A discourse analysis study of traditional health practitioners’ role in the treatment of female sexual violence and its mental health sequelae in KwaZulu-Natal
- Authors: Muthwa, Nqobile
- Date: 2024-04
- Subjects: Women -- Violence against -- South Africa , Sex discrimination against women -- South Africa , Physicians -- South Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63904 , vital:73625
- Description: South Africa is considered the epicentre of rape, leading to its reputation as the ‘rape capital of the world’. As a way of mitigating the risk of re-victimisation to individuals who have experienced rape, hospital-based post-rape centres were developed to offer services and support to rape victims. The uptake of these services remains scant as issues such as rape stigma, limited knowledge on their availability and alternative health systems limits their usage. In South Africa, there exists medical pluralism, which refers to multiple ways of making sense of illness and treatment seeking methods. It is estimated that around 80% of South Africans utilise the services of traditional health practitioners in conjunction with biomedical health practices or as a standalone service to get alternative solutions for their health needs. Victims of rape need to access a wide range of services such as post-exposure prophylaxis (PEP), medical examinations, and emergency contraception. There has been a paucity in research looking into the alternative treatments accessed by rape victims who do not access services in the formal healthcare system. It is against this backdrop that this study explored the construction and treatment formulation of rape by traditional health practitioners. The study focused on the use of language and how it becomes action that influences the services rendered to rape victims. Thematic analysis, discourse and conversational analytical approaches were used to analyse data that emerges from the one-on-one interviews. 15 traditional healers who identified as abathandazi, Izangoma and izinyanga were selected to participate in the present study. The healthworlds framework and social constructionism were used to make sense of how traditional health practitioners construct rape and how the dominant discourses surrounding rape influence how they understand their position as healthcare providers. The main findings of the study illustrated that in the healthworld of traditional healers’ understanding of rape was constructed as ukungcola nobumnyama / impurity and darkness. These discourses spoke to the perception of rape as an aberration as one’s ancestors should prevent traumas and catastrophes from befalling on the individual. When rape occurs, it signalled spiritual problems resulting into a phenomenon where ancestors cannot safeguard the living. Under these discourse rape was also constructed as something that taints, impurifies and contaminates not just the raped individual but their entire bloodline and ancestors. As a result of the discourse surrounding rape, cleansing and purification rituals played a huge role in post-rape care. In addition, traditional health practitioners viewed their role as facilitators in reestablishing the relationship between the raped individual and their ancestors. The study observed that rape victims who share the same healthworld are likely to experience spiritual transgressions following rape which will have long-lasting effects on the psychological health outcomes of victims. The present study recommends a post-rape care model that advocates for collaborative opportunities between biomedical and traditional healthcare practitioners. This model can be integrated into existing post-rape care systems to provide holistic and comprehensive healthcare that addresses biopsychosocial as well as the spiritual and cultural influences of rape. , Thesis (DPhil) -- Faculty of Health Science, School of Behavioural & Lifestyle Sciences, 2024
- Full Text:
- Date Issued: 2024-04
- Authors: Muthwa, Nqobile
- Date: 2024-04
- Subjects: Women -- Violence against -- South Africa , Sex discrimination against women -- South Africa , Physicians -- South Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63904 , vital:73625
- Description: South Africa is considered the epicentre of rape, leading to its reputation as the ‘rape capital of the world’. As a way of mitigating the risk of re-victimisation to individuals who have experienced rape, hospital-based post-rape centres were developed to offer services and support to rape victims. The uptake of these services remains scant as issues such as rape stigma, limited knowledge on their availability and alternative health systems limits their usage. In South Africa, there exists medical pluralism, which refers to multiple ways of making sense of illness and treatment seeking methods. It is estimated that around 80% of South Africans utilise the services of traditional health practitioners in conjunction with biomedical health practices or as a standalone service to get alternative solutions for their health needs. Victims of rape need to access a wide range of services such as post-exposure prophylaxis (PEP), medical examinations, and emergency contraception. There has been a paucity in research looking into the alternative treatments accessed by rape victims who do not access services in the formal healthcare system. It is against this backdrop that this study explored the construction and treatment formulation of rape by traditional health practitioners. The study focused on the use of language and how it becomes action that influences the services rendered to rape victims. Thematic analysis, discourse and conversational analytical approaches were used to analyse data that emerges from the one-on-one interviews. 15 traditional healers who identified as abathandazi, Izangoma and izinyanga were selected to participate in the present study. The healthworlds framework and social constructionism were used to make sense of how traditional health practitioners construct rape and how the dominant discourses surrounding rape influence how they understand their position as healthcare providers. The main findings of the study illustrated that in the healthworld of traditional healers’ understanding of rape was constructed as ukungcola nobumnyama / impurity and darkness. These discourses spoke to the perception of rape as an aberration as one’s ancestors should prevent traumas and catastrophes from befalling on the individual. When rape occurs, it signalled spiritual problems resulting into a phenomenon where ancestors cannot safeguard the living. Under these discourse rape was also constructed as something that taints, impurifies and contaminates not just the raped individual but their entire bloodline and ancestors. As a result of the discourse surrounding rape, cleansing and purification rituals played a huge role in post-rape care. In addition, traditional health practitioners viewed their role as facilitators in reestablishing the relationship between the raped individual and their ancestors. The study observed that rape victims who share the same healthworld are likely to experience spiritual transgressions following rape which will have long-lasting effects on the psychological health outcomes of victims. The present study recommends a post-rape care model that advocates for collaborative opportunities between biomedical and traditional healthcare practitioners. This model can be integrated into existing post-rape care systems to provide holistic and comprehensive healthcare that addresses biopsychosocial as well as the spiritual and cultural influences of rape. , Thesis (DPhil) -- Faculty of Health Science, School of Behavioural & Lifestyle Sciences, 2024
- Full Text:
- Date Issued: 2024-04
Exploring the views of selected, unafflicted women from Walvis bay and Windhoek, Namibia, regarding intimate partner killing and its effect on their well-being.
- Authors: Amadhila,Luise Utuhole
- Date: 2024-04
- Subjects: Intimate partner violence , Gender-based violence , Post-traumatic stress disorder in women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63653 , vital:73575
- Description: Intimate Partner Killing (IPK), popularly known as passion killing in certain regions, such as in southern parts of Africa, Europe, and America, and also referred to as intimate partner homicide, is a global concern. In Namibia, the rate at which men take the lives of their intimate partners due to failed romantic relationships has sparked apprehension within the communities. This study delves into the perspectives of unafflicted women in Namibia, shedding light on the broader impact of intimate partner killing on female well-being. Using a qualitative approach, the study conducted face-to-face, semi-structured interviews with 14 participants. Grounded theory was applied to analyse the collected data and form categories from it. The data were transcribed and analysed using codes, thematic analysis, and interpretation. The theoretical frameworks intersectionality theory, social feminist theory, structuralist theory and systems theory underpin this study. The findings reveal that intimate partner killing severely affects women’s mental health, leading to vicarious trauma characterised by fear and anxiety. Participants reported difficulty experiencing positive emotions in their romantic relationships due to the pervasive uncertainty of this growing issue. Intimate partner killing leaves women feeling scared, unsafe, and traumatised, often prompting them to exercise extreme caution in their relationships to avoid becoming victims themselves. Symptoms such as feeling unsafe, scared, and traumatised align with post-traumatic stress and generalised anxiety. The study recommends implementing policy interventions and stringent laws in Namibia to prevent or discourage men from resorting to violence against their loved ones. Moreover, establishing assistance centres staffed with social work and mental health professionals is crucial to counselling and supporting women experiencing post-traumatic stress and anxiety resulting from intimate partner violence. , Thesis (PhD) -- Faculty of Health Sciences, School of behavioural Sciences, 2024
- Full Text:
- Date Issued: 2024-04
- Authors: Amadhila,Luise Utuhole
- Date: 2024-04
- Subjects: Intimate partner violence , Gender-based violence , Post-traumatic stress disorder in women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63653 , vital:73575
- Description: Intimate Partner Killing (IPK), popularly known as passion killing in certain regions, such as in southern parts of Africa, Europe, and America, and also referred to as intimate partner homicide, is a global concern. In Namibia, the rate at which men take the lives of their intimate partners due to failed romantic relationships has sparked apprehension within the communities. This study delves into the perspectives of unafflicted women in Namibia, shedding light on the broader impact of intimate partner killing on female well-being. Using a qualitative approach, the study conducted face-to-face, semi-structured interviews with 14 participants. Grounded theory was applied to analyse the collected data and form categories from it. The data were transcribed and analysed using codes, thematic analysis, and interpretation. The theoretical frameworks intersectionality theory, social feminist theory, structuralist theory and systems theory underpin this study. The findings reveal that intimate partner killing severely affects women’s mental health, leading to vicarious trauma characterised by fear and anxiety. Participants reported difficulty experiencing positive emotions in their romantic relationships due to the pervasive uncertainty of this growing issue. Intimate partner killing leaves women feeling scared, unsafe, and traumatised, often prompting them to exercise extreme caution in their relationships to avoid becoming victims themselves. Symptoms such as feeling unsafe, scared, and traumatised align with post-traumatic stress and generalised anxiety. The study recommends implementing policy interventions and stringent laws in Namibia to prevent or discourage men from resorting to violence against their loved ones. Moreover, establishing assistance centres staffed with social work and mental health professionals is crucial to counselling and supporting women experiencing post-traumatic stress and anxiety resulting from intimate partner violence. , Thesis (PhD) -- Faculty of Health Sciences, School of behavioural Sciences, 2024
- Full Text:
- Date Issued: 2024-04
The curious case of Albert Ellis: a psychobiographical case study
- Authors: van Rensburg, Philip
- Date: 2024-04
- Subjects: Psychotherapy , Ellis, Albert -- Interviews , Rational emotive behavior therapy
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63928 , vital:73627
- Description: Although much has been written on the life and work of American psychologist Albert Ellis, none of the literature adopts a specific psychobiographical framework and no instrumental case studies on the life of Ellis exist. The primary aim of this psychobiographical case study is to provide a psychobiographical exploration and description of aspects of Albert Ellis’ life within his sociohistorical context. More specifically, Ellis’ upbringing with an immigrant past and the role this has played relating to Ellis’ curiosity towards issues of sex and women. The findings of this psychobiographical case study will also be conveyed to inform on the role that culture and cultural diversity has on how an individual experiences and deals with conflict in their life. A specific area of interest in this study is the culture of the twentieth century, with a special focus on the relationship individuals had with sex, as well as examining the lived experience of immigrants during this time. Aspects of Albert Ellis' life within the sociohistorical context of the twentieth century is illustrated by using certain psychological techniques to the available biographical data. This is accomplished by looking at Ellis' experiences and how they influenced the creation of his own paradigm of rational emotive behaviour therapy. Furthermore, Ellis is conceptualised using Karen Horney’s theory of the dynamic relationship, which exists between cultural processes and conflicting human character traits and their impact on behavioural motivation. This study adopts an inductive research approach. Therefore, it implements an instrumental, single-case research design and is exploratory-descriptive in nature. The subject was chosen through purposive sampling and data will be analysed utilising three linked subprocesses theorised by Miles and Huberman. , Thesis (DPhil) -- Faculty of Health Science, School of Behavioural & Lifestyle Sciences, 2024
- Full Text:
- Date Issued: 2024-04
- Authors: van Rensburg, Philip
- Date: 2024-04
- Subjects: Psychotherapy , Ellis, Albert -- Interviews , Rational emotive behavior therapy
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/63928 , vital:73627
- Description: Although much has been written on the life and work of American psychologist Albert Ellis, none of the literature adopts a specific psychobiographical framework and no instrumental case studies on the life of Ellis exist. The primary aim of this psychobiographical case study is to provide a psychobiographical exploration and description of aspects of Albert Ellis’ life within his sociohistorical context. More specifically, Ellis’ upbringing with an immigrant past and the role this has played relating to Ellis’ curiosity towards issues of sex and women. The findings of this psychobiographical case study will also be conveyed to inform on the role that culture and cultural diversity has on how an individual experiences and deals with conflict in their life. A specific area of interest in this study is the culture of the twentieth century, with a special focus on the relationship individuals had with sex, as well as examining the lived experience of immigrants during this time. Aspects of Albert Ellis' life within the sociohistorical context of the twentieth century is illustrated by using certain psychological techniques to the available biographical data. This is accomplished by looking at Ellis' experiences and how they influenced the creation of his own paradigm of rational emotive behaviour therapy. Furthermore, Ellis is conceptualised using Karen Horney’s theory of the dynamic relationship, which exists between cultural processes and conflicting human character traits and their impact on behavioural motivation. This study adopts an inductive research approach. Therefore, it implements an instrumental, single-case research design and is exploratory-descriptive in nature. The subject was chosen through purposive sampling and data will be analysed utilising three linked subprocesses theorised by Miles and Huberman. , Thesis (DPhil) -- Faculty of Health Science, School of Behavioural & Lifestyle Sciences, 2024
- Full Text:
- Date Issued: 2024-04
Effect of a school-based health intervention on the non-communicable disease risk status of schoolchildren from disadvantaged communities
- Authors: Dolley, Danielle
- Date: 2023-04
- Subjects: school-based health intervention , Non-communicable diseases , Cardiovascular diseases
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/66388 , vital:75063
- Description: Background: Non-communicable diseases (NCDs) such as cardiovascular diseases (CVDs) and dyslipidaemia are a global public health concern, but more so in low- income countries where the underprivileged are exposed to unhealthy lifestyle practices with limited access to primary health care. Poor dietary habits and physical inactivity have also led to the unprecedented rise of NCD risk factors among school- aged children, which places them at greater risk of disease later in life. These NCDs are largely driven by obesity which has continued to rise in sub-Saharan Africa. However, high levels of undernutrition (such as stunting, underweight and wasting) among children are also present, thereby translating to a dual burden of malnutrition. Promoting regular physical activity (PA) among children is crucial for the health of future generations as it assists in weight reduction, improves insulin sensitivity, reduces blood pressure and is associated with good health and wellbeing. However, physical education (PE), the most obvious vehicle to develop the motor abilities of children, creating opportunities for their sports skills development and educating learners about the importance of PA as a lifestyle, has long been overlooked since the transformation of the South African school curriculum. Furthermore, many in-service PE teachers were not trained to teach the new multi-disciplinary Life Skills and Life Orientation subjects, of which PE forms a small part. Evidence shows that many PE teachers lack the content knowledge and practical skills to implement the subject, which raises the question of how many children, especially those in low-income communities, are participating in quality PE needed to foster healthy lifestyles and prevent the risk of NCDs. Therefore, this study aimed to investigate the effect of a 20- week school-based health intervention on NCD risk factors of primary schoolchildren from low-income schools in Gqeberha, South Africa. Methods: A cluster randomised control trial was used to test a 20-week intervention, which included three components, namely [1] the KaziKidz toolkit (comprised of pre- prepared PE, health, hygiene and nutrition lessons, equipment for PE, and painted games) [2] a PE coach (human movement science graduate to assist teachers) and [3]two 90-min training workshops. Eight schools were randomly selected to participatein the study: four intervention schools received the KaziKidz toolkit, while the externalsupport components were staggered across three intervention schools, and the Chapter 1: Introduction 2 remaining four schools served as the control group. Altogether 961 children (491 boys and 511 girls) from grades 4 to 6 (8 - 13 years old, M=10.88±1.19 yrs) participated In the study. Demographic information and socio-economic status were captured with a questionnaire. Further measures included height, weight, waist circumference, blood pressure, glycated haemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, accelerometer-based PA and cardiorespiratory fitness (CRF). Results: Cross-sectional baseline data showed that 43.1% of the sample presented with at least one NCD risk factor, and 17% presented with an elevated clustered risk score (CRS). In addition, higher CRF and moderate to vigorous PA (MVPA) were associated with a lowered CRS whereby an elevated CRS was halved for every 49 min increase in MVPA (95% CI 27 - 224) or every 2.17 ml/kg/min increase in CRF, as determined via estimated VO2max (95% CI 1.66 - 3.12). Overall, 13% of the cohort were underweight, 12% overweight, 7% obese, and 64% engaged in an average of 60 min MVPA per day. The results also identified an inverse association between body mass index categories and the total duration of MVPA achieved per day as children categorised as underweight to normal‐weight (boys: OR = 3.89, 95% CI: 2.18 - 6.93; girls: OR =1.78, 95% CI: 1.13 - 2.80) were more likely to engage in 60 min per day of MVPA than overweight to obese children. Finally, the school-based health intervention results revealed improvements in children's NCD risk factors and increased MVPA levels when the intervention conditions included the workshops and, in some cases, the PE coach. The KaziKidz toolkit (on its own) showed little to no improvements in NCD risk factors and MVPA levels. Conclusion: School-based health interventions have the potential to improve the NCD risk factors of children attending low-income schools in South Africa. These findings also add to our understanding of implementing interventions in settings where teachers are not sufficiently trained to teach PE. Therefore, school-based health interventions, including a toolkit, should be accompanied by workshops to equip educators with the necessary tools to confidently facilitate PE lessons and integrate a range of PE activities into their classrooms. Future research is recommended to determine the long-term sustainability of school-based health interventions and the long-term post-intervention impact on NCD risk factors. , Thesis (PhD) -- Faculty of Health Science, Department of Human Movement Science, 2023
- Full Text:
- Date Issued: 2023-04
- Authors: Dolley, Danielle
- Date: 2023-04
- Subjects: school-based health intervention , Non-communicable diseases , Cardiovascular diseases
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/66388 , vital:75063
- Description: Background: Non-communicable diseases (NCDs) such as cardiovascular diseases (CVDs) and dyslipidaemia are a global public health concern, but more so in low- income countries where the underprivileged are exposed to unhealthy lifestyle practices with limited access to primary health care. Poor dietary habits and physical inactivity have also led to the unprecedented rise of NCD risk factors among school- aged children, which places them at greater risk of disease later in life. These NCDs are largely driven by obesity which has continued to rise in sub-Saharan Africa. However, high levels of undernutrition (such as stunting, underweight and wasting) among children are also present, thereby translating to a dual burden of malnutrition. Promoting regular physical activity (PA) among children is crucial for the health of future generations as it assists in weight reduction, improves insulin sensitivity, reduces blood pressure and is associated with good health and wellbeing. However, physical education (PE), the most obvious vehicle to develop the motor abilities of children, creating opportunities for their sports skills development and educating learners about the importance of PA as a lifestyle, has long been overlooked since the transformation of the South African school curriculum. Furthermore, many in-service PE teachers were not trained to teach the new multi-disciplinary Life Skills and Life Orientation subjects, of which PE forms a small part. Evidence shows that many PE teachers lack the content knowledge and practical skills to implement the subject, which raises the question of how many children, especially those in low-income communities, are participating in quality PE needed to foster healthy lifestyles and prevent the risk of NCDs. Therefore, this study aimed to investigate the effect of a 20- week school-based health intervention on NCD risk factors of primary schoolchildren from low-income schools in Gqeberha, South Africa. Methods: A cluster randomised control trial was used to test a 20-week intervention, which included three components, namely [1] the KaziKidz toolkit (comprised of pre- prepared PE, health, hygiene and nutrition lessons, equipment for PE, and painted games) [2] a PE coach (human movement science graduate to assist teachers) and [3]two 90-min training workshops. Eight schools were randomly selected to participatein the study: four intervention schools received the KaziKidz toolkit, while the externalsupport components were staggered across three intervention schools, and the Chapter 1: Introduction 2 remaining four schools served as the control group. Altogether 961 children (491 boys and 511 girls) from grades 4 to 6 (8 - 13 years old, M=10.88±1.19 yrs) participated In the study. Demographic information and socio-economic status were captured with a questionnaire. Further measures included height, weight, waist circumference, blood pressure, glycated haemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, accelerometer-based PA and cardiorespiratory fitness (CRF). Results: Cross-sectional baseline data showed that 43.1% of the sample presented with at least one NCD risk factor, and 17% presented with an elevated clustered risk score (CRS). In addition, higher CRF and moderate to vigorous PA (MVPA) were associated with a lowered CRS whereby an elevated CRS was halved for every 49 min increase in MVPA (95% CI 27 - 224) or every 2.17 ml/kg/min increase in CRF, as determined via estimated VO2max (95% CI 1.66 - 3.12). Overall, 13% of the cohort were underweight, 12% overweight, 7% obese, and 64% engaged in an average of 60 min MVPA per day. The results also identified an inverse association between body mass index categories and the total duration of MVPA achieved per day as children categorised as underweight to normal‐weight (boys: OR = 3.89, 95% CI: 2.18 - 6.93; girls: OR =1.78, 95% CI: 1.13 - 2.80) were more likely to engage in 60 min per day of MVPA than overweight to obese children. Finally, the school-based health intervention results revealed improvements in children's NCD risk factors and increased MVPA levels when the intervention conditions included the workshops and, in some cases, the PE coach. The KaziKidz toolkit (on its own) showed little to no improvements in NCD risk factors and MVPA levels. Conclusion: School-based health interventions have the potential to improve the NCD risk factors of children attending low-income schools in South Africa. These findings also add to our understanding of implementing interventions in settings where teachers are not sufficiently trained to teach PE. Therefore, school-based health interventions, including a toolkit, should be accompanied by workshops to equip educators with the necessary tools to confidently facilitate PE lessons and integrate a range of PE activities into their classrooms. Future research is recommended to determine the long-term sustainability of school-based health interventions and the long-term post-intervention impact on NCD risk factors. , Thesis (PhD) -- Faculty of Health Science, Department of Human Movement Science, 2023
- Full Text:
- Date Issued: 2023-04
Educational interventions for primary caregivers related to infection prevention and control in stroke patients in a rural setting of Mutasa district, Zimbabwe
- Authors: Chikanya, Violet Kestha
- Date: 2022-12
- Subjects: Educational interventions -- Zimbabwe , Cross infection -- Prevention -- Zimbabwe , Primary caregivers
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/60133 , vital:63146
- Description: Infection prevention and control offer safe and effective practices for patients and healthcare workers in any setting, including the home environment. Understanding and applying principles are based on knowledge and training of caregivers. The incidence of stroke has increased significantly in some sub-Saharan countries. Most patients with stroke are admitted into hospital during the acute phase of care, and are then discharged for further care and management at home. Recovery at home after a stroke takes a long time under the care of primary caregivers with either little or no health care training, exposing these patients to a variety of risky infections. Education on infection prevention and control is therefore encouraged to guide primary caregivers in caring for these patients. The study objectives sought to explore and describe knowledge and practices of primary caregivers, and information given by village health workers to primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients in a rural setting in Mutasa district, Zimbabwe. The study also sought to develop and validate educational interventions for primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients. A quantitative research paradigm was used in the study. Multistage random sampling was used to select 20 wards and 200 villages. Using a margin of error of 5% and 95% confidence, the sample consisted of 200 primary caregivers and 200 village health workers. The study was conducted in three phases. Phase One comprised data collection from primary caregivers and village health workers regarding prevention and control of chest, skin, and urinary tract infections. Data were collected using a structured interviewer-administered questionnaire for primary caregivers and a self-administered questionnaire for village health workers. The research instruments collected data on socio-demographics, knowledge, practices and infection prevention and control information given by village health workers to primary caregivers. The Visual Basic for Applications package was used for data analysis. x The study results revealed that a significant number of primary caregivers had low knowledge levels in terms of stroke and infections that frequently occur in home-based stroke patients. About a third of primary caregivers did not know the standard infection prevention and control measures to prevent infections, and a substantial proportion of the primary caregivers did not practise the recommended measures to prevent and control chest, skin and urinary tract infections in home-based stroke patients. It was found that village health workers provided limited health education on stroke, its complications, and measures to prevent and control chest, skin and urinary tract infections to primary caregivers. In Phase Two, educational interventions in the form of a job aid comprising worksheets for primary caregivers to prevent and control chest, skin and urinary tract infections in home-based stroke patients in a rural setting were developed. In Phase Three, the draft job aid was reviewed by an eight-member expert panel. Feedback from the reviewers was used to develop the final job aid for enhancing the knowledge and practices of primary caregivers in terms of infection prevention and control in home-based stroke patients. Throughout the study, the researcher adhered to ethical considerations, namely respect for persons, beneficence, and justice. The quality of data collected was ensured by applying the principles of validity and reliability in the development stage of the questionnaire and by conducting a pilot study. Rigorous evaluation of the developed job aid is required to establish its validity. It is recommended that the job aid be included in nurse training and continuing education programs. The trainings should be cascaded to the village health workers and primary caregivers of other bed-ridden patients. The job aid will also reach more caregivers if translated to other local languages. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
- Authors: Chikanya, Violet Kestha
- Date: 2022-12
- Subjects: Educational interventions -- Zimbabwe , Cross infection -- Prevention -- Zimbabwe , Primary caregivers
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/60133 , vital:63146
- Description: Infection prevention and control offer safe and effective practices for patients and healthcare workers in any setting, including the home environment. Understanding and applying principles are based on knowledge and training of caregivers. The incidence of stroke has increased significantly in some sub-Saharan countries. Most patients with stroke are admitted into hospital during the acute phase of care, and are then discharged for further care and management at home. Recovery at home after a stroke takes a long time under the care of primary caregivers with either little or no health care training, exposing these patients to a variety of risky infections. Education on infection prevention and control is therefore encouraged to guide primary caregivers in caring for these patients. The study objectives sought to explore and describe knowledge and practices of primary caregivers, and information given by village health workers to primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients in a rural setting in Mutasa district, Zimbabwe. The study also sought to develop and validate educational interventions for primary caregivers to prevent and control chest infections, skin infections and urinary tract infections in home-based stroke patients. A quantitative research paradigm was used in the study. Multistage random sampling was used to select 20 wards and 200 villages. Using a margin of error of 5% and 95% confidence, the sample consisted of 200 primary caregivers and 200 village health workers. The study was conducted in three phases. Phase One comprised data collection from primary caregivers and village health workers regarding prevention and control of chest, skin, and urinary tract infections. Data were collected using a structured interviewer-administered questionnaire for primary caregivers and a self-administered questionnaire for village health workers. The research instruments collected data on socio-demographics, knowledge, practices and infection prevention and control information given by village health workers to primary caregivers. The Visual Basic for Applications package was used for data analysis. x The study results revealed that a significant number of primary caregivers had low knowledge levels in terms of stroke and infections that frequently occur in home-based stroke patients. About a third of primary caregivers did not know the standard infection prevention and control measures to prevent infections, and a substantial proportion of the primary caregivers did not practise the recommended measures to prevent and control chest, skin and urinary tract infections in home-based stroke patients. It was found that village health workers provided limited health education on stroke, its complications, and measures to prevent and control chest, skin and urinary tract infections to primary caregivers. In Phase Two, educational interventions in the form of a job aid comprising worksheets for primary caregivers to prevent and control chest, skin and urinary tract infections in home-based stroke patients in a rural setting were developed. In Phase Three, the draft job aid was reviewed by an eight-member expert panel. Feedback from the reviewers was used to develop the final job aid for enhancing the knowledge and practices of primary caregivers in terms of infection prevention and control in home-based stroke patients. Throughout the study, the researcher adhered to ethical considerations, namely respect for persons, beneficence, and justice. The quality of data collected was ensured by applying the principles of validity and reliability in the development stage of the questionnaire and by conducting a pilot study. Rigorous evaluation of the developed job aid is required to establish its validity. It is recommended that the job aid be included in nurse training and continuing education programs. The trainings should be cascaded to the village health workers and primary caregivers of other bed-ridden patients. The job aid will also reach more caregivers if translated to other local languages. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-12
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Development of a strategy to promote prenatal physical activity participation among women in Buffalo City Municipality, South Africa
- Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Okafor, Uchenna Benedine https://orcid.org/0000-0002-0435-2041
- Date: 2022-03
- Subjects: Prenatal care , Exercise for pregnant women
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/22919 , vital:53218
- Description: Research has proven that prenatal physical activity practice is associated with multiple health benefits; however, most women in South Africa rarely participate in prenatal physical activity. In contrast to more developed countries, there is dearth of research focusing specifically on prenatal physical activity and exercise among South African women. Nevertheless, in order to effectively, and strategically promote such prenatal activity, such information is important to plan for an intervention strategy. The main aim of this study was to assess the level, patterns, and associated factors of prenatal physical activity; beliefs, knowledge, attitudes, perceived benefits, and sources of information women received during pregnancy; and, furthermore, to develop an effective and relevant intervention strategy to facilitate the participation in this particular activity in Buffalo City Municipality, Eastern Cape, South Africa. Methods The study was a mixed-method, cross-sectional study design with both quantitative and qualitative data collection and analyses. The sequential explanatory design was adopted to merge and mix different datasets to be collected and analysed. The quantitative data involved a convenient sample of 1082 pregnant women in 12 randomly selected primary healthcare clinics offering antenatal health services in Buffalo City, Eastern Cape. The Pregnancy Physical Activity Questionnaire was interviewer-administered to women at each antenatal health clinic on pre-specified days, in a designated room allocated to the primary researcher by the health facility manager. The descriptive statistics were frequency distribution, percentages, mean and standard deviation. Furthermore, the bivariate and multivariate analyses were performed on two categories of participants, namely inactive or active, to determine the factors affecting prenatal physical activity behaviour. Furthermore, multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels, and the associations between prenatal physical activity levels and socio-demographic, lifestyle, and obstetrics characteristics were determined using a chi-squared analyses. The significance level was set at p = 0.05. In addition, a qualitative descriptive approach was applied, using semi-structured face-to-face interviews with 15 purposively selected pregnant women, as well as 17 midwives offering antenatal health-care services to pregnant women in the 12 selected healthcare clinics. Qualitative data were analysed using a thematic content analysis. To develop the physical activity strategy for the promotion of prenatal physical activity practice, three frameworks were applied, namely the Strength, Weakness, Opportunity and Threat (SWOT), the Political, Economic Growth, Socio-Cultural, Technological, Laws and Environmental (PESTLE), and, lastly, the Build, Overcome, Explore and Minimise (BOEM) analytical frameworks. To facilitate the validation of the strategy, the findings were additionally analysed, after which, appropriate intervention strategies promoting prenatal physical activity were developed by again using the SWOT and PESTLE analytical strategic frameworks. This process involved a purposive sampling of seven experts with knowledge of and a proven academic and scholarly background in prenatal physical activity and maternal health. Next, the developed physical activity strategy was presented to various stakeholders, which included six primary healthcare managers, two midwives, and pregnant women purposively selected in each of the 12 chosen antenatal health clinics for the validation process. The stakeholders discussed, deliberated on, and provided comments and opinions of the feasibility and implementation of the developed prenatal physical activity for promotion of physical activity practices in the Eastern Cape Province. Results The findings of this particular study demonstrated low levels of prenatal physical activity among pregnant women, and, further indicated that the most preferred form of activity was light-intensity and household activities. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2– 156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31) were negatively associated with prenatal physical activity, while prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. In addition, the pregnant women were aware of the safety (88.2%) and benefits of physical activity for both mother and baby (79.6%), improved labour and delivery (93.1%), promote energy (89.0%), and should be discontinued when tired (76.6%). However, they also held the contradictory belief that pregnancy is “a time to rest” (56.5%). Furthermore, the most common sources of information about prenatal physical activity were the media, television, the radio and Internet-based websites (70.2%). Most women affirmed that prenatal physical activity reduced infant weight (61.4%), lessen moodiness (90.4), decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). The majority of women indicated that prenatal physical activity improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). The results from the quantitative data revealed that the major modifiable barriers to prenatal physical activity were tiredness (73.3%), lack of advice from healthcare professionals (nurses/midwives) (64.7%), low energy (64.5%), and non-accessibility to physical activity facilities (63.0%). The results were confirmed in the qualitative data, based on the Ecological Model, in which women also mentioned tiredness, work and household responsibilities, a lack of motivation, and the lack of physical activity advice and information on the relevant recommendations and guidelines. Overall, 62.4% women had high knowledge regarding prenatal physical activity; and half of the women showed a positive attitude toward it (50.1%). Whilst participants had knowledge of other types of antenatal exercises, 80.9% of the women had no knowledge of swimming exercise. Negative attitudes towards physical activity included the feeling of tiredness (67.7%), lack of interest (64.8%), and inadequate information on physical activity (59.5%). In addition, the study highlighted that midwives rarely educate and counsel pregnant women about prenatal physical activity during scheduled antenatal visits, which was attributed largely to the shortage of midwives handling many responsibilities at clinics. Nevertheless, the midwives did express a willingness to provide effective physical activity education and counselling on prenatal physical activity, if supported by relevant training and workshops. Furthermore, they further recommended the use of the Mom Connect application, which is a technological device designed by the National Department of Health, to distribute relevant information about maternal and child health. The prenatal physical activity strategies developed to address the above-mentioned and other barriers associated with prenatal physical activity include the use of scientific and technological innovations to provide basic information on prenatal physical activity to pregnant women by means of Mom Connect, and, by collaborating with the various cellphone and network companies in South Africa. Another strategy was to integrate prenatal physical activity training into the curricula of the existing higher institutions of learning that provide teaching of maternal health in the Eastern Cape Province. Additional strategies included the documentation and subsequent clarification of misconceptions about the safety concerns often associated with prenatal physical activity by making the documents accessible to all women at the clinics in the form of a small pamphlet or booklet. Lastly, stakeholders suggested that the government offer periodic prenatal physical activity campaigns, which should be presented in local community town halls and clinics and by other stakeholders to address the current lack of awareness and effectively eliminate misrepresentations and falsehoods around the safety of prenatal physical activity within geographical setting of the Eastern Cape Province. Conclusion Despite the advantages of prenatal physical activity practices, most pregnant women in South Africa do not participate in moderate-intensity physical activity. Notably, while women perceive prenatal physical activity as beneficial to both mother and baby, such theoretical knowledge is not easily translatable into practice. The predominant sources of information on prenatal physical activity are the television, the radio, and other media, which may be potentially misleading or contradictory to evidence-based physical activity practice. Furthermore, tiredness, a lack of time, work and household responsibilities, and a lack of motivation were major modifiable barriers to prenatal physical activity by the women. In addition, pregnant women rarely receive information on prenatal physical activity. Consequently, to address the needs of the pregnant women as highlighted in this study, a prenatal physical activity intervention strategy was developed and validated by key stakeholders to promote prenatal physical activity and exercise practice among women, taken in account the local context. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
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
Best practice psychosocial–cultural care guideline for primary caregivers of couples in the Talensi and Nabdam districts of Ghana experiencing infertility
- Authors: Kuug, Anthony Kolsabilik
- Date: 2021-04
- Subjects: Caregivers -- Infertility -- Ghana , Couples -- Infertility -- Ghana
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51264 , vital:43258
- Description: Infertility remains a major clinical and social problem, affecting approximately one in every ten couples. The implications of infertility range from physical abuse to denial of family property, divorce, psychological problems, such as withdrawal, anxiety and depression to social isolation, scorn, rejection and stigmatisation. The health of infertile couples needs holistic attention because, while their medical and surgical needs are addressed to correct physical and physiological barriers of infertility, their psychological and emotive needs, which constitute the psychosocial aspects of infertility, need to be addressed as well. The current study explored and described the experiences of couples with infertility and primary caregivers who rendered care to couples. The study aimed to develop a best practice psychosocial-cultural care guideline for primary caregivers to enhance the management of couples experiencing infertility in Talensi and Nabdam districts of the Upper East Region in Ghana. The study followed a qualitative design while making use of explorative, descriptive contextual and interpretive ethnographic approaches. The research populations comprised couples experiencing infertility and the primary caregivers who cared for them, consisting of public health nurses and midwives. The research study comprised three phases. In Phase 1, semi-structured interviews, narrative sketching and storytelling were used to collect data on experiences of couples with infertility while semi-structured interviews were used to explore and describe the experiences of primary caregivers who cared for them. The interviews were transcribed and analysed using Tesch’s eight steps of data analysis to make sense of the data collected. The researcher ensured the validity of the study by conforming to the Lincoln and Guba’s approach to trustworthiness by using an independent coder to validate the researcher’s coding. In Phase 2, an integrative literature review was conducted to identify previous guidelines and systematic reviews regarding psychosocial–cultural care of infertility. Relevant guidelines and reviews were selected and critically appraised. Data were extracted and synthesised for the development of a best practice guideline for psychosocial–cultural care of couples experiencing infertility. An independent appraiser critically appraised relevant guidelines to ensure trustworthiness. In phase 3, the findings of Phases 1 and 2 were integrated to formulate a draft best practice guideline for psychosocial–cultural care of couples experiencing infertility. The guideline was reviewed by a six-member expert panel and modified based on their recommendations, suggestions and comments leading to the finalisation of the best practice psychosocial–cultural care guideline for primary caregivers of couples experiencing infertility in the Talensi and Nabdam districts in Ghana. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Kuug, Anthony Kolsabilik
- Date: 2021-04
- Subjects: Caregivers -- Infertility -- Ghana , Couples -- Infertility -- Ghana
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51264 , vital:43258
- Description: Infertility remains a major clinical and social problem, affecting approximately one in every ten couples. The implications of infertility range from physical abuse to denial of family property, divorce, psychological problems, such as withdrawal, anxiety and depression to social isolation, scorn, rejection and stigmatisation. The health of infertile couples needs holistic attention because, while their medical and surgical needs are addressed to correct physical and physiological barriers of infertility, their psychological and emotive needs, which constitute the psychosocial aspects of infertility, need to be addressed as well. The current study explored and described the experiences of couples with infertility and primary caregivers who rendered care to couples. The study aimed to develop a best practice psychosocial-cultural care guideline for primary caregivers to enhance the management of couples experiencing infertility in Talensi and Nabdam districts of the Upper East Region in Ghana. The study followed a qualitative design while making use of explorative, descriptive contextual and interpretive ethnographic approaches. The research populations comprised couples experiencing infertility and the primary caregivers who cared for them, consisting of public health nurses and midwives. The research study comprised three phases. In Phase 1, semi-structured interviews, narrative sketching and storytelling were used to collect data on experiences of couples with infertility while semi-structured interviews were used to explore and describe the experiences of primary caregivers who cared for them. The interviews were transcribed and analysed using Tesch’s eight steps of data analysis to make sense of the data collected. The researcher ensured the validity of the study by conforming to the Lincoln and Guba’s approach to trustworthiness by using an independent coder to validate the researcher’s coding. In Phase 2, an integrative literature review was conducted to identify previous guidelines and systematic reviews regarding psychosocial–cultural care of infertility. Relevant guidelines and reviews were selected and critically appraised. Data were extracted and synthesised for the development of a best practice guideline for psychosocial–cultural care of couples experiencing infertility. An independent appraiser critically appraised relevant guidelines to ensure trustworthiness. In phase 3, the findings of Phases 1 and 2 were integrated to formulate a draft best practice guideline for psychosocial–cultural care of couples experiencing infertility. The guideline was reviewed by a six-member expert panel and modified based on their recommendations, suggestions and comments leading to the finalisation of the best practice psychosocial–cultural care guideline for primary caregivers of couples experiencing infertility in the Talensi and Nabdam districts in Ghana. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
Co-generating a people-centred approach to addressing student hunger at a South African university
- Authors: Mansvelt, Natalie
- Date: 2021-04
- Subjects: Food security -- South Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51309 , vital:43262
- Description: While considerable progress has been made regarding access to higher education in South Africa for previously excluded and disadvantaged students, great challenges are experienced in terms of student well-being. One of the key factors contributing to students’ ability to complete their studies successfully is food-related challenges. Various programmes have been introduced at institutions of higher education to assist and support students who lack funds for food. However, these programmes are characteristic of the welfarist model, as it is often based on needs, short-term by nature, and dependent on external resources. Furthermore, it reduces students to the role of passive beneficiaries. This research answers the question of how student hunger can be addressed through co-generating a people-centred approach at one higher education institution in South Africa. The study was underpinned by Sen’s capabilities approach to enable a theoretical understanding of the issue of student hunger. Additionally, Korten’s people-centred development provided the value base of the study to place students at the centre of the problem-solving process. An approach to student hunger that would be participative, student-centred, and enhancing nutritional capabilities was invited. Situated within the critical paradigm, I employed the participatory action research design to facilitate a process whereby students critically questioned the issue of hunger and took action to address the issue. Eight students from various study fields volunteered to co-research the issue of student hunger. Over the period of one year, we generated data using different methods (including photovoice, community self-survey, workshops, purposeful group discussions, focus group discussions, and my reflective notes). We applied cyclical processes to plan, implement, and reflect on actions intended to address student hunger. Through a combination of collaborative and individual processes of data analysis, we responded to four subquestions through four phases, which culminated in the co-construction of a people-centred approach to student hunger. Students’ conceptualisations of student hunger revealed two types: hunger of the stomach and hunger of the mind. The cyclical relationship between the two types infers that nutritional well-being is not achieved adequately when students have the means to acquire food. Choices regarding the utilisation of the available means also need consideration. The findings revealed that students apply the conscientisation framework in the ways that they plan to address student hunger. Applying value-driven processes, actions entailed physical dialogues with groups of people. The approach developed in this study offers strategies for the stakeholders who attend to student hunger, to collaborate and make contributions towards comprehensively resolving the complex issue. It primarily could be useful to institutions of higher education as the suggested coordinators of a collaborative structure. A second part of the developed approach puts forward a strategy to address the financial capabilities of students. The study contributes a consideration to constraints that stem from students’ mindsets and adoption of a prevailing culture that maintains student hunger. This demonstrates that resolutions to addressing student hunger might be more effective and sustainable if the context, views and participation of people experiencing the hunger are considered. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Mansvelt, Natalie
- Date: 2021-04
- Subjects: Food security -- South Africa
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51309 , vital:43262
- Description: While considerable progress has been made regarding access to higher education in South Africa for previously excluded and disadvantaged students, great challenges are experienced in terms of student well-being. One of the key factors contributing to students’ ability to complete their studies successfully is food-related challenges. Various programmes have been introduced at institutions of higher education to assist and support students who lack funds for food. However, these programmes are characteristic of the welfarist model, as it is often based on needs, short-term by nature, and dependent on external resources. Furthermore, it reduces students to the role of passive beneficiaries. This research answers the question of how student hunger can be addressed through co-generating a people-centred approach at one higher education institution in South Africa. The study was underpinned by Sen’s capabilities approach to enable a theoretical understanding of the issue of student hunger. Additionally, Korten’s people-centred development provided the value base of the study to place students at the centre of the problem-solving process. An approach to student hunger that would be participative, student-centred, and enhancing nutritional capabilities was invited. Situated within the critical paradigm, I employed the participatory action research design to facilitate a process whereby students critically questioned the issue of hunger and took action to address the issue. Eight students from various study fields volunteered to co-research the issue of student hunger. Over the period of one year, we generated data using different methods (including photovoice, community self-survey, workshops, purposeful group discussions, focus group discussions, and my reflective notes). We applied cyclical processes to plan, implement, and reflect on actions intended to address student hunger. Through a combination of collaborative and individual processes of data analysis, we responded to four subquestions through four phases, which culminated in the co-construction of a people-centred approach to student hunger. Students’ conceptualisations of student hunger revealed two types: hunger of the stomach and hunger of the mind. The cyclical relationship between the two types infers that nutritional well-being is not achieved adequately when students have the means to acquire food. Choices regarding the utilisation of the available means also need consideration. The findings revealed that students apply the conscientisation framework in the ways that they plan to address student hunger. Applying value-driven processes, actions entailed physical dialogues with groups of people. The approach developed in this study offers strategies for the stakeholders who attend to student hunger, to collaborate and make contributions towards comprehensively resolving the complex issue. It primarily could be useful to institutions of higher education as the suggested coordinators of a collaborative structure. A second part of the developed approach puts forward a strategy to address the financial capabilities of students. The study contributes a consideration to constraints that stem from students’ mindsets and adoption of a prevailing culture that maintains student hunger. This demonstrates that resolutions to addressing student hunger might be more effective and sustainable if the context, views and participation of people experiencing the hunger are considered. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
Enriching the physical education pedagogical content knowledge of foundation phase teachers
- Kahts-Kramer, Samantha Andrea
- Authors: Kahts-Kramer, Samantha Andrea
- Date: 2021-04
- Subjects: Physical education and training , Early childhood education -- Curricula
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51242 , vital:43236
- Description: Physical Education (PE) is vital for the holistic development of Foundation Phase learners. Foundation Phase teachers working in low resource contexts, however, being generalists rather than specialists, struggle to teach PE effectively, even when supplied with programmes by external experts. I was interested in finding out why, and what could be done to help them integrate Fundamental Movement Skills (FMS) into their teaching, to benefit their learners. I proceeded from the hypothesis that teachers should play an active part in their own development, otherwise any Continual Professional Teacher Development (CPTD) would not bring about the change desired. I argued that if CPTD training and support is embedded within their context and based on teaching philosophies that foster teacher transformation, empowerment, and advocacy, then teachers might be more likely to commit to teaching PE. My aim in this study was thus to develop a collaborative process of CPTD with Foundation Phase teachers in low resource schools to enrich their pedagogical content knowledge (PCK) of PE and FMS within their contexts of social disadvantage. I initially adopted a qualitative design, but during this study, I realised that a more participatory approach was needed. I therefore present my study in two phases In Phase One, I answered the question: What are Foundation Phase teachers’ experiences of implementing PE in low resource schools? I did so to inform the design of an appropriately suited CPTD model for Phase Two of this study. I used a qualitative research design situated within the interpretive paradigm. I purposively sampled 24 Foundation Phase teachers to partake in semi-structured interviews. Thematic analysis revealed three broad themes, namely, personal, and systemic barriers to PE, as well as positive responses to challenges. The overlap between themes was significant, highlighting the complexity of teachers’ experiences and perceptions of PE. Teachers’ positive responses emphasised that they possess the creativity and advocacy to overcome challenges posed and necessitated that I adopt a participatory design to work with teachers to develop a collaborative form of CPTD. Phase Two of this study was guided by the questions set by the participating teachers. Ten Foundation Phase teachers from two schools volunteered to be part of the study. In Cycle One they asked: What do we need to learn to be able to effectively implement PE? The findings of Cycle One led them to ask the following question in Cycle Two: How can we improve our confidence to teach PE within our school contexts? Participants did so through collaboratively creating PE lessons which they then implemented and evaluated. The findings of Phase Two highlighted how Foundation Phase teachers can be guided to empower themselves to overcome the barriers to teaching PE that they face in their low resource schools. Based on teachers’ CPTD experiences, I then addressed the third question of this study: What CPTD guidelines can be generated to enable Foundation Phase teachers to improve on and to implement their PCK of PE and FMS at low resource schools? Five CPTD guidelines aimed at collaborative and transformative PE-based CPTD focused on whole school transformation were identified. I provide a graphic depiction of the CPTD guidelines that explains how it can be operationalised. These CPTD guidelines and process model provide valuable knowledge to inform CPTD policy and practice of PE in the Foundation Phase in low resource schools. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Kahts-Kramer, Samantha Andrea
- Date: 2021-04
- Subjects: Physical education and training , Early childhood education -- Curricula
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51242 , vital:43236
- Description: Physical Education (PE) is vital for the holistic development of Foundation Phase learners. Foundation Phase teachers working in low resource contexts, however, being generalists rather than specialists, struggle to teach PE effectively, even when supplied with programmes by external experts. I was interested in finding out why, and what could be done to help them integrate Fundamental Movement Skills (FMS) into their teaching, to benefit their learners. I proceeded from the hypothesis that teachers should play an active part in their own development, otherwise any Continual Professional Teacher Development (CPTD) would not bring about the change desired. I argued that if CPTD training and support is embedded within their context and based on teaching philosophies that foster teacher transformation, empowerment, and advocacy, then teachers might be more likely to commit to teaching PE. My aim in this study was thus to develop a collaborative process of CPTD with Foundation Phase teachers in low resource schools to enrich their pedagogical content knowledge (PCK) of PE and FMS within their contexts of social disadvantage. I initially adopted a qualitative design, but during this study, I realised that a more participatory approach was needed. I therefore present my study in two phases In Phase One, I answered the question: What are Foundation Phase teachers’ experiences of implementing PE in low resource schools? I did so to inform the design of an appropriately suited CPTD model for Phase Two of this study. I used a qualitative research design situated within the interpretive paradigm. I purposively sampled 24 Foundation Phase teachers to partake in semi-structured interviews. Thematic analysis revealed three broad themes, namely, personal, and systemic barriers to PE, as well as positive responses to challenges. The overlap between themes was significant, highlighting the complexity of teachers’ experiences and perceptions of PE. Teachers’ positive responses emphasised that they possess the creativity and advocacy to overcome challenges posed and necessitated that I adopt a participatory design to work with teachers to develop a collaborative form of CPTD. Phase Two of this study was guided by the questions set by the participating teachers. Ten Foundation Phase teachers from two schools volunteered to be part of the study. In Cycle One they asked: What do we need to learn to be able to effectively implement PE? The findings of Cycle One led them to ask the following question in Cycle Two: How can we improve our confidence to teach PE within our school contexts? Participants did so through collaboratively creating PE lessons which they then implemented and evaluated. The findings of Phase Two highlighted how Foundation Phase teachers can be guided to empower themselves to overcome the barriers to teaching PE that they face in their low resource schools. Based on teachers’ CPTD experiences, I then addressed the third question of this study: What CPTD guidelines can be generated to enable Foundation Phase teachers to improve on and to implement their PCK of PE and FMS at low resource schools? Five CPTD guidelines aimed at collaborative and transformative PE-based CPTD focused on whole school transformation were identified. I provide a graphic depiction of the CPTD guidelines that explains how it can be operationalised. These CPTD guidelines and process model provide valuable knowledge to inform CPTD policy and practice of PE in the Foundation Phase in low resource schools. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
Strategies to facilitate the utilisation of child healthcare services in the Nkwanta South Municipality, Ghana
- Authors: Nyande, Felix Kwasi
- Date: 2021-04
- Subjects: Child health services -- Ghana
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51439 , vital:43277
- Description: Child health outcomes in Ghana and Sub-Saharan Africa have remained poor compared to other regions of the world. More than half of the global deaths among children under five years of age occur in sub-Saharan Africa. Neonatal and under five child death rates continue to remain high in Ghana, mainly because of the high death rates recorded in the rural areas. Adequate and prompt utilisation of child healthcare services contributes to improved child health outcomes. Despite all the efforts to improve child health, the utilisation of child healthcare services in rural areas in Ghana such as the Nkwanta South Municipality has remained poor. The purpose of this study was therefore to develop strategies that could facilitate the utilisation of child healthcare services by caregivers for their children in need in the Nkwanta South Municipality, Ghana. A qualitative approach, using an exploratory, descriptive and contextual design was implemented for this study. The research comprised the following three phases. Phase One comprised the empirical phase which explored and described the experiences of three groups of participants namely, nurses who rendered child healthcare services in both hospitals and clinics; caregivers of children under five years of age who utilised the available child healthcare services and caregivers of child under five years of age who did not utilise the available child healthcare services. Data was collected through semi-structured interviews conducted with these participants and analysed qualitatively according to the six steps outlined in Creswell (2014:197). Four main themes and 10 sub-themes emerged from the data analysis and were presented and discussed. Phase Two consisted of the compilation of the conceptual framework using the survey list by Dickoff, James and Wiendenbach (1968:423). The conceptual framework was compiled based on the findings of the empirical phase and the WHO Health for All model which was the theoretical framework that underpinned this study. The conceptual framework was also later used as the lens for the development and description of the strategies to facilitate the utilisation of child healthcare services by caregivers for their children in need in Phase Three. Phase Three of the study was the final phase of the research and it involved the development and description of the strategies that could be used by nurses to facilitate the use of child healthcare services by caregivers for their children in need in Nkwanta South Municipality, Ghana. Five strategies were developed and described in this phase. The five strategies were: training and deployment of nurses; capacity building for nurses to support quality child healthcare delivery; resourcing healthcare facilities; community engagement and participation and stakeholder collaboration. The evaluation criteria of Chinn and Kramer (2011:197) were used by six experts to evaluate the strategies. The strategies were evaluated and found to be understandable, clear, simple, applicable and significant to nursing practice. It can thus be concluded that the purpose of the study was achieved since strategies were developed to facilitate the utilisation of child healthcare services by caregivers for their children in need in the Nkwanta South Municipality, Ghana. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Nyande, Felix Kwasi
- Date: 2021-04
- Subjects: Child health services -- Ghana
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51439 , vital:43277
- Description: Child health outcomes in Ghana and Sub-Saharan Africa have remained poor compared to other regions of the world. More than half of the global deaths among children under five years of age occur in sub-Saharan Africa. Neonatal and under five child death rates continue to remain high in Ghana, mainly because of the high death rates recorded in the rural areas. Adequate and prompt utilisation of child healthcare services contributes to improved child health outcomes. Despite all the efforts to improve child health, the utilisation of child healthcare services in rural areas in Ghana such as the Nkwanta South Municipality has remained poor. The purpose of this study was therefore to develop strategies that could facilitate the utilisation of child healthcare services by caregivers for their children in need in the Nkwanta South Municipality, Ghana. A qualitative approach, using an exploratory, descriptive and contextual design was implemented for this study. The research comprised the following three phases. Phase One comprised the empirical phase which explored and described the experiences of three groups of participants namely, nurses who rendered child healthcare services in both hospitals and clinics; caregivers of children under five years of age who utilised the available child healthcare services and caregivers of child under five years of age who did not utilise the available child healthcare services. Data was collected through semi-structured interviews conducted with these participants and analysed qualitatively according to the six steps outlined in Creswell (2014:197). Four main themes and 10 sub-themes emerged from the data analysis and were presented and discussed. Phase Two consisted of the compilation of the conceptual framework using the survey list by Dickoff, James and Wiendenbach (1968:423). The conceptual framework was compiled based on the findings of the empirical phase and the WHO Health for All model which was the theoretical framework that underpinned this study. The conceptual framework was also later used as the lens for the development and description of the strategies to facilitate the utilisation of child healthcare services by caregivers for their children in need in Phase Three. Phase Three of the study was the final phase of the research and it involved the development and description of the strategies that could be used by nurses to facilitate the use of child healthcare services by caregivers for their children in need in Nkwanta South Municipality, Ghana. Five strategies were developed and described in this phase. The five strategies were: training and deployment of nurses; capacity building for nurses to support quality child healthcare delivery; resourcing healthcare facilities; community engagement and participation and stakeholder collaboration. The evaluation criteria of Chinn and Kramer (2011:197) were used by six experts to evaluate the strategies. The strategies were evaluated and found to be understandable, clear, simple, applicable and significant to nursing practice. It can thus be concluded that the purpose of the study was achieved since strategies were developed to facilitate the utilisation of child healthcare services by caregivers for their children in need in the Nkwanta South Municipality, Ghana. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
The use of psychology in roman catholic seminary admissions in Southern Africa
- Authors: Mitchell, Gregory Paul
- Date: 2021-04
- Subjects: Catholic Church -- Africa, Southern -- Psychological aspects -- Congresses
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51344 , vital:43266
- Description: Psychological assessment forms part of Roman Catholic seminary admissions in Southern Africa. The present study sought to explore and describe the perceptions and experiences of the role, purpose, and nature of the use of psychology in Roman Catholic seminary admissions in the territory of the Southern African Catholic Bishops’ Conference. A qualitative research design was selected, which utilised the grounded theory method. Church authorities and clinicians, recruited by means of purposive snowball sampling, were interviewed in individual semi-structured interviews. The findings were interpreted in relation to the narrative of a vocation to the Roman Catholic priesthood, international practice guidelines, as well as literature regarding the context of the Southern African Roman Catholic Church. Proposed guidelines for this process in Southern Africa were generated based on the experiences of the participants and this iterative process of thematic analysis. Potential guidelines, grounded in the research data, emerged in the following focus areas: the vocation to the priesthood, contextual and systemic factors, the clinician, the assessment process, factors to be assessed, the psychological report, the decision to admit to seminary, feedback, and psychology in formation. These are recommended to the Southern African Catholic Bishops’ Conference in draft form to be implemented in a participatory manner. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text: false
- Date Issued: 2021-04
- Authors: Mitchell, Gregory Paul
- Date: 2021-04
- Subjects: Catholic Church -- Africa, Southern -- Psychological aspects -- Congresses
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51344 , vital:43266
- Description: Psychological assessment forms part of Roman Catholic seminary admissions in Southern Africa. The present study sought to explore and describe the perceptions and experiences of the role, purpose, and nature of the use of psychology in Roman Catholic seminary admissions in the territory of the Southern African Catholic Bishops’ Conference. A qualitative research design was selected, which utilised the grounded theory method. Church authorities and clinicians, recruited by means of purposive snowball sampling, were interviewed in individual semi-structured interviews. The findings were interpreted in relation to the narrative of a vocation to the Roman Catholic priesthood, international practice guidelines, as well as literature regarding the context of the Southern African Roman Catholic Church. Proposed guidelines for this process in Southern Africa were generated based on the experiences of the participants and this iterative process of thematic analysis. Potential guidelines, grounded in the research data, emerged in the following focus areas: the vocation to the priesthood, contextual and systemic factors, the clinician, the assessment process, factors to be assessed, the psychological report, the decision to admit to seminary, feedback, and psychology in formation. These are recommended to the Southern African Catholic Bishops’ Conference in draft form to be implemented in a participatory manner. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text: false
- Date Issued: 2021-04
Usage of traditional medicines and other indigenous practices by childbearing women during pregnancy in Makoni District, Zimbabwe
- Authors: Chituku, Sibongile
- Date: 2020-09
- Subjects: Traditional medicine -- Zimbabwe , Medicinal plants
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20142 , vital:45347
- Description: Use of traditional medicinal plants (TMPs) during pregnancy, labour and delivery is common globally although evidence on their therapeutic effectiveness and safety is scarce. Research relating to indigenous practices and utilisation of traditional medicinal plants by childbearing women during pregnancy in Makoni District, Zimbabwe was carried out. The study included identification of culturally important indigenous knowledge (IK) practices and TMPs used by pregnant women in order to understand how such plants and practices may affect maternal, foetal, labour, and infant outcomes. Four hundred questionnaires were distributed to postnatal mothers in Makoni District, aimed at obtaining information on IK practices associated with utilisation of TMPs by childbearing women during pregnancy. In addition to this, five focused group discussions were carried out between September 2016 and December 2017 with 66 traditional healers from Makoni District. Documented information included names of utilised plants, plant parts used, dosage, methods of preparation and administration, and reasons for use. Voucher specimens of the utilised plant species were collected. Brine shrimp lethality test was used to evaluate potential toxicity of the documented plant species. The collected data were analysed used Epi info version 7.1 and SPSS version 16.5. Quantitative data revealed that 168 (42.0percent) of pregnant women in Makoni District use TMPs and 95 (23.8percent) used traditional practices (including elephant dung) for maternal and childcare. Among the women who used TMPs were those who experienced precipitated and prolonged labour. Correlation was found between demographic factors and utilisation of TMPs. For example, being a Christian was significantly associated with using TMPs with relative risk (RR) value of 8.9. Postnatal mothers who used TMPs during their pregnancy were 82.0percent less likely to have their membranes ruptured artificially, RR = 0.2 and more likely to experience late decelerations during active phase (RR = 2.8) than those who did not use TMPs. The differences between those who used TMPs and those who did not during pregnancy and labour, showed no significant differences in infant outcomes. The ethnobotanical survey revealed that a total of 47 plant species from 27 families and 13 non-plant products were used as herbal, complementary and alternative medicines (CAM) by pregnant women. More than half of all the documented plant species (59.8percent), belonged to the Fabaceae (19.1), Asteraceae, (8.5percent), Convolvulaceae (6.4percent), Asparagaceae, Euphorbiaceae, Malvaceae, Rubiaceae, Vitaceae and Xanthorrhoeaceae (4.3percent each) families. The most used plants were shrubs (40.4percent), trees (27.7percent), climbers (17.0percent), herbs (12.8percent) and a grasses (2.1percent). The most used plant parts were roots (61.7percent), leaves (25.5percent), fruits (12.8percent) and bark (10.6percent). A total of 26 medical conditions were treated with the majority of medicinal plants used to dilate or widen the birth canal (55.3percent) and to augment labour or speed up the delivery process (46.8percent). Interviews with traditional healers revealed that 14.9percent of the documented herbal medicines were used to guard against witchcraft and to prevent the infants’ illnesses. Other major uses of herbal medicines during pregnancy included their use to lower blood pressure or hypertension during pregnancy (12.8percent), to prevent caesarean section (10.6percent) and to loosen or relax muscles during pregnancy (8.5percent). Widely used non-plant products included soil of a burrowing mole (relative frequency citation (RFC) value of 0.61), elephant dung (RFC = 0.59), wasp nest (RFC = 0.32) and soap (RFC = 25). The majority of these non-plant products (22.8percent) were used to dilate birth canal (7.6percent) and augment labour (15.2percent). None of the twenty-five species with (RFC) > 0.05 evaluated for potential toxicity were categorised as toxic, but Albizia amara, Datura stramonium and Ricinus communis were categorised as having medium toxicity levels, nine species as having low toxicity levels while 13 species were categorised as non-toxic. This study provides valuable insights into the use of medicinal plants used by women during pregnancy, labour, delivery and post-delivery in Makoni District, Zimbabwe. Medicinal plants play an integral role in the provision of basic health care in Zimbabwe. However, the brine shrimp lethality test results categorised some of the prescribed species such as Albizia amara, Datura stramonium and Ricinus communis as having medium levels of toxicity and this is a cause of concern regarding utilization of TMPs during pregnancy. Therefore, TMPs used during pregnancy should be subjected to detailed phytochemical, pharmacological and toxicological experiments aimed at identifying some of the potential toxic compounds and side effects associated with intake of TMPs and associated herbal products. , Thesis (PhD(Nursing)) -- Faculty of Health Sciences, 2020
- Full Text:
- Date Issued: 2020-09
- Authors: Chituku, Sibongile
- Date: 2020-09
- Subjects: Traditional medicine -- Zimbabwe , Medicinal plants
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/20142 , vital:45347
- Description: Use of traditional medicinal plants (TMPs) during pregnancy, labour and delivery is common globally although evidence on their therapeutic effectiveness and safety is scarce. Research relating to indigenous practices and utilisation of traditional medicinal plants by childbearing women during pregnancy in Makoni District, Zimbabwe was carried out. The study included identification of culturally important indigenous knowledge (IK) practices and TMPs used by pregnant women in order to understand how such plants and practices may affect maternal, foetal, labour, and infant outcomes. Four hundred questionnaires were distributed to postnatal mothers in Makoni District, aimed at obtaining information on IK practices associated with utilisation of TMPs by childbearing women during pregnancy. In addition to this, five focused group discussions were carried out between September 2016 and December 2017 with 66 traditional healers from Makoni District. Documented information included names of utilised plants, plant parts used, dosage, methods of preparation and administration, and reasons for use. Voucher specimens of the utilised plant species were collected. Brine shrimp lethality test was used to evaluate potential toxicity of the documented plant species. The collected data were analysed used Epi info version 7.1 and SPSS version 16.5. Quantitative data revealed that 168 (42.0percent) of pregnant women in Makoni District use TMPs and 95 (23.8percent) used traditional practices (including elephant dung) for maternal and childcare. Among the women who used TMPs were those who experienced precipitated and prolonged labour. Correlation was found between demographic factors and utilisation of TMPs. For example, being a Christian was significantly associated with using TMPs with relative risk (RR) value of 8.9. Postnatal mothers who used TMPs during their pregnancy were 82.0percent less likely to have their membranes ruptured artificially, RR = 0.2 and more likely to experience late decelerations during active phase (RR = 2.8) than those who did not use TMPs. The differences between those who used TMPs and those who did not during pregnancy and labour, showed no significant differences in infant outcomes. The ethnobotanical survey revealed that a total of 47 plant species from 27 families and 13 non-plant products were used as herbal, complementary and alternative medicines (CAM) by pregnant women. More than half of all the documented plant species (59.8percent), belonged to the Fabaceae (19.1), Asteraceae, (8.5percent), Convolvulaceae (6.4percent), Asparagaceae, Euphorbiaceae, Malvaceae, Rubiaceae, Vitaceae and Xanthorrhoeaceae (4.3percent each) families. The most used plants were shrubs (40.4percent), trees (27.7percent), climbers (17.0percent), herbs (12.8percent) and a grasses (2.1percent). The most used plant parts were roots (61.7percent), leaves (25.5percent), fruits (12.8percent) and bark (10.6percent). A total of 26 medical conditions were treated with the majority of medicinal plants used to dilate or widen the birth canal (55.3percent) and to augment labour or speed up the delivery process (46.8percent). Interviews with traditional healers revealed that 14.9percent of the documented herbal medicines were used to guard against witchcraft and to prevent the infants’ illnesses. Other major uses of herbal medicines during pregnancy included their use to lower blood pressure or hypertension during pregnancy (12.8percent), to prevent caesarean section (10.6percent) and to loosen or relax muscles during pregnancy (8.5percent). Widely used non-plant products included soil of a burrowing mole (relative frequency citation (RFC) value of 0.61), elephant dung (RFC = 0.59), wasp nest (RFC = 0.32) and soap (RFC = 25). The majority of these non-plant products (22.8percent) were used to dilate birth canal (7.6percent) and augment labour (15.2percent). None of the twenty-five species with (RFC) > 0.05 evaluated for potential toxicity were categorised as toxic, but Albizia amara, Datura stramonium and Ricinus communis were categorised as having medium toxicity levels, nine species as having low toxicity levels while 13 species were categorised as non-toxic. This study provides valuable insights into the use of medicinal plants used by women during pregnancy, labour, delivery and post-delivery in Makoni District, Zimbabwe. Medicinal plants play an integral role in the provision of basic health care in Zimbabwe. However, the brine shrimp lethality test results categorised some of the prescribed species such as Albizia amara, Datura stramonium and Ricinus communis as having medium levels of toxicity and this is a cause of concern regarding utilization of TMPs during pregnancy. Therefore, TMPs used during pregnancy should be subjected to detailed phytochemical, pharmacological and toxicological experiments aimed at identifying some of the potential toxic compounds and side effects associated with intake of TMPs and associated herbal products. , Thesis (PhD(Nursing)) -- Faculty of Health Sciences, 2020
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- Date Issued: 2020-09
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