviews were thematically analysed using an inductive approach. RESULTS Participants from the study had a good understanding of HIV and HIV transmission. They perceived HIV infection as a death sentence, a consequence of immoral behaviour and an indication of failure as man. Reluctance to test for HIV was due to the perception that testing hastens the onset of symptoms and death, whereas disclosure of an HIV-positive status was described as difficult due to the fear of stigmatization. Some of the barriers to accessing HIV testing services included masculine norms, the belief that sickness is equated with weakness, a perceived lack of confidentiality at health facilities and how female-dominated clinics were not male-friendly spaces. Suggestions to improve HIV testing among men included improving targeted education, home-based testing services and utilizing traditional meetings to address men. CONCLUSION The findings of this study may suggest that healthy men in the Zithulele catchment area of the rural Eastern Cape are not accessing HIV testing and treatment services. The reasons behind this reluctance include false beliefs around HIV and testing, the fear of discrimination, disruption of masculine norms and reluctance to access care at female-dominated health facilities. Further research is needed to explore ways to reach, educate and encourage men to test earlier for HIV. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
- Authors: Scotcher, Philippa Claire
- Date: 2021-10
- Subjects: HIV infections
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6842 , vital:51017
- Description: BACKGROUND South Africa carries the largest burden of Human Immunodeficiency Virus (HIV) in the world, with over 7.9 million people infected and over 70 000 HIV-related deaths in 2019. Men are 25% more likely to die from Acquired Immune Deficiency Syndrome (AIDS) compared to women, even though women are more likely to be infected. Despite these numbers, only 24.1% of HIV-positive men compared to 64.8% of HIV-positive women were aware of their status. Statistics indicate that men in South Africa are not testing for HIV until it is too late. In order to focus efforts on the prevention of HIV transmission, there is a need to understand why men are not accessing HIV testing and treatment services earlier. This study aims to explore the knowledge, attitudes, and perceptions towards HIV testing of isiXhosa-speaking men in the Zithulele catchment area of the rural Eastern Cape. METHODS This was a qualitative study using the phenomenological approach. It was conducted among a purposive sample of isiXhosa-speaking men from the Zithulele catchment area, in the OR Tambo district of the Eastern Cape Province. Ten semi-structured interviews and one focus group were conducted in isiXhosa. Interviews were audiorecorded, transcribed, and translated into English. The interviews were thematically analysed using an inductive approach. RESULTS Participants from the study had a good understanding of HIV and HIV transmission. They perceived HIV infection as a death sentence, a consequence of immoral behaviour and an indication of failure as man. Reluctance to test for HIV was due to the perception that testing hastens the onset of symptoms and death, whereas disclosure of an HIV-positive status was described as difficult due to the fear of stigmatization. Some of the barriers to accessing HIV testing services included masculine norms, the belief that sickness is equated with weakness, a perceived lack of confidentiality at health facilities and how female-dominated clinics were not male-friendly spaces. Suggestions to improve HIV testing among men included improving targeted education, home-based testing services and utilizing traditional meetings to address men. CONCLUSION The findings of this study may suggest that healthy men in the Zithulele catchment area of the rural Eastern Cape are not accessing HIV testing and treatment services. The reasons behind this reluctance include false beliefs around HIV and testing, the fear of discrimination, disruption of masculine norms and reluctance to access care at female-dominated health facilities. Further research is needed to explore ways to reach, educate and encourage men to test earlier for HIV. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
Experiences of patients with cancer regarding decentralization of oncology services at a selected tertiary hospital in the Eastern Cape
- Authors: Jojo, Lumkile
- Date: 2021-09
- Subjects: Cancer -- Nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26907 , vital:66080
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-09
- Authors: Jojo, Lumkile
- Date: 2021-09
- Subjects: Cancer -- Nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26907 , vital:66080
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-09
Experiences of patients with cancer regarding decentralization of oncology services at a selected tertiary hospital in the Eastern Cape
- Authors: Jojo, Lumkile Wilmot
- Date: 2021-09
- Subjects: Cancer -- Patients , Oncology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23510 , vital:58074
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities. Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-09
- Authors: Jojo, Lumkile Wilmot
- Date: 2021-09
- Subjects: Cancer -- Patients , Oncology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23510 , vital:58074
- Description: Background: Cancer burden is a global public health concern. It is associated with high morbidities and mortalities worldwide. Over the past decade, there has been a constant increase in the incidence of cancer cases affecting mostly low-income countries and middle- income countries. South Africa as a middle-income country is also affected by this cancer rise. The limited access to oncology services contributed to the late presentation and late diagnosis. In the Eastern Cape, oncology services were previously offered in Port Elizabeth and East London only. Oncology unit was recently opened in Mthatha to decentralize oncology services in the province. The purpose of the study was to explore the experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape province of South Africa. Objectives were to describe experiences of patients with cancer regarding decentralization of oncology services at a public tertiary hospital in the Eastern Cape, and to describe the quality of oncology services provided by a public tertiary hospital in the Eastern Cape. Methods: a qualitative research approach with a descriptive, explorative, and contextual design was undertaken in this study, to get the perspective of the oncology healthcare service recipients on the decentralization of oncology services at a public tertiary hospital. An interview guide was used to get experiences of the cancer patients attending oncology clinic. Interviews were conducted to 19 participants on a one-to-one basis. With ethical consideration, all COVID-19 protocols were observed. All interviews were transcribed carefully against their audio-recordings. Field notes were also taken by the researcher on what was heard, observed, thought and experienced during the interview process. The concept of trustworthiness was used to ensure rigour throughout this study. Data was analysed by means of thematic analysis. Data was organized into themes using the Tesch’s approach to open coding in qualitative research. Results: seven themes emerged: 1) experience related to a high level of satisfaction with services provided and desired expectations, 2) waiting time, 3) availability of human and material resources, 4) attitude of health care workers, 5) appropriate treatment and care, 6) access to services, and 7) need for improved infrastructural facilities. Many patients had positive experiences about decentralization of oncology services in the province. Most patients were happy about travelling short distances, a smaller number of days, using less money and the time it takes to see a doctor. They also expressed their satisfaction on the quality of oncology services rendered in the unit. The waiting times were acceptable, medicines available and staff had positive attitudes towards the patients. The study revealed that, there were complaints about infrastructure, poor hospital record keeping, and lack of resources. The themes which emanated from the recordings of the study showed that patients with cancer, attending oncology clinic at a public tertiary hospital had positive experiences in this decentralized oncology unit. The services rendered at the facility were of acceptable quality. Staff had positive attitude towards their patients. All patients were seen by the doctors within acceptable waiting time, and they all got their prescribed medication. Access to services was much improved in terms of distance, number of days travelled by patients to access the service and time taken to see the doctor for appointments. Conclusion: The hospital must improve its infrastructure, record keeping, security, and expand the services. Put more focus on cancer awareness programs. , Thesis (MPA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-09
Experiences of patients on short term drug resistant tuberculosis regimen at Nelson Mandela District TB Specialist Hospital
- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
Knowledge and attitudes of women regarding cervical cancer and papanicolau smear screening in Caleb Motshabi, Bloemfontein
- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
Psychosocial impact of mental illness on family caregivers of mental healthcare users in Mangaung District
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-08
The implementation of National Core Standards with specific reference to clinical leadership: A case of Frere Hospital
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-06
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-06
A best practice guideline for the management of the quality of objective structured clinical examinations at a multi-campus public college of nursing
- Authors: Nyangeni, Thandolwakhe
- Date: 2021-04
- Subjects: Nursing assessment-- Management , Clinical Competence -- Management
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51466 , vital:43281
- Description: An Objective Structured Clinical Examination (OSCE) is a robust method of clinical assessment which, when properly planned and executed, results in a high quality and credible student assessment. However, concerns regarding its uniformity, fairness, objectivity and accuracy have been raised. Concerns regarding the management of the quality of OSCEs at a public College of Nursing in the Eastern Cape were raised by the College’s stakeholders. No best practice guideline had been developed regarding the management of the quality of OSCEs for this College. The aim of this study was therefore to develop a best practice guideline for the management of the quality of OSCEs at a public College of Nursing. The Transformative Pedagogy Theory proposed by Khedkar and Nair was used as a philosophical underpinning for this study. The Joanna Briggs Institute (JBI) model for evidence-based healthcare was used as a theoretical basis for this study. In Phase One, a qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of nurse educators regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. Semi-structured individual interviews were used to collect data from fourteen (n=14) nurse educators. Thereafter, a qualitative document analysis of fifteen (n=15) external moderators’ reports was conducted to explore the information external moderators shared regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. A document analysis checklist designed by the researcher was used to extract the data from external moderators’ reports. Tesch’s method of data analysis was utilised to analyse the data from the interviews while the data analysis process proposed by Dalglish, Khalid and McMahon was used to analyse the data from the external moderator’s reports. In Phase Two, an integrative literature review was conducted to search, select, extract, appraise and synthesise best practices regarding the management of the quality of OSCEs in health sciences education. The adapted integrative literature review steps, as proposed by de Souza, da Silva and de Carvalho, were utilised to guide this phase. Data of a total of thirteen (n=13) articles were extracted and synthesised. In Phase Three, the findings of Phase One and Phase Two were synthesised, as a basis for informing the development of a best practice guideline for the management of the quality of OSCEs. The National Institute for Health and Care (NICE) and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) frameworks were used as a basis for developing the best practice guideline for the management of the quality of OSCEs at a multi-campus public College of Nursing. The draft best practice guideline was reviewed by eight (n=8) expert reviewers who were experienced in conducting OSCE’s and best practice guideline development. Lincoln and Guba’s principles—namely credibility, transferability, dependability and confirmability were applied to ensure the trustworthiness of the interview data. Wesley’s criteria- namely triangulation, thick description and audit trail were used to ensure the trustworthiness of the document analysis. The principles as stipulated in the Belmont Report were applied in order to ensure the ethical soundness of this study. Findings of the interviews and the document analysis in Phase One revealed that, while there are measures currently in place to facilitate quality in the management of OSCEs in this College of Nursing, there are gaps such as uncertainty in the assessment practices being used and resource constraints that hinder the overall quality of OSCEs. The participants indicated the need for the development of a best practice guideline for the management of the quality of OSCEs at this College. Findings from the integrative literature review in Phase Two revealed three themes, namely: apply quality measures in the preparation and planning phase of OSCEs; apply quality measures in the implementation phase of OSCEs; and apply quality measures in the evaluation phase of OSCEs. For Phase Three, the developed best practice guideline included three recommendations regarding the quality measures that should be applied in each of the three phases of OSCEs. It is recommended for the developed best practice guideline to be further refined, piloted and implemented to be used by nurse educators and other relevant stakeholders Once implemented, the guideline is expected to enhance the management of the quality of OSCEs at the multi-campus College of Nursing and, ultimately, nursing and patient outcomes through quality nursing education and assessment. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Nyangeni, Thandolwakhe
- Date: 2021-04
- Subjects: Nursing assessment-- Management , Clinical Competence -- Management
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51466 , vital:43281
- Description: An Objective Structured Clinical Examination (OSCE) is a robust method of clinical assessment which, when properly planned and executed, results in a high quality and credible student assessment. However, concerns regarding its uniformity, fairness, objectivity and accuracy have been raised. Concerns regarding the management of the quality of OSCEs at a public College of Nursing in the Eastern Cape were raised by the College’s stakeholders. No best practice guideline had been developed regarding the management of the quality of OSCEs for this College. The aim of this study was therefore to develop a best practice guideline for the management of the quality of OSCEs at a public College of Nursing. The Transformative Pedagogy Theory proposed by Khedkar and Nair was used as a philosophical underpinning for this study. The Joanna Briggs Institute (JBI) model for evidence-based healthcare was used as a theoretical basis for this study. In Phase One, a qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of nurse educators regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. Semi-structured individual interviews were used to collect data from fourteen (n=14) nurse educators. Thereafter, a qualitative document analysis of fifteen (n=15) external moderators’ reports was conducted to explore the information external moderators shared regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. A document analysis checklist designed by the researcher was used to extract the data from external moderators’ reports. Tesch’s method of data analysis was utilised to analyse the data from the interviews while the data analysis process proposed by Dalglish, Khalid and McMahon was used to analyse the data from the external moderator’s reports. In Phase Two, an integrative literature review was conducted to search, select, extract, appraise and synthesise best practices regarding the management of the quality of OSCEs in health sciences education. The adapted integrative literature review steps, as proposed by de Souza, da Silva and de Carvalho, were utilised to guide this phase. Data of a total of thirteen (n=13) articles were extracted and synthesised. In Phase Three, the findings of Phase One and Phase Two were synthesised, as a basis for informing the development of a best practice guideline for the management of the quality of OSCEs. The National Institute for Health and Care (NICE) and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) frameworks were used as a basis for developing the best practice guideline for the management of the quality of OSCEs at a multi-campus public College of Nursing. The draft best practice guideline was reviewed by eight (n=8) expert reviewers who were experienced in conducting OSCE’s and best practice guideline development. Lincoln and Guba’s principles—namely credibility, transferability, dependability and confirmability were applied to ensure the trustworthiness of the interview data. Wesley’s criteria- namely triangulation, thick description and audit trail were used to ensure the trustworthiness of the document analysis. The principles as stipulated in the Belmont Report were applied in order to ensure the ethical soundness of this study. Findings of the interviews and the document analysis in Phase One revealed that, while there are measures currently in place to facilitate quality in the management of OSCEs in this College of Nursing, there are gaps such as uncertainty in the assessment practices being used and resource constraints that hinder the overall quality of OSCEs. The participants indicated the need for the development of a best practice guideline for the management of the quality of OSCEs at this College. Findings from the integrative literature review in Phase Two revealed three themes, namely: apply quality measures in the preparation and planning phase of OSCEs; apply quality measures in the implementation phase of OSCEs; and apply quality measures in the evaluation phase of OSCEs. For Phase Three, the developed best practice guideline included three recommendations regarding the quality measures that should be applied in each of the three phases of OSCEs. It is recommended for the developed best practice guideline to be further refined, piloted and implemented to be used by nurse educators and other relevant stakeholders Once implemented, the guideline is expected to enhance the management of the quality of OSCEs at the multi-campus College of Nursing and, ultimately, nursing and patient outcomes through quality nursing education and assessment. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A case study of Jeffrey Dahmer
- Authors: Freeman, Chanté F
- Date: 2021-04
- Subjects: Serial murders -- Case studies , Personality development -- Psychological aspects
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51032 , vital:43202
- Description: Jeffrey Lionel Dahmer is an infamous serial killer and cannibal. He was described as a normal, but shy little boy, yet developed into an adult who brutally murdered, engaged in necrophiliac acts, dismembered and ate parts of his victims. This study took the form of an intrinsic case study with the aim to explore and describe the personality development of Jeffrey Dahmer. This exploration examined Dahmer’s known childhood experiences through the theoretical perspective of Otto Kernberg’s (1974, 1975, 1976) Object Relations Theory, in order to understand how Dahmer’s personality was formed. Data was collected from multiple resources, including books, authoritative biographies, academic articles, and internet sources available in the public domain. It was analysed using Miles, Huberman, and Saldaña’s (2014) three-step process namely, data condensation, data display, and conclusion drawing and verification. This study’s findings confirmed the formation of pathological behavioural patterns supported by primitive defence mechanisms, associated with Kernberg’s lower level pathologies. It reflected Dahmer’s pathological formation of psychic structures seen in a diffuse identity and impaired formation of the superego, that supported these patterns. Additionally, the research was valuable in enhancing the researcher’s insight into personality development according to Kernberg’s Object Relations Theory. This study may also be beneficial to practising clinicians and professionals as an example of the early identification of personality pathology. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Freeman, Chanté F
- Date: 2021-04
- Subjects: Serial murders -- Case studies , Personality development -- Psychological aspects
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51032 , vital:43202
- Description: Jeffrey Lionel Dahmer is an infamous serial killer and cannibal. He was described as a normal, but shy little boy, yet developed into an adult who brutally murdered, engaged in necrophiliac acts, dismembered and ate parts of his victims. This study took the form of an intrinsic case study with the aim to explore and describe the personality development of Jeffrey Dahmer. This exploration examined Dahmer’s known childhood experiences through the theoretical perspective of Otto Kernberg’s (1974, 1975, 1976) Object Relations Theory, in order to understand how Dahmer’s personality was formed. Data was collected from multiple resources, including books, authoritative biographies, academic articles, and internet sources available in the public domain. It was analysed using Miles, Huberman, and Saldaña’s (2014) three-step process namely, data condensation, data display, and conclusion drawing and verification. This study’s findings confirmed the formation of pathological behavioural patterns supported by primitive defence mechanisms, associated with Kernberg’s lower level pathologies. It reflected Dahmer’s pathological formation of psychic structures seen in a diffuse identity and impaired formation of the superego, that supported these patterns. Additionally, the research was valuable in enhancing the researcher’s insight into personality development according to Kernberg’s Object Relations Theory. This study may also be beneficial to practising clinicians and professionals as an example of the early identification of personality pathology. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A comparative study of occupational hazards amongst public hospital healthcare workers in urban and rural areas of KwaZulu Natal, South Africa
- Authors: Ngobe, Sinoneliso Avuyisiwe
- Date: 2021-04
- Subjects: Community health services , Health risk assessment -- South Africa , Hazardous materials-- KwaZulu Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/56081 , vital:55291
- Description: The role of healthcare workers (HCWs) is to render services to the sick. While executing their duties, these HCWs can fall ill due to various occupational exposures. HCWs are exposed to a range of hazards including physical, biological, chemical and ergonomic hazards. These hazards can cause physical injuries, diseases, mental strain and other adverse health effects.: The aim of this study was to assess the prevalence of occupational hazards amongst HCWs in urban and rural areas of the KwaZulu-Natal province, South Africa: A descriptive cross-sectional research design was utilised on the estimated sample size of 270 respondents, from ten public hospitals. The sampling method used to identify participants was convenience sampling and data was collected through a self-administered, semi-structured questionnaire. The analysed data was presented in descriptive and inferential summary statistics. The data was analysed using graphical and numerical descriptive statistics as well as inferential statistical techniques. The statistical significance was set at P0.05. The results revealed that both urban and rural HCWs were exposed to physical, biological, chemical and ergonomic hazards. Overall, physical hazards were the most frequently reported form of hazard exposure at 98,6%, followed by biological hazards (96,7%), ergonomic hazards (94,4%) and chemical hazards (23,7%). The duration of exposure to hazards varied from 12 months to 5 years. In a period of 12 months, radiation, cold, heat, slips and trips were the most common sources of physical hazard exposure while direct contact with patient bodily fluids was the most common source of biological hazard exposure and mercury was the most common source of chemical hazard exposure. More than a quarter of the HCWs had experienced some form of assault by a patient in the preceding 12 months. Over a three-year period, both urban and rural area HCWs reported the use of post-exposure prophylaxis and experienced symptoms of chemical exposure at work. Less than 6% of the HCWs had developed an occupational disease in the previous five years. There were no statistically significant differences in total exposure to hazards between urban and rural area HCW. , Thesis (Mtech) --Faculty of Health Sciences, School of Behavioural Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Ngobe, Sinoneliso Avuyisiwe
- Date: 2021-04
- Subjects: Community health services , Health risk assessment -- South Africa , Hazardous materials-- KwaZulu Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/56081 , vital:55291
- Description: The role of healthcare workers (HCWs) is to render services to the sick. While executing their duties, these HCWs can fall ill due to various occupational exposures. HCWs are exposed to a range of hazards including physical, biological, chemical and ergonomic hazards. These hazards can cause physical injuries, diseases, mental strain and other adverse health effects.: The aim of this study was to assess the prevalence of occupational hazards amongst HCWs in urban and rural areas of the KwaZulu-Natal province, South Africa: A descriptive cross-sectional research design was utilised on the estimated sample size of 270 respondents, from ten public hospitals. The sampling method used to identify participants was convenience sampling and data was collected through a self-administered, semi-structured questionnaire. The analysed data was presented in descriptive and inferential summary statistics. The data was analysed using graphical and numerical descriptive statistics as well as inferential statistical techniques. The statistical significance was set at P0.05. The results revealed that both urban and rural HCWs were exposed to physical, biological, chemical and ergonomic hazards. Overall, physical hazards were the most frequently reported form of hazard exposure at 98,6%, followed by biological hazards (96,7%), ergonomic hazards (94,4%) and chemical hazards (23,7%). The duration of exposure to hazards varied from 12 months to 5 years. In a period of 12 months, radiation, cold, heat, slips and trips were the most common sources of physical hazard exposure while direct contact with patient bodily fluids was the most common source of biological hazard exposure and mercury was the most common source of chemical hazard exposure. More than a quarter of the HCWs had experienced some form of assault by a patient in the preceding 12 months. Over a three-year period, both urban and rural area HCWs reported the use of post-exposure prophylaxis and experienced symptoms of chemical exposure at work. Less than 6% of the HCWs had developed an occupational disease in the previous five years. There were no statistically significant differences in total exposure to hazards between urban and rural area HCW. , Thesis (Mtech) --Faculty of Health Sciences, School of Behavioural Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A narrative biography of sexual trauma and subsequent substance abuse
- Authors: Jansen, Tazminne
- Date: 2021-04
- Subjects: Sexual abuse victims -- South Africa -- Biography , Substance abuse -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51231 , vital:43234
- Description: In South Africa, substance abuse and sexual assault and/or abuse are major concerns. Society has become desensitised to these topics because of its high prevalence rate. Substance abuse is often greeted with stereotypes and prejudices that view individuals as a problem to society. The proposed research employed a qualitative, exploratory, and descriptive strategy of inquiry, guided by narrative biographical research design. Social constructionism was employed as a theoretical framework to explore how an individual had constructed her life story, with a specific focus on her experience of sexual trauma and subsequent substance abuse. A non-probability purposive sampling method was used to recruit a research participant who was in the public domain as a motivational speaker in an attempt to guard against retraumatisation. Two data collection methods were employed, namely one-on-one semi-structured interviews and an invitation to the participant to journal about her experience, guided by specific stimulus questions. Thematic narrative analysis was employed as a method of data analysis. The outcome of the investigation had provided a narrative account of the research question at hand with the following themes coming to the forefront:- Early childhood experiences ( pre-sexual abuse), sexual trauma, recovery and meaning making. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Jansen, Tazminne
- Date: 2021-04
- Subjects: Sexual abuse victims -- South Africa -- Biography , Substance abuse -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51231 , vital:43234
- Description: In South Africa, substance abuse and sexual assault and/or abuse are major concerns. Society has become desensitised to these topics because of its high prevalence rate. Substance abuse is often greeted with stereotypes and prejudices that view individuals as a problem to society. The proposed research employed a qualitative, exploratory, and descriptive strategy of inquiry, guided by narrative biographical research design. Social constructionism was employed as a theoretical framework to explore how an individual had constructed her life story, with a specific focus on her experience of sexual trauma and subsequent substance abuse. A non-probability purposive sampling method was used to recruit a research participant who was in the public domain as a motivational speaker in an attempt to guard against retraumatisation. Two data collection methods were employed, namely one-on-one semi-structured interviews and an invitation to the participant to journal about her experience, guided by specific stimulus questions. Thematic narrative analysis was employed as a method of data analysis. The outcome of the investigation had provided a narrative account of the research question at hand with the following themes coming to the forefront:- Early childhood experiences ( pre-sexual abuse), sexual trauma, recovery and meaning making. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A Psychobiographical Study of Charles Manson
- Authors: Flatela, Sambesiwe
- Date: 2021-04
- Subjects: Psychology -- Biographical methods , Personality development -- Psychological aspects , Criminals -- United States -- Biography
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51021 , vital:43201
- Description: Charles Manson was notorious for his antisocial behaviour and influence; through his charisma, he formed a group of followers known as the Manson family. Manson and his followers became involved in various criminal activities which culminated in the murder of 7 people. These murders were not committed by Manson per say, but he planned them, and incited his followers to commit them; this resulted in a trial and Manson going to prison, being given a life sentence. He continued to influence people while he served his sentence in prison. Manson died of natural causes in November 2017. The research study explores and describes the life of Manson in the form of a psychobiography. The aim of the study was to gain insight into the personality development of Charles Manson. This was achieved by applying Otto Kernberg’s Object Relations Theory to Manson’s known life experiences. Various data was collected and triangulated, using primary and secondary sources. Miles, Huberman, and Saldana’s (2013) three step procedure was used to analyse the data. The findings highlight the influence of genetics and rejection as pivotal to the unfolding of Manson’s personality, and provide insight into how his antisocial patterns unfolded. They highlight, in particular, his use of control, dominance and devaluation to protect his positive experience of self. , Thesis (MA) -- Faculty of Health Sciences, Department of Psychology, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Flatela, Sambesiwe
- Date: 2021-04
- Subjects: Psychology -- Biographical methods , Personality development -- Psychological aspects , Criminals -- United States -- Biography
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51021 , vital:43201
- Description: Charles Manson was notorious for his antisocial behaviour and influence; through his charisma, he formed a group of followers known as the Manson family. Manson and his followers became involved in various criminal activities which culminated in the murder of 7 people. These murders were not committed by Manson per say, but he planned them, and incited his followers to commit them; this resulted in a trial and Manson going to prison, being given a life sentence. He continued to influence people while he served his sentence in prison. Manson died of natural causes in November 2017. The research study explores and describes the life of Manson in the form of a psychobiography. The aim of the study was to gain insight into the personality development of Charles Manson. This was achieved by applying Otto Kernberg’s Object Relations Theory to Manson’s known life experiences. Various data was collected and triangulated, using primary and secondary sources. Miles, Huberman, and Saldana’s (2013) three step procedure was used to analyse the data. The findings highlight the influence of genetics and rejection as pivotal to the unfolding of Manson’s personality, and provide insight into how his antisocial patterns unfolded. They highlight, in particular, his use of control, dominance and devaluation to protect his positive experience of self. , Thesis (MA) -- Faculty of Health Sciences, Department of Psychology, 2021
- Full Text:
- Date Issued: 2021-04
A psychobiographical study of Gavin Maxwell: a Kernberg object relations approach
- Authors: Walters, Jacqueline
- Date: 2021-04
- Subjects: Personality development -- Psychological aspects , Psychology -- Biographical methods
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/52363 , vital:43619
- Description: Gavin Maxwell was an author and naturalist. He published a memoir called A Ring of Bright Water, which shaped the way millions of readers viewed nature. Maxwell wrote simple prose which paints an idyllic and moving picture of his time spent in his “lost paradise”, alongside his beloved animals, most notably his otters. However, in reality Maxwell was a man in conflict, seen in volatile relationships, financial recklessness, and the preference for the company of animals over people. The aim of this study was to explore Maxwell’s life to gain insight into his personality development. This was achieved by applying Otto Kernberg’s Object Relations Theory to his life experiences. In doing so the author hoped to gain an understanding of the personality dynamics that led to Maxwell’s relational difficulties and eccentricities. Data was collected by triangulating multiple sources of information on his life. Miles and Huberman’s (1994) three step approach was used to analyse data collected. These steps are: data reduction, data display, and conclusion drawing and verification. The research study found that Maxwell’s personality development was likely arrested at the third stage of Kernberg’s model. Maxwell relied primarily on immature defence mechanisms based in splitting and possessed a fragile ego structure which he protected through grandiosity. The findings indicated that Maxwell’s personality falls in the borderline level of functioning with a strong likelihood of pathological narcissism. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Walters, Jacqueline
- Date: 2021-04
- Subjects: Personality development -- Psychological aspects , Psychology -- Biographical methods
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/52363 , vital:43619
- Description: Gavin Maxwell was an author and naturalist. He published a memoir called A Ring of Bright Water, which shaped the way millions of readers viewed nature. Maxwell wrote simple prose which paints an idyllic and moving picture of his time spent in his “lost paradise”, alongside his beloved animals, most notably his otters. However, in reality Maxwell was a man in conflict, seen in volatile relationships, financial recklessness, and the preference for the company of animals over people. The aim of this study was to explore Maxwell’s life to gain insight into his personality development. This was achieved by applying Otto Kernberg’s Object Relations Theory to his life experiences. In doing so the author hoped to gain an understanding of the personality dynamics that led to Maxwell’s relational difficulties and eccentricities. Data was collected by triangulating multiple sources of information on his life. Miles and Huberman’s (1994) three step approach was used to analyse data collected. These steps are: data reduction, data display, and conclusion drawing and verification. The research study found that Maxwell’s personality development was likely arrested at the third stage of Kernberg’s model. Maxwell relied primarily on immature defence mechanisms based in splitting and possessed a fragile ego structure which he protected through grandiosity. The findings indicated that Maxwell’s personality falls in the borderline level of functioning with a strong likelihood of pathological narcissism. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A psychobiographical study of Harvey Milk
- Authors: Pretorius, Neil Zietsman
- Date: 2021-04
- Subjects: Gay rights , Psychology -- Biographical methods
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51600 , vital:43321
- Description: The aim of the study was to explore and describe Harvey Milk’s identity development and performance from the theoretical perspective of Narrative Therapy. Harvey (1930-1978), was an American Gay Rights activist who became one of the first openly gay political candidates to be elected to public office in the United States in 1977, before being assassinated in 1978. The study was conducted within a postmodern Social Constructionist epistemology which applied Michael White and David Epston’s (1990) Narrative Therapy as a particular theoretical lens to understand Harvey’s lived experiences. Harvey was chosen as the research subject based on his ability to construct his public identity as an openly gay politician and activist in defiance of the contemporarily dominant heteronormative discourse, despite the danger this posed to his personal safety. His selection was made through purposive sampling which facilitated a qualitative, single case psychobiographical study. Data on Harvey was obtained from both primary and secondary sources available in the public domain, and was analysed using Narrative Therapy concepts that describe individual identity. The study’s findings detail the narrative processes Harvey underwent and the discursive influences he experienced to move from being a closeted gay man, who hid his sexuality from public view, to an openly gay trailblazing Gay Rights activist, who fiercely challenged the norms and effects of heteronormativity on both his own life and that of his gay community. The study emphasises the value of psychobiography and Narrative Therapy to understand individual identity construction and performance. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Pretorius, Neil Zietsman
- Date: 2021-04
- Subjects: Gay rights , Psychology -- Biographical methods
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51600 , vital:43321
- Description: The aim of the study was to explore and describe Harvey Milk’s identity development and performance from the theoretical perspective of Narrative Therapy. Harvey (1930-1978), was an American Gay Rights activist who became one of the first openly gay political candidates to be elected to public office in the United States in 1977, before being assassinated in 1978. The study was conducted within a postmodern Social Constructionist epistemology which applied Michael White and David Epston’s (1990) Narrative Therapy as a particular theoretical lens to understand Harvey’s lived experiences. Harvey was chosen as the research subject based on his ability to construct his public identity as an openly gay politician and activist in defiance of the contemporarily dominant heteronormative discourse, despite the danger this posed to his personal safety. His selection was made through purposive sampling which facilitated a qualitative, single case psychobiographical study. Data on Harvey was obtained from both primary and secondary sources available in the public domain, and was analysed using Narrative Therapy concepts that describe individual identity. The study’s findings detail the narrative processes Harvey underwent and the discursive influences he experienced to move from being a closeted gay man, who hid his sexuality from public view, to an openly gay trailblazing Gay Rights activist, who fiercely challenged the norms and effects of heteronormativity on both his own life and that of his gay community. The study emphasises the value of psychobiography and Narrative Therapy to understand individual identity construction and performance. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04