An exploration of first-time mothers' experiences of exclusive breastfeeding and support in the Buffalo City Metropolitan, South Africa
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
- Full Text:
- Date Issued: 2018
- Authors: Dasheka, Zukiswa Theodorah
- Date: 2018
- Subjects: Breastfeeding--South Africa Breastfeeding
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/11096 , vital:37130
- Description: There are inadequate child feeding practices worldwide, and this varies amongst the regions. Suboptimal exclusive breastfeeding remains the key contributor to the leading causes of child mortalities, namely, diarrhoea and acute respiratory infections. An infant who is not exclusively breastfed for the first six months of life has fourteen times likelihood of dying of all causes, especially, diarrhoea and pneumonia compared to an exclusively breastfed infant. Worldwide, only 40 percent infants are exclusively breastfed for the first six months of their lives. South Africa, on the other hand, has an alarming figure of only 8 percent infants that are exclusively breastfed for six months. A qualitative approach, with an exploratory, descriptive and contextual research design was chosen to seek deeper understanding and meaning of first-time mothers’ experiences regarding exclusive breastfeeding practices and support’s influence on maintenance of exclusive breastfeeding within their natural environment. First-time mothers were the population for this study while the target population were first-time mothers who had given birth to a live, full term and healthy infant, regardless of the delivery mode in one of the Community Health Centres or hospitals within Buffalo City Metropolitan, South Africa. A non-probability, purposive sample of 10 participants was used. Ethical approval was granted by the University of Fort Hare Research Ethics Committee. The Eastern Cape Department of Health issued the clearance certificate. Informed consent was obtained from participants before data collection. Emotional risk protection was managed by the researcher through stopping of the interviews when the participant seemed emotional affected by the interviews. The relevant ethical considerations were accommodated. Trustworthiness was ensured through observing the principles of transferability, credibility, confirmability and dependability. Data were collected through individual face-to-face interviews using a semi-structured interview guide and conducted at the participant’s home or at the local clinic per participants’ choice. Two audio-recorders were used to capture the data. Data were then analysed according to Creswell’s steps and Tesch’s eight coding steps. Codes, categories, sub-categories and themes were formulated. Findings The key findings were challenges, empowerment, support and resilience during initiation of breastfeeding and diverse support and resilience during maintenance of exclusive breastfeeding. Conclusion All participants agreed on the benefits of breastfeeding, receiving information about exclusive breastfeeding during antenatal care and making a decision to exclusively breastfeed upon delivery. It is evident that the information received by first-time mothers is not congruent with the challenges they faced during initiation. There is a need, therefore, for nurses to find a way of sharing breastfeeding practice with the community members in order to avoid mixed messages which end up confusing to the first-time mother. Furthermore, the education given to the first-time mothers needs to be individualised to focus on individual needs of these mothers. Given the current staffing structure in the delivery centres, nurses are not always enough to give full focus and practical assistance to first-time mothers. It is therefore recommended that peer supporters be available to play this role, post-delivery, before the first-time mother is discharged. The formulation of compulsory supportive group among the first-time mothers was suggested.
- Full Text:
- Date Issued: 2018
Exploring experiences of student nurses regarding the implementation of community-based education at the nursing college in the Eastern Cape
- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
- Full Text:
- Date Issued: 2018
- Authors: Sefatsa, Thenjiwe
- Date: 2018
- Subjects: Community education -- South Africa -- Eastern Cape Nurses -- Education -- South Africa -- Eastern Cape Community development -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10657 , vital:35653
- Description: The aim of the study was to explore the experiences of student nurses regarding the implementation of CBE and allow them to tell their story of how CBE impacted to their academic experience. Purposive non-probability sampling was the method of choice. The following research question guided this study: What are the experiences of nursing students at the nursing college on the implementation of CBE as a teaching-learning strategy? The participants in this study were the fourth year students registered in the four year diploma and have been exposed to CBE, according to regulation 425 of the Nursing Act, 2005(Act No.33 of 2005). Fifty (50) students voluntarily participated in the focus groups discussions. Data analysis was done concurrently with data collection. Data was analysed manually as it was categorised into themes, categories, and subcatagories. For this study, a category system/ template was developed to code the data according to the categories, therefore related concepts were grouped together to facilitate the coding process. The final analysis led to the development of a report presenting the interpretation and presentation of results. RESULTS The study results revealed that students had benefited from CBE as a teaching learning strategy. Furthermore, participants reported that CBE had an impact in their training in terms of acquisition of skills, personal and professional growth and correlation of theory to practice. Discussions of findings, along with recommendations for practice conclude the study. Suggestions might be made to improve ways in the implementation of CBE in the nursing college
- Full Text:
- Date Issued: 2018
Screening for cardiometabolic risk factors among commercial drivers in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Adedokun, Aanuoluwa Odunayo
- Date: 2018
- Subjects: Diabetes -- South Africa -- Eastern Cape Obesity -- South Africa -- Eastern Cape Commercial vehicles
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10431 , vital:35463
- Description: Cardio-metabolic risk factors are the aggregates of conditions that increase the susceptibility of developing cardio-metabolic diseases such as cardiovascular diseases (CVD) and diabetes. This includes insulin resistance, obesity, hyperglyceamia, dyslipoproteinemia, hyperinsulinemia and hypertension. This condition are worsen by smoking and physical inactivity as they mostlyare not easily detected. This was a cross-sectional survey of 403 commercial taxi drivers at ten different taxi ranks in BCMM. The study utilized a convenient sampling technique for the participants of the study. The WHO STEPwise approach was used for data collection. The WHO STEPwise questionnaire was used for a face-to-face interview. Socio-demographic (sex, age, marital status, driving experience, income) and behavioural characteristics (smoking, alcohol consumption, consumption of sweet drinks, physical activity, and dietary intake) of participants were obtained. Also, objective reports concerning anthropometric measurements (weight, height, waist and hip circumference), blood pressure and biochemical measurement that is the blood glucose measurement. All anthropometric measurements were taken following a standard procedure using a Lufkin nonextensible flexible anthropometric tape (W606PM), Rosscraft, Canada and a SECA weighing scale and stadiometer (Hamburg, Germany). Blood pressure was checked also in accordance with standard protocols using a Medic+ Digital Blood Pressure Monitor Model 1219 (Hamburg, Germany). A validated ACCU-CHEK glucose monitoring apparatus (Mannheim, Germany) wasused for blood glucose measurement. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kg/m2 –29.9 kg/m2 and≥ 30 kg/m2, respectively. Pre-hypertension was defined according JNC-8 criteria a systolic blood pressure of 120- 139 mmHg and diastolic of BP 80-89 mmHg while hypertension was defined as an average of two systolic BP ≥140mmHg and/or diastolic BP of ≥90mmHg or a history of hypertension or anti hypertensive medication use. Diabetes status was determined using the fasting blood glucose (FBG) test and defined as a FBG ≥ 7.0mmol/L or self-reports of history or current diabetes medication use (treatment), while pre-diabetes was defined as a FBG of 5.6-6.9mmol/L. Awareness of diabetes was defined as self-reported history of diabetes among the people with diabetes. Metabolic syndrome status was determined according to the National agreement among makers of abdominal obesity. Statistical Package for Social Sciences (SPSS) was used for data analysis. The mean age of the participants was 43.3 (SD12.5) years. The prevalence of overweight and obesity was 34.0 percent and 38.0 percent, respectively. Age, marital status, period of driving, not-smoking, hypertension and diabetes were significantly associated with obesity. In logistic regression analysis, after adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were the independent and significant determinants of obesity. The prevalence rates of abdominal obesity by waist circumference (WC), waist-hip-ratio (WHR), waist-to-height ratio (WHtR) and neck circumference (NC) were 61.5 percent, 67.5 percent, 80.1 percent and 65.3 percent, respectively. A strong correlations exists between WHR and WC (>0.64); and WHtR and WC (>0.62). There exists a good agreement between WC and WHR. Also, a moderate agreement exists between WC and WHtR, WC and NC, WHR and WHtR, and WHtR and NC. The prevalence of above normal body composition for participants with hypertension was 71.0 percent, 65.9 percent, 63.2 percent and 66.5 percent by WC, WHR, WHtR and NC, respectively. For diabetes, the prevalence was 20.6 percent, 19.4 percent, 17.0 percent and 18.6 percent by WC, WHR, WHtR and NC, respectively. Waist circumference was a stronger predictor of hypertension and diabetics, with odds ratio of 3.7 (95 percent CI: 2.3-6.1 and 3.1 (95 percent CI: 1.6-6.0), compared to NC, with odds ratio of 1.7 (95 percent CI: 1.1-2.8). The prevalence of pre-hypertension was 33.7 percent and hypertension was 57.0 percent. Age, marital status, level of education, period of driving, obesity, alcohol, sweet drinks consumption and diabetes were significantly associated with hypertension. After adjusting for confounders, age >35 years (P=0.004), obesity and alcohol use (P<0.001), period of driving >5years (p=0.028) and diabetes (P=0.003) were significant predictors of hypertension. Prevalence of pre-diabetes and diabetes was 17 percent and 16 percent, respectively. Of those who were diabetic (n=63), the majority were aware of their diabetes status (n=43) and were on treatment (n=30). Age, marital status, level of education, period of driving, obesity, sweet drinks consumption, physical activities and hypertension were significantly associated with diabetes. Only age >35 (AOR= 3.6, CI 1.2-11.1), ever married (AOR= 3.3, CI 1.5-7.0) and hypertension (AOR= 3.4, CI 1.7-6.8) were the independent predictors of diabetes after adjusting for confounders. The prevalence of metabolic syndrome was 22 percent. Age, marital status, level of education, physical inactivity and period of driving were significantly associated with metabolic syndrome. After adjusting for confounders, only age above 35 years (Adjusted Odd Ratio [AOR] =3.8, CI=1.4- 9.5), ever married (AOR=3.0, CI=1.6-5.3) and period of driving above five years (AOR= 2.4, CI=1.2-4.7) were the significant and independent predictors of metabolic syndrome. About 30 percent of the participants were daily smokers, 37 percent consume alcohol regularly and only 18 percent were physically active, while 82 percent were physically inactive. In conclusion, there was a high prevalence of obesity, hypertension and diabetes among the commercial drivers in this setting, which is associated with unhealthy lifestyles (smoking, excessive alcohol consumption, physical inactivity). Interventions aimed at promoting cardiovascular health of commercial drivers such as health education and workplace screening, should prioritize weight reduction, healthy eating and physical activity in this population.
- Full Text:
- Date Issued: 2018
- Authors: Adedokun, Aanuoluwa Odunayo
- Date: 2018
- Subjects: Diabetes -- South Africa -- Eastern Cape Obesity -- South Africa -- Eastern Cape Commercial vehicles
- Language: English
- Type: Thesis , Masters , Nursing Science
- Identifier: http://hdl.handle.net/10353/10431 , vital:35463
- Description: Cardio-metabolic risk factors are the aggregates of conditions that increase the susceptibility of developing cardio-metabolic diseases such as cardiovascular diseases (CVD) and diabetes. This includes insulin resistance, obesity, hyperglyceamia, dyslipoproteinemia, hyperinsulinemia and hypertension. This condition are worsen by smoking and physical inactivity as they mostlyare not easily detected. This was a cross-sectional survey of 403 commercial taxi drivers at ten different taxi ranks in BCMM. The study utilized a convenient sampling technique for the participants of the study. The WHO STEPwise approach was used for data collection. The WHO STEPwise questionnaire was used for a face-to-face interview. Socio-demographic (sex, age, marital status, driving experience, income) and behavioural characteristics (smoking, alcohol consumption, consumption of sweet drinks, physical activity, and dietary intake) of participants were obtained. Also, objective reports concerning anthropometric measurements (weight, height, waist and hip circumference), blood pressure and biochemical measurement that is the blood glucose measurement. All anthropometric measurements were taken following a standard procedure using a Lufkin nonextensible flexible anthropometric tape (W606PM), Rosscraft, Canada and a SECA weighing scale and stadiometer (Hamburg, Germany). Blood pressure was checked also in accordance with standard protocols using a Medic+ Digital Blood Pressure Monitor Model 1219 (Hamburg, Germany). A validated ACCU-CHEK glucose monitoring apparatus (Mannheim, Germany) wasused for blood glucose measurement. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kg/m2 –29.9 kg/m2 and≥ 30 kg/m2, respectively. Pre-hypertension was defined according JNC-8 criteria a systolic blood pressure of 120- 139 mmHg and diastolic of BP 80-89 mmHg while hypertension was defined as an average of two systolic BP ≥140mmHg and/or diastolic BP of ≥90mmHg or a history of hypertension or anti hypertensive medication use. Diabetes status was determined using the fasting blood glucose (FBG) test and defined as a FBG ≥ 7.0mmol/L or self-reports of history or current diabetes medication use (treatment), while pre-diabetes was defined as a FBG of 5.6-6.9mmol/L. Awareness of diabetes was defined as self-reported history of diabetes among the people with diabetes. Metabolic syndrome status was determined according to the National agreement among makers of abdominal obesity. Statistical Package for Social Sciences (SPSS) was used for data analysis. The mean age of the participants was 43.3 (SD12.5) years. The prevalence of overweight and obesity was 34.0 percent and 38.0 percent, respectively. Age, marital status, period of driving, not-smoking, hypertension and diabetes were significantly associated with obesity. In logistic regression analysis, after adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were the independent and significant determinants of obesity. The prevalence rates of abdominal obesity by waist circumference (WC), waist-hip-ratio (WHR), waist-to-height ratio (WHtR) and neck circumference (NC) were 61.5 percent, 67.5 percent, 80.1 percent and 65.3 percent, respectively. A strong correlations exists between WHR and WC (>0.64); and WHtR and WC (>0.62). There exists a good agreement between WC and WHR. Also, a moderate agreement exists between WC and WHtR, WC and NC, WHR and WHtR, and WHtR and NC. The prevalence of above normal body composition for participants with hypertension was 71.0 percent, 65.9 percent, 63.2 percent and 66.5 percent by WC, WHR, WHtR and NC, respectively. For diabetes, the prevalence was 20.6 percent, 19.4 percent, 17.0 percent and 18.6 percent by WC, WHR, WHtR and NC, respectively. Waist circumference was a stronger predictor of hypertension and diabetics, with odds ratio of 3.7 (95 percent CI: 2.3-6.1 and 3.1 (95 percent CI: 1.6-6.0), compared to NC, with odds ratio of 1.7 (95 percent CI: 1.1-2.8). The prevalence of pre-hypertension was 33.7 percent and hypertension was 57.0 percent. Age, marital status, level of education, period of driving, obesity, alcohol, sweet drinks consumption and diabetes were significantly associated with hypertension. After adjusting for confounders, age >35 years (P=0.004), obesity and alcohol use (P<0.001), period of driving >5years (p=0.028) and diabetes (P=0.003) were significant predictors of hypertension. Prevalence of pre-diabetes and diabetes was 17 percent and 16 percent, respectively. Of those who were diabetic (n=63), the majority were aware of their diabetes status (n=43) and were on treatment (n=30). Age, marital status, level of education, period of driving, obesity, sweet drinks consumption, physical activities and hypertension were significantly associated with diabetes. Only age >35 (AOR= 3.6, CI 1.2-11.1), ever married (AOR= 3.3, CI 1.5-7.0) and hypertension (AOR= 3.4, CI 1.7-6.8) were the independent predictors of diabetes after adjusting for confounders. The prevalence of metabolic syndrome was 22 percent. Age, marital status, level of education, physical inactivity and period of driving were significantly associated with metabolic syndrome. After adjusting for confounders, only age above 35 years (Adjusted Odd Ratio [AOR] =3.8, CI=1.4- 9.5), ever married (AOR=3.0, CI=1.6-5.3) and period of driving above five years (AOR= 2.4, CI=1.2-4.7) were the significant and independent predictors of metabolic syndrome. About 30 percent of the participants were daily smokers, 37 percent consume alcohol regularly and only 18 percent were physically active, while 82 percent were physically inactive. In conclusion, there was a high prevalence of obesity, hypertension and diabetes among the commercial drivers in this setting, which is associated with unhealthy lifestyles (smoking, excessive alcohol consumption, physical inactivity). Interventions aimed at promoting cardiovascular health of commercial drivers such as health education and workplace screening, should prioritize weight reduction, healthy eating and physical activity in this population.
- Full Text:
- Date Issued: 2018
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