A systematic review of mental health care access in disadvantaged communities in South Africa
- Authors: Dube, Nkosingiphile Zama
- Date: 2025-04-25
- Subjects: Mental health services South Africa , Rural mental health services South Africa , Social psychiatry South Africa , Healers South Africa , Help-seeking , Systematic reviews (Medical research)
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478295 , vital:78174
- Description: Background: Access to mental healthcare in disadvantaged rural communities in South Africa faces numerous challenges, particularly due to cultural beliefs that impact help-seeking behaviours. Systematic reviews provide critical insights into the barriers and facilitators of healthcare access in such contexts. This review aims to evaluate the available literature on mental healthcare access in rural South African communities, with a specific focus on the influence of cultural beliefs on help-seeking behaviours. Methods: A systematic search was conducted across databases, including PubMed, Scopus, and Web of Science, to identify studies published between 2010 and 2023. Studies were included if they examined barriers to mental healthcare access in rural South African settings and involved culturally relevant factors. Screening, selection, and appraisal of studies were carried out using PRISMA guidelines, with data extracted and synthesized through qualitative thematic analysis. Results: A total of 24 studies met the inclusion criteria. Key findings identified barriers such as financial constraints, scarcity of mental health facilities, stigma, long distances to services, language barriers, and cultural beliefs. Cultural practices, such as attributing mental distress to witchcraft or ancestral displeasure, were found to influence perceptions of mental health and discourage professional intervention, with traditional healers and community elders frequently being the preferred resource. Some community members, despite limited knowledge, utilized smartphones for mental health applications, while others relied on traditional practices and community support networks. Conclusion: This review underscores the need for a culturally sensitive, integrated approach to mental healthcare in rural South Africa, blending traditional and modern practices. Recommendations include conducting rural needs assessments, fostering collaboration between mental health practitioners and traditional healers, and enhancing teacher training. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
- Authors: Dube, Nkosingiphile Zama
- Date: 2025-04-25
- Subjects: Mental health services South Africa , Rural mental health services South Africa , Social psychiatry South Africa , Healers South Africa , Help-seeking , Systematic reviews (Medical research)
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478295 , vital:78174
- Description: Background: Access to mental healthcare in disadvantaged rural communities in South Africa faces numerous challenges, particularly due to cultural beliefs that impact help-seeking behaviours. Systematic reviews provide critical insights into the barriers and facilitators of healthcare access in such contexts. This review aims to evaluate the available literature on mental healthcare access in rural South African communities, with a specific focus on the influence of cultural beliefs on help-seeking behaviours. Methods: A systematic search was conducted across databases, including PubMed, Scopus, and Web of Science, to identify studies published between 2010 and 2023. Studies were included if they examined barriers to mental healthcare access in rural South African settings and involved culturally relevant factors. Screening, selection, and appraisal of studies were carried out using PRISMA guidelines, with data extracted and synthesized through qualitative thematic analysis. Results: A total of 24 studies met the inclusion criteria. Key findings identified barriers such as financial constraints, scarcity of mental health facilities, stigma, long distances to services, language barriers, and cultural beliefs. Cultural practices, such as attributing mental distress to witchcraft or ancestral displeasure, were found to influence perceptions of mental health and discourage professional intervention, with traditional healers and community elders frequently being the preferred resource. Some community members, despite limited knowledge, utilized smartphones for mental health applications, while others relied on traditional practices and community support networks. Conclusion: This review underscores the need for a culturally sensitive, integrated approach to mental healthcare in rural South Africa, blending traditional and modern practices. Recommendations include conducting rural needs assessments, fostering collaboration between mental health practitioners and traditional healers, and enhancing teacher training. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
Strategies for the implementation of clinical practice guidelines in the intensive care : a systematic review
- Authors: Mpasa, Ferestas
- Date: 2014
- Subjects: Systematic reviews (Medical research) , Physician practice patterns , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10059 , http://hdl.handle.net/10948/d1020046
- Description: Implementation strategies for the use of clinical practice guidelines are an integral component in bridging the gap between the best research evidence and clinical practice. However, despite some remarkable investments in health research regarding clinical practice guidelines implementation strategies, it is not yet known which of these are the most effective for intensive care units. The purpose of this research study was to systematically identify and /or search, appraise, extract and synthesize the best available evidence for clinical practice guidelines implementation strategies in intensive care units, in order to develop a draft guideline for clinical practice guidelines implementation strategies in the intensive care units. A systematic review design was used to systematically identify and /or search, appraise, extract and synthesize the best available evidence from the eligible included Level 2 studies (randomized controlled trials and quasi-experimental studies). Level 2 studies were applicable because they present robust evidence in the research results regarding effectiveness of clinical practice guideline implementation strategies. Furthermore, although other systematic reviews conducted in this area before, they included studies of In addition, no systematic review was identified that reviewed Level 2 studies and developed a guideline for clinical practice guideline implementation strategies in the intensive care units. Hence, including only Level 2 studies was distinctive to this research study. Databases searched included: CINAHL with full text, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials Issue 8 of 12, August 2013, and MEDLINE via PUBMED. Hand search in bound journals was also done. The search strategy identified 315 potentially relevant studies. After the process of critical appraisal, thirteen Level 2 studies were identified as relevant for the review. Of the 13 relevant studies, 10 were randomized controlled trials and three were quasi experimental studies. After the critical appraisal ten RCTs were included in the systematic review. Three studies (quasi-experimental) were excluded on the basis of methodological quality after the critical appraisal and agreement by the two independent reviewers. The Joanna Briggs Institute Critical Appraisal MASTARI Instrument for Randomized Controlled trials/ Experimental studies, and The Joanna Briggs Institute data extraction tools were used to critically appraise, and extract data from the ten included randomized controlled trials. The two reviewers who performed the critical appraisal were qualified critical care professional nurses and experts in research methodology. These reviewers conducted the critical appraisal independently to ensure the objectivity of the process. Appropriate ethical considerations were maintained throughout the process of the research study. The results indicated that 80 percent of the included studies were conducted in adult intensive care units while 20 percent were conducted in the neonatal intensive care units. Furthermore, 60 percent of the studies were conducted in the United States of America, 10 percent in France, a further 10 percent in Taiwan, another 10 percent in England and yet another 10 percfent was conducted in Australia and Newzealand. The included studies utilized more than one (multifaceted) implementation strategies to implement clinical practice guidelines in the intensive care units. The first most utilized were: printed educational materials; Information/ educational sessions/meetings; audit and feedback and champion/local opinion leaders; seconded by educational outreach visits; and computer or internet usage. Third most used were active/passive reminders; systems support; academic detailing/ one-on-one sessions teleconferences/videoconferences and workshops/in services. Fourth most used were ollaboration/interdisciplinary teams; slide shows, teleconferences/videoconferences and discussions. Fifth most used were practical training; monitoring visits and grand rounds. However all the strategies were of equal importance. Conclusively, the included studies utilized multifaceted implementation strategies. However, no study indicated the use of a guideline for the implementation strategies in the process of clinical practice guidelines implementation. The systematic review developed a draft guideline for clinical practice guideline implementation strategies in the intensive care units. The guideline will enhance effective implementation of clinical practice guidelines in such a complex environment.
- Full Text:
- Date Issued: 2014
- Authors: Mpasa, Ferestas
- Date: 2014
- Subjects: Systematic reviews (Medical research) , Physician practice patterns , Intensive care units
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10059 , http://hdl.handle.net/10948/d1020046
- Description: Implementation strategies for the use of clinical practice guidelines are an integral component in bridging the gap between the best research evidence and clinical practice. However, despite some remarkable investments in health research regarding clinical practice guidelines implementation strategies, it is not yet known which of these are the most effective for intensive care units. The purpose of this research study was to systematically identify and /or search, appraise, extract and synthesize the best available evidence for clinical practice guidelines implementation strategies in intensive care units, in order to develop a draft guideline for clinical practice guidelines implementation strategies in the intensive care units. A systematic review design was used to systematically identify and /or search, appraise, extract and synthesize the best available evidence from the eligible included Level 2 studies (randomized controlled trials and quasi-experimental studies). Level 2 studies were applicable because they present robust evidence in the research results regarding effectiveness of clinical practice guideline implementation strategies. Furthermore, although other systematic reviews conducted in this area before, they included studies of In addition, no systematic review was identified that reviewed Level 2 studies and developed a guideline for clinical practice guideline implementation strategies in the intensive care units. Hence, including only Level 2 studies was distinctive to this research study. Databases searched included: CINAHL with full text, Google Scholar, Academic search complete, Cochrane Register for Randomized Controlled Trials Issue 8 of 12, August 2013, and MEDLINE via PUBMED. Hand search in bound journals was also done. The search strategy identified 315 potentially relevant studies. After the process of critical appraisal, thirteen Level 2 studies were identified as relevant for the review. Of the 13 relevant studies, 10 were randomized controlled trials and three were quasi experimental studies. After the critical appraisal ten RCTs were included in the systematic review. Three studies (quasi-experimental) were excluded on the basis of methodological quality after the critical appraisal and agreement by the two independent reviewers. The Joanna Briggs Institute Critical Appraisal MASTARI Instrument for Randomized Controlled trials/ Experimental studies, and The Joanna Briggs Institute data extraction tools were used to critically appraise, and extract data from the ten included randomized controlled trials. The two reviewers who performed the critical appraisal were qualified critical care professional nurses and experts in research methodology. These reviewers conducted the critical appraisal independently to ensure the objectivity of the process. Appropriate ethical considerations were maintained throughout the process of the research study. The results indicated that 80 percent of the included studies were conducted in adult intensive care units while 20 percent were conducted in the neonatal intensive care units. Furthermore, 60 percent of the studies were conducted in the United States of America, 10 percent in France, a further 10 percent in Taiwan, another 10 percent in England and yet another 10 percfent was conducted in Australia and Newzealand. The included studies utilized more than one (multifaceted) implementation strategies to implement clinical practice guidelines in the intensive care units. The first most utilized were: printed educational materials; Information/ educational sessions/meetings; audit and feedback and champion/local opinion leaders; seconded by educational outreach visits; and computer or internet usage. Third most used were active/passive reminders; systems support; academic detailing/ one-on-one sessions teleconferences/videoconferences and workshops/in services. Fourth most used were ollaboration/interdisciplinary teams; slide shows, teleconferences/videoconferences and discussions. Fifth most used were practical training; monitoring visits and grand rounds. However all the strategies were of equal importance. Conclusively, the included studies utilized multifaceted implementation strategies. However, no study indicated the use of a guideline for the implementation strategies in the process of clinical practice guidelines implementation. The systematic review developed a draft guideline for clinical practice guideline implementation strategies in the intensive care units. The guideline will enhance effective implementation of clinical practice guidelines in such a complex environment.
- Full Text:
- Date Issued: 2014
- «
- ‹
- 1
- ›
- »