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Status of physical activity and physical fitness among intermediate-phase schoolchildren from marginalised communities in Port Elizabeth
- Authors: Ncanywa, Sesethu
- Date: 2022-04
- Subjects: Child development--South Africa--Eastern Cape , Children--Physiology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55833 , vital:53905
- Description: The purpose of the study was to investigate the current status of physical activity (PA) and physical fitness (PF) of intermediate-phase schoolchildren from marginalised communities in Port Elizabeth. A total of 985 schoolchildren (n=505 boys, n=474 girls) aged 8 to 16 years, from eight quintile 3 government schools participated in this study. These schools included four schools from the Township area and four from the Northern areas in Port Elizabeth. The tests included in the study were PA (Actigraph accelerometer), PF (20 m shuttle run test and grip strength), and body composition (body mass index and body fat percentage). Results showed that girls had higher body mass index (BMI) and body fat percentage (BF%), lower VO2max, less time spent on average per day on moderate to vigorous physical activity (MVPA) and lower grip strength (GS) as compared to boys (p0.05). No significant differences were found between the two geographic areas with regards to VO2max, GS, BMI and BF% (p>0.05). However, when confounding variables were considered, there was a significant difference in the BMI (p=0.0007), BF% (p=0.0003) and GS (p=0.0004) of the children from the two geographic areas. A negative correlation was found between VO2max and BMI A positive correlation was found between VO2max and MVPA . Overall, girls seem to be more at risk than boys for future non communicable diseases. These findings highlight the importance of promoting PA and monitored PF in children, and particularly in girls from marginalised communities. , Thesis (MA) -- Faculty of Health Sciences, School of lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Ncanywa, Sesethu
- Date: 2022-04
- Subjects: Child development--South Africa--Eastern Cape , Children--Physiology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/55833 , vital:53905
- Description: The purpose of the study was to investigate the current status of physical activity (PA) and physical fitness (PF) of intermediate-phase schoolchildren from marginalised communities in Port Elizabeth. A total of 985 schoolchildren (n=505 boys, n=474 girls) aged 8 to 16 years, from eight quintile 3 government schools participated in this study. These schools included four schools from the Township area and four from the Northern areas in Port Elizabeth. The tests included in the study were PA (Actigraph accelerometer), PF (20 m shuttle run test and grip strength), and body composition (body mass index and body fat percentage). Results showed that girls had higher body mass index (BMI) and body fat percentage (BF%), lower VO2max, less time spent on average per day on moderate to vigorous physical activity (MVPA) and lower grip strength (GS) as compared to boys (p0.05). No significant differences were found between the two geographic areas with regards to VO2max, GS, BMI and BF% (p>0.05). However, when confounding variables were considered, there was a significant difference in the BMI (p=0.0007), BF% (p=0.0003) and GS (p=0.0004) of the children from the two geographic areas. A negative correlation was found between VO2max and BMI A positive correlation was found between VO2max and MVPA . Overall, girls seem to be more at risk than boys for future non communicable diseases. These findings highlight the importance of promoting PA and monitored PF in children, and particularly in girls from marginalised communities. , Thesis (MA) -- Faculty of Health Sciences, School of lifestyle Sciences, 2022
- Full Text:
- Date Issued: 2022-04
An appraisal of strategies to mitigate related to non-communicable diseases of the eye: a case study of Michael Mapongwane Health Clinic in Khayelitsha, Western Cape Metro District
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Ngcebetsha, Avela Ayanda
- Date: 2022-03
- Subjects: Chronically ill--Care , Ophthalmic nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22908 , vital:53186
- Description: Preventive and curative eye-care services are a critical component of care for patients diagnosed with chronic diseases. The South African constitution guarantees health as a fundamental human right of all citizens. While most chronically ill patients are managed at the primary health care centers, eye care services are currently contracted to private service providers. The extent to which people, especially the chronically ill patients, have access to eye-care service under the current structure is less understood. The study aims to establish the effectiveness and sustainability of the eye-care service delivery model at the Michael Mapongwane CHC, with specific reference to access to eye-care services. Specifically, the study examined the rate and determinants of eye-care service utilisation, assess user’s satisfaction and perspectives of primary health workers and private service providers regarding the current structure of eye-care services. The study adopted a descriptive and explanatory design, which involved a survey and semi-structured interviews. The survey was conducted among 423 patients attending the two primary health centers selected for this study. Patients with chronic illness were recruited over a period of one month. Overall, 365 patients with chronic illness and 58 patients without chronic illness took part in the study. Descriptive and inferential statistics were used to analyse the quantitative date. Purposive sampling was used to select nine health workers and 10 private eye-care service providers for the semi-structured interviews. The data obtained were transcribed and coded. Thematic content analysis was performed on the qualitative data. The results show that less than half of the respondents (n=168) had ever had an eye test, and an even lower proportion (n=115) had had an eye test in the past two years. Age, female sex, formal rural dwelling, marital status, and income were significantly associated with ever having an eye test done. The results reveal a gross inequality in access to eye care test. Only 19.2% of patients diagnosed with hypertension had had their eyes examined. Even fewer proportions of the patients (8.5%) had had their eyes examined during or after diagnosis for hypertension. Likewise, only one in three patients diagnosed with diabetes has had their eyes examined before or after they were diagnosed with diabetes. The majority of patients who had used the services affirmed that it was easy to access eye care services. While most respondents agreed that waiting time to make an appointment was not too long, over half of them affirmed that waiting to see an eye doctor was too long. Most users were reasonably satisfied with the eye care services received. Primary health care providers highlighted challenges such as work overload, poor infrastructure, and patient’s forgetfulness of the appointment dates as factors affecting access to eye care services in their clinic. The primary challenges the private eye-care service providers experienced were small rooms or inappropriate clinic rooms, language barrier and inadequate support from the clinics. In conclusion, this study has shown that access to preventive and curative health care services was among patients attending primary health care centres, and especially those with chronic illness. The current structure of eye care services makes it difficult for patients to access care and for providers to provide quality care. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
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
Exploration of the factors influencing the upscaling of medical male circumcision targets in selected hospitals in eThekwini District, South Africa
- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Tshabalala, Sandile Clement
- Date: 2022-03
- Subjects: Circumcision
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22005 , vital:51930
- Description: Medical male circumcision has been shown to reduce female to male HIV transmission. This study was designed to examine the underlying factors responsible for, or influencing, the inability of the health care system to achieve the MMC targets in selected hospitals in KZN. The objective of this study to was explore the challenges that lead to failure of the government to meet set targets, regarding the implementation of the MMC programme in the province of KZN, as perceived by the health care workers. Methodology A mixed quantitative and qualitative study where 150 questionnaires were used and in-depth open-ended interviews were conducted. Participants were from Clairwood and Wentworth hospitals in the district of eThekwini, KwaZulu-Natal. Eighteen healthcare workers (nurse managers, doctors, nurses and counsellors) were purposively selected from the two hospitals. Results Findings showed that poor marketing of MMC, in line with the cultural and religious inclination of the catchment populations, had an effect on the targets. The fear of pain by the male clients came out as the biggest factor followed by the fear of having an HIV test done. The six weeks healing period before indulgence in sexual intercourse had a part to play in the reluctance of clients to do MMC. Some clients feared losing the ability to have an erection post MMC and would therefore not come for MMC. Other contributory factors for failure to reach targets included shortage of staff, poor mobilisation by the staff due to lack of training on how to mobilise and how to market MMC, lack of availability of mobilisation and marketing resources, inadequate and inequitable allocated of resources. Other factors include, lack of incentives for staff to stay in the programme or even within the Department, lack of training, cultural and religious beliefs in the community. The staff also felt that the MMC targets were too high. Notwithstanding, the staff members were willing to learn how to market MMC and to mobilise clients. Clients and community education on the importance of MMC and the combination of this process with good sexual behaviour would improve MMC uptake and reduce HIV prevalence and the incidence. Conclusions The fear of pain, fear to do HIV test and the fear to loose erection were the most prominent reasons why the males would not come for MMC procedure. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2022
- Full Text:
- Date Issued: 2022-03
The contribution of efficient financial management on public health service delivery at King Cetshwayo District in KwaZulu Natal
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
- Authors: Msane, Sihlesabambo Londiwe
- Date: 2022-03
- Subjects: Public health -- Finance
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21882 , vital:51839
- Description: The aim of this research is to develop strategies that the DOH could put into place to improve its internal controls in financial management in order to contribute towards service delivery at Ngwelezane, Queen Nandi and Eshowe hospitals within King Cetshwayo District. The study used a mix of qualitative and quantitative study methods, however using one research instrument to collect both qualitative and quantitative data from 37 financial managers in these three hospitals. Data analysis using content analysis (of qualitative data) and percentage frequency analysis (of quantitative date) yielded study findings. This study found that financial managers are fairly competent regarding ‘effective communication’, ‘team work’, and ‘financial leadership’; the study results did not show respondents’ clear comprehension of Auditor General findings and processes followed to implement the recommendations in order to assess internal controls; and findings also indicate that financial managers meet objectives of financial management through cash flow, budget forecasts and expenditure. Developing a framework that will guide and monitor the application of financial strategies with the aim of improving service delivery will involve enhancing financial managers’ knowledge of District and Institution Service Delivery Plans, allocating resources properly and efficiently during the budgeting exercise, establishing internal strategies to maximise accountability and transparency, having fraud prevention strategies in these institution, and putting measures in place to be able to forecast budgetary adverse. It is recommended that the Executive Management facilitates strategic break-away sessions for the financial managers to workshop them on practical ways to improve the efficiency of financial management on public health service delivery, as outlined in this study. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-03
Causes of high staff-turnover amongst professional nurses at selected health facilities in Kwazulu-Natal Province
- Mabaso, Sindisiwe Carol Catherine
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
- Authors: Mabaso, Sindisiwe Carol Catherine
- Date: 2022-02
- Subjects: Primary health care -- South Africa -- KwaZulu-Natal , Labor turnover -- South Africa -- KwaZulu-Natal
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21838 , vital:51822
- Description: BACKGROUND: Staff turnover, defined as the total separations from employment, is expensive, can result in lost capacity, and can limit local health departments’ ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in local health departments. This study sought to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province and to identify corrective measures. Professional nurses are a critical staff category in any health organisation and make up the backbone of health care system. It is thus vital to ensure that this category is retained for the benefit of health services and its ultimate beneficiary, the patient. Furthermore, Personnel and Salaries System (PERSAL) statistics have shown that the hospitals selected for this study viz., Nkandla Local Municipality (LM) has more that two times (28%) the turnover rates (TORs) for PNs when compared to the district target of 11%, thus the decision to conduct this study at this particular municipality. METHODOLOGY: This research adopted a mixed methods retrospective study where both quantitative and qualitative approach was used to analyse data. The primary data source was the Exit Interview forms completed when a staff member resigns. It consists of three sections viz., section one contained demographics of each respondent with variables such as name PERSAL number, gender, rank, appointment and termination dates; section two contained closed ended statements on potential causes of termination where the respondent answered yes or no to statements such as offered senior position; and section three which was mostly qualitative information where respondents stated own additional views and comments regarding other causes of termination and recommended solutions. Both sections one and two were analysed using quantitative analysis while section three was analysed using qualitative analysis. Qualitative data from comments sections of the exit interview forms was thematically presented and analysed. These results were grouped into five themes namely; Career Progression, Management, Unacceptable or Poor Conditions of Service, Remuneration and Personal Issues. These previously completed exit interview forms were manually analysed in order to determine the causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province, during the period 2015-2016. Exit interview forms, previously completed by professional nurses for the period 2015 to 2016, were collected from both Nkandla LM district hospitals namely Ekombe and Nkandla. A self-designed spread sheet was used to collate the quantitative data from the exit interview forms which contained personal and demographic data (names, gender, PERSAL numbers, appointment and termination dates, rank, etc.), type of exit, and causes of exit, comments and proposed changes, following which it was manually analysed. RESULTS: A total of 54 participants completed the exit interview forms and selected the causes of service termination which were relevant to them. Ekombe Hospital participants were twelve (12) and Nkandla Hospital participants were forty two (42). Not all professional nurses who exited the service during the study period completed the exit interview form. The exit interview form completion rate was 78% (54/69). Twenty-four percent (13/54) of participants did not complete the exit interview form in full. The quantitative analysis revealed that the gender distribution of participants was mostly female, making 80% (43/54). The majority of participants, 30% (16/54), had 21-25 years’ service prior to exiting. On qualitative data analysis, the majority of participants selected unacceptable or poor conditions of service as the cause of service termination 65% (35/54) participants. This trend was also similar when each hospital participants’ selections were examined. In Ekombe Hospital 83% (10/12) participants’ selected unacceptable or poor conditions of service as the cause of service termination and in Nkandla Hospital this was 60% (25/42) participants. The majority of participants, 78% (42/54), stated that they still intended to re-join the department, and most were seeking employment in the public service. Furthermore, 70% (38/54), of the participants stated they would have stayed had their expectations been met. Further examination of themes and sub-themes derived from the qualitative data of the exit interview forms, the majority of comments, (20 comments), were related to Unacceptable or Poor Conditions of Service as the cause of termination. Sub themes analysis further identified resource shortages as the most common comments related to this determination. CONCLUSION: The leading causes of high staff-turnover amongst professional nurses at selected health facilities in KwaZulu-Natal province was determined to be unacceptable or poor conditions of service. On thematic analysis of qualitative data that emerged from the exit interview forms, the key areas that contributed to this determination included mainly resource constraints issues such as shortage of staff, shortage of equipment, shortage of funds, as well as poor infrastructure. Recommendations for staff retention and improvements in service conditions have been proposed. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-02
Factors associated with infant mortality in Sarah Baartman District, Eastern Cape Province, South Africa
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2022-02
- Authors: Muavha, Mukondeleli Selina
- Date: 2022-02
- Subjects: Infants--Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22067 , vital:51980
- Description: This study aimed to investigate the factors associated with infant mortality in Sarah Baartman District hospitals. A quantitative descriptive case-control design was used to investigate and describe the association between maternal socio-demographic, infant, environmental factors, and infant mortality. A data abstraction instrument was used to identify cases and their controls, and to retrieve information related to antenatal and obstetric care for the mothers of both cases and controls, as well as some information related to perinatal care for both mother and infant, from the registers in the district hospitals in Sarah Baartman district for the financial years 2015/2016 to 2017/2018. This was followed by structured questionnaires which were hand-delivered, to the mothers of the cases and controls. This study showed that seven maternal socio-demographic factors (educational level, mother’s source of income, religion, where mother took sick child to, frequency of visits by a health care worker within the last one year, number of alive siblings, and history of intrauterine death) were significantly related to infant mortality among the study participants. Among the environmental factors, the type of house, availability of tap and type of toilet were significantly related to infant mortality among the study participants. The study recommends public policies concerning maternal health through targeting mothers for food supplementation and prenatal care to reduce infant mortality rates. Infant mortality in the study area can also be reduced by improving mother’s education because women’s education has spill over effects on fertility and maternal health care behaviour. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2022-02
Factors influencing the performance of staff members in a tertiary hospital
- Combrink, Cornelius Johannes
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-12
- Authors: Combrink, Cornelius Johannes
- Date: 2021-12
- Subjects: Community health services
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21642 , vital:51737
- Description: Healthcare services within a hospital setting are the basic aspects for the success of service delivery and staff performance in this regard. The paramount component of human resources makes a positive contribution to a healthcare system. Recently, it has been recognised that the performance of healthcare personnel ought to be a key factor for a sustainable performance system. Nevertheless, it is generally known that healthcare workers fail to accomplish the anticipated outcomes of health interventions. This concept leads to the research question: Why is the public sector known for poor service delivery and poor performance? This study aims to determine the factors that impact on the health worker’s performance in a tertiary hospital in South-Africa. A framework will be carefully constructed and cautiously implemented to improve and develop the performance of healthcare workers in this hospital. The vast scope and population involved in this study make a quantitative research approach most suitable, along with a non-probability purposive sampling method. A survey method using an electronic questionnaire that was circulated via a web survey, and a paper-based questionnaire that was distributed within the hospital were used to obtain a diverse perception of the healthcare workers. Data analysis included determining factors, group differences and correlations using the SPSS-27 program. The target population included all healthcare workers in the tertiary hospital – from junior employees to senior management level staff. Statistical data analysis collected for this study revealed four major factors (politics-related resources, resource, training and socioeconomic) that play a major role in the trends of performance culture at the selected tertiary hospital. These results lead to the understanding that the hospital is currently experiencing inadequate human resources management components such as recognition of employees who perform above expectations; execution of a performance appraisal system; lack in implementing the annual salary increase; unfavourable working conditions (lack of resources); troublesome management skills, and insufficient feedback on performance outcomes. These features are directly associated with the quality and degree of the performance of healthcare personnel. Based on the results, a management framework was proposed. The framework consists of activities that will improve the healthcare profession; strengthen expertise and knowledge; develop management skills; enhance knowledge through research and, ultimately, upgrade the performance of healthcare personnel. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-12
Assessment of compliance to the maintenance procedure of medical equipment in a selected hospital, Oliver Reginald Tambo District, Eastern Cape Province
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Mbangata, Mzuyanda
- Date: 2021-11
- Subjects: Equipment health monitoring , Maintenance--Equipment and supplies
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21871 , vital:51838
- Description: Background Medical equipment assumes a major part in diagnosis, prevention and treatment of diseases as well as illness and rehabilitation of patients. The maintenance of medical equipment is one of the most vital components in quality health care service delivery and it should not be ignored in the hospital. Therefore, it is critical that medical equipment must be maintained, and be in good working condition to ensure it completes its life cycle, also to prevent possible injuries to the patients and clinicians/end-users. Proper maintenance of medical equipment needs compliance with the manufacturer’s recommendations. Inappropriate maintenance of medical equipment leads to medical equipment malfunctioning, decreases the level of medical equipment performance, and wastes money and other resources. The equipment downtime makes health care services not accessible to patients. Maintenance includes the following activities, medical equipment acceptance, preventive maintenance, inspection, calibration and repair following the manufacturer’s recommendations. Aim of the study The purpose of the study was to assess compliance to the maintenance procedures of medical equipment in a selected hospital in Oliver Reginald Tambo District, Eastern Cape Province. Methodology A qualitative descriptive design was used to access information regarding compliance with the maintenance of medical equipment in a selected hospital, in Oliver Reginald Tambo District, Eastern Cape. The compliance was accessed at the selected hospital that has eight departments. The research objectives gave a framework for how the research was to be conducted. The data was collected through semi-structured interviews until data saturation. An open coding Tesch’s qualitative method was used for data analysis. A purposive sampling technique was used to select participants who were knowledgeable and responsible for management of medical equipment maintenance. The participants were experienced clinicians and technicians answerable for medical equipment maintenance and management. The researcher adhered to ethical and trustworthiness principles. Findings The following themes and their related categories emerged as compliance procedures adhered to/applied: i) Determinants of applied procedures; ii) Compliance with maintenance that is facilitate frequent checks, daily regular testing of equipment; iii) Report faulty equipment; iv) Send equipment for repairs; v) Do follow up on repairs; and vi) Keep machines working all the time. Contributory factors to non-compliance included: Unavailability of funds; technical staff shortage; lack of technical training; non-compliance in performance of quality checks; lack of training of end users; lack of set of maintenance plans; and long procurement process. Complications aligned with non-compliance: Inappropriate referral patients; inaccessibility of health care services; and misdiagnosing patients. Recommendations The strengthening of clinical engineering department with human resources (technical staff), finance (funds for spare parts) and physical resources (workspace, testing equipment and tools, service manuals etc.) Prioritise medical equipment maintenance also improvement of maintenance budget allocation and utilization. Provision of training for end users and technical staff. Establishment and implementation of maintenance plan and improvement of procurement processes. Conclusion The selected hospital is partially compliant with the maintenance of medical equipment because the hospital performs only reactive maintenance. It evidently appeared that affected service delivery is initiated by the shortage of technical staff and equipment availability and reliability. The hospital needs to focus and improve on the above mentioned factors affecting medical equipment maintenance. The results showed that improper maintenance of medical equipment contributes to the overcrowding of tertiary hospitals through unnecessary referrals due to medical equipment malfunctioning. The study contributes to improving the maintenance management of medical equipment. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Knowledge, attitudes, and practices of the treatment options for dental caries among the adult patients for dental caries in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Veleekizhakethil, Legy
- Date: 2021-11
- Subjects: Dental caries , Periodontics
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22968 , vital:53257
- Description: Dentistry offers several caries-preventive measures, some of which emphasise not only patient’s responsibility to manage their disease, but also how dental professionals should manage it. Consequently, this study aimed to examine the knowledge, attitudes, and practices of adult patients towards treatment options relating to dental caries in the geographical context of Buffalo City Metropolitan Municipality, situated in the Eastern Cape Province of South Africa. Purpose Firstly, this quantitative study set out to assess the existing oral health knowledge, attitudes, and practices among an adult population visiting dental health facilities in Buffalo City Metropolitan Municipality, in East London, Eastern Cape, South Africa. Secondly, it aimed to examine the prevalence of dental caries, periodontal diseases and tooth associated diseases in this specific setting. Furthermore, the study sought to provide baseline data in order to organise a successful dental prevention programme. The data obtained will determine the layout of policies to be put forward to the Department of Health. Methodology The researcher took a quantitative approach and conducted descriptive surveys from November 2019 to March 2020. A close-ended, structured questionnaire for data collection was designed based on the aspects of knowledge, attitudes, practices and behaviour pertaining to the area of dental caries. A clinical examination of dental status was performed using dental probes, dental mirrors and tooth air-drying. All decay, and missing, filled or restored teeth due to dental caries, along with the presence of calculus, gingival, and periodontal lesions were recorded. Results Participants had an average knowledge score of 80percent with a 95percent confidence interval of (76percent; 84percent). The majority knew the importance of cleaning their teeth (88.9percent), were aware of the effects of sugary diets (80.7percent), avoided sugary foods (64.6percent), and lastly were aware of the causes of dental caries (71.3percent). However it is concerning that most had never visited a dentist, as reflected by 69.1percent of participants agreeing or strongly agreeing. At least 70percent of those who responded were satisfied with their dentists in that they ( the dentists) freely share ideas and opinions and provide advice on options for dental care. The study revealed a high prevalence of dental caries with a ratio of 6.23. Conclusions The majority of the participants affirmed the importance of visiting the dentist for a routine dental examination. In addition, the majority are aware that sugary diets are associated with dental caries. However, there is a high prevalence of dental caries among participants in this setting. Therefore, dentists should provide preventive measures, along with professional restorative and plaque removal, to curb the burden of dental caries and periodontal diseases. The type and extent of preventive measures must be adjusted according to the patient’s individual needs. Dental health professionals must collaborate with other health-care providers to promote preventive dental health. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Low uptake and early removal of Implanon NXT among women of reproductive age in Limpopo
- Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Magomani, Nandu Victoria https://orcid.org/ 0000-0001-5473-9984
- Date: 2021-11
- Subjects: Contraceptive drug implants
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21849 , vital:51829
- Description: Implanon NXT also referred to as subdermal Implant, is a long-acting subdermal contraceptive method available in the South African public health care system since 2014. The implant was introduced to broaden the choice for women of childbearing age to delay or prevent unwanted pregnancies. Following a surge in popularity, reports of early removals and frequent adverse effects led to a significant decrease in its uptake in the country. Insufficient knowledge on Implanon, poor management of side effects, poor counseling by health care workers, and lack of partner support were the main themes that were picked from the interview, influencing uptake or early removals of the Implanon. The major concerning side effect reported was uncontrolled and irregular heavy bleeding The purpose of the study was to explore the factors associated with low uptake and early removals of Implanon NXT among women of reproductive age in one district in Limpopo province. A qualitative research design was used, primarily as exploratory and descriptive in nature. Participants were identified using non-probable, purposeful voluntary sampling. Data collection was achieved using open-ended structured interviews with sixteen (16) women aged from18-49. Data was analysed using thematic method of organizing data into categories, followed by coding and sorting the data to identify patterns and interpret the meanings and responses. An independent consultant was involved to confirm the thematic areas identified after which consensus discussions took place to finalize the analysed data. From the results, it appeared that there was a need that Implanon should be marketed by use of digital platforms and print media for information sharing. These platforms should be utilized by DOH from the National, provincial, district, facility and community levels. There should be clear protocol on how to manage different kinds of side effects, and this information should be rolled out to the implementation level. Health Care workers should provide client education and counselling services to the clients about the effectiveness of the method. Male partner involvement is crucial to provide support for women on contraceptives and to support their contraceptive choices. Mentorship will help providers to attain their proficiency in Implanon counselling, insertions, and removals. Lastly, availing adequate and effective youth-friendly services to enable young people to open up more about challenges and options that can be explored. For the adolescents and youth, these services should be provided by trained providers not at the general unit, where there is a mixture of adult population and the elderly, but at youth zones to enhance the uptake of Implanon NXT. Recommendations are for clinical practice area, for generic student education as well as for further research. The conclusions confirm that the government need to revitalise the Implanon program, to drive the uptake and reduce early removals. Training of health workers and mentorship should emphasize more comprehensive counselling, provide adequate information on what is to be expected and more importantly, how to treat and manage the side effects. That early removals due to side effects become the last option as information need to be widely available to all users utilising the traditional methods and modern methods such as digital platforms to spread the correct information and create demand for the Implanon. The functional service-provision-based youth-friendly services which will cater for the needs of young women and adolescents is highlighted as it provides a comfortable and conducive environment to provide and receive a comprehensive sexual reproductive health and rights services. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Retrospective analysis of factors contributing to parasuicide among youth in Buffalo City Metropolitan Municipality, Eastern Cape, South Africa
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
- Authors: Nganto, Yanga
- Date: 2021-11
- Subjects: Parasuicide -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22897 , vital:53181
- Description: Parasuicide is a problem that affects the youth locally and globally. Parasuicide has negative psychological impacts on youth. This study was designed to assess elements of parasuicide in the Buffalo City Metropolitan Municipality of South Africa, using records of patients admitted to Frere and Cecilia Makiwane hospitals between 2016 and 2020. The purpose of the study was to conduct a descriptive retrospective review of parasuicide among youth to determine trends, causes, and contributing factors of committing parasuicide. Methods A retrospective, quantitative and descriptive study was conducted with 200 files of patients aged between 18 and 35 years conveniently sampled. These patients diagnosed as committed parasuicide and were admitted at Frere and Cecilia Makiwane hospitals over a period of four years from 1 April 2016 to 31 March 202. Only record files of patients’ residing in East London and Mdantsane catchment area were selected. Raw data was collected for a period of twelve weeks using a developed data collection tool developed in Ms Excel spreadsheet. Results In this sample, the large number of the patients were under 26 years (60.5%), female (57%), single (92.5%), and Black (99.5%). Furthermore, majority of the patients had attained secondary education (89.5%), were unemployed (83%) and living with their families (59%). There were different methods and agents used by participants to commit parasuicide and reasons differed from person to person. Among patients who reported a suicide attempt, organophosphates were most commonly used agent for self-poisoning (47%, n=94), followed by substances such as use of drugs and alcohol (n=57, 28.5%), violence (n=27, 13.5%), corrosive agents including bleach and Jik (n=11, 5.5%), and hydrogen peroxide including acidic sub-stances like battery acid (n=11, 5.5%). The common reason found in the study and indicates participants had psychiatric disorder (34.5%). Conclusion Limiting access to organophosphate agents and other lethal means is an effective strategy that should be adopted to prevent parasuicide among youth. Timely identification of risks or warning signs, social prevention and immediate intervention at the state level will play an important role in controlling parasuicide among youth. Moreover, improving health care services with psychotherapy support would empower youth with skills that would enhance their self-confidence, self-worth and resilience. Consequently, attainment of these attributes would result in the prevention and control of parasuicide amongst youth. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-11
Barriers to participation in sports among urban adolescents at an International School in Cape Town, South Africa
- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
- Authors: Klaasen, Robyn Jade
- Date: 2021-10
- Subjects: Urban teenagers -- Sports , Sports administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22155 , vital:51991
- Description: The benefits of participating in sport have been well documented and great emphasis has been placed on the role that it plays in the development of character and social skills, apart from physical and psychological benefits. Sport represents an optimal means of enabling children and adolescents to meet their daily requirements for physical activity to maintain health. Conversely, despite all of the widely acknowledged benefits, participation in sport among children and adolescents continues to decline throughout the world. Although a great deal of research has been conducted to identify barriers to participation in sport, most of it has concerned poor, rural, disadvantaged, or other marginalised groups. As a consequence, a large proportion of the research has attributed low rates of participation in sport to practical barriers, which usually take the forms of either logistical problems or a lack of resources. The aim of this study was to identify the barriers to participation in sport among adolescents in an affluent, urban setting, at an international school in Cape Town, South Africa. The Barriers to Sport Participation Questionnaire was used to identify the social, personal, and practical barriers that affected 107 adolescents who were enrolled in the school. The data was analysed by means of the SPSS (IBM, Version 27) software package and seven significant barriers were identified. Fear of academic failure, environmental constraints, and lack of interest were identified as the primary barriers, thereby emphasising the significant influence of personal barriers, rather than practical ones. It was also found that the influence of particular barriers was greater on females than their male counterparts and that the respondents who either did not participate in sport themselves or were from households in which other members did not do so were more adversely affected by some barriers than the others. Significant correlations were found between some grades and certain barriers, the most notable being those between respondents in Grades 7, 9, and 10 and the fear of academic failure barrier. In light of these findings, it could be concluded that the global decline in participation in sport among the youth is a complex problem and that particular barriers, which might not have been identified in previous research, could be particularly influential in affluent environments. As it is evident that as barriers can be specific to particular groups and settings, the optimal means of overcoming them is unlikely to be found through the adoption of a one-size-fitsall approach. Instead, further research and customised interventions are required. , Thesis (HMS) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
Knowledge, Attitudes and Perceptions Towards HIV Testing Among IsiXhosa-Speaking Men in The Zithulele Catchment Area of The Rural Eastern Cape Province, South Africa
- Authors: Scotcher, Philippa Claire
- Date: 2021-10
- Subjects: HIV infections
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6842 , vital:51017
- Description: BACKGROUND South Africa carries the largest burden of Human Immunodeficiency Virus (HIV) in the world, with over 7.9 million people infected and over 70 000 HIV-related deaths in 2019. Men are 25% more likely to die from Acquired Immune Deficiency Syndrome (AIDS) compared to women, even though women are more likely to be infected. Despite these numbers, only 24.1% of HIV-positive men compared to 64.8% of HIV-positive women were aware of their status. Statistics indicate that men in South Africa are not testing for HIV until it is too late. In order to focus efforts on the prevention of HIV transmission, there is a need to understand why men are not accessing HIV testing and treatment services earlier. This study aims to explore the knowledge, attitudes, and perceptions towards HIV testing of isiXhosa-speaking men in the Zithulele catchment area of the rural Eastern Cape. METHODS This was a qualitative study using the phenomenological approach. It was conducted among a purposive sample of isiXhosa-speaking men from the Zithulele catchment area, in the OR Tambo district of the Eastern Cape Province. Ten semi-structured interviews and one focus group were conducted in isiXhosa. Interviews were audiorecorded, transcribed, and translated into English. The interviews were thematically analysed using an inductive approach. RESULTS Participants from the study had a good understanding of HIV and HIV transmission. They perceived HIV infection as a death sentence, a consequence of immoral behaviour and an indication of failure as man. Reluctance to test for HIV was due to the perception that testing hastens the onset of symptoms and death, whereas disclosure of an HIV-positive status was described as difficult due to the fear of stigmatization. Some of the barriers to accessing HIV testing services included masculine norms, the belief that sickness is equated with weakness, a perceived lack of confidentiality at health facilities and how female-dominated clinics were not male-friendly spaces. Suggestions to improve HIV testing among men included improving targeted education, home-based testing services and utilizing traditional meetings to address men. CONCLUSION The findings of this study may suggest that healthy men in the Zithulele catchment area of the rural Eastern Cape are not accessing HIV testing and treatment services. The reasons behind this reluctance include false beliefs around HIV and testing, the fear of discrimination, disruption of masculine norms and reluctance to access care at female-dominated health facilities. Further research is needed to explore ways to reach, educate and encourage men to test earlier for HIV. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
- Authors: Scotcher, Philippa Claire
- Date: 2021-10
- Subjects: HIV infections
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/6842 , vital:51017
- Description: BACKGROUND South Africa carries the largest burden of Human Immunodeficiency Virus (HIV) in the world, with over 7.9 million people infected and over 70 000 HIV-related deaths in 2019. Men are 25% more likely to die from Acquired Immune Deficiency Syndrome (AIDS) compared to women, even though women are more likely to be infected. Despite these numbers, only 24.1% of HIV-positive men compared to 64.8% of HIV-positive women were aware of their status. Statistics indicate that men in South Africa are not testing for HIV until it is too late. In order to focus efforts on the prevention of HIV transmission, there is a need to understand why men are not accessing HIV testing and treatment services earlier. This study aims to explore the knowledge, attitudes, and perceptions towards HIV testing of isiXhosa-speaking men in the Zithulele catchment area of the rural Eastern Cape. METHODS This was a qualitative study using the phenomenological approach. It was conducted among a purposive sample of isiXhosa-speaking men from the Zithulele catchment area, in the OR Tambo district of the Eastern Cape Province. Ten semi-structured interviews and one focus group were conducted in isiXhosa. Interviews were audiorecorded, transcribed, and translated into English. The interviews were thematically analysed using an inductive approach. RESULTS Participants from the study had a good understanding of HIV and HIV transmission. They perceived HIV infection as a death sentence, a consequence of immoral behaviour and an indication of failure as man. Reluctance to test for HIV was due to the perception that testing hastens the onset of symptoms and death, whereas disclosure of an HIV-positive status was described as difficult due to the fear of stigmatization. Some of the barriers to accessing HIV testing services included masculine norms, the belief that sickness is equated with weakness, a perceived lack of confidentiality at health facilities and how female-dominated clinics were not male-friendly spaces. Suggestions to improve HIV testing among men included improving targeted education, home-based testing services and utilizing traditional meetings to address men. CONCLUSION The findings of this study may suggest that healthy men in the Zithulele catchment area of the rural Eastern Cape are not accessing HIV testing and treatment services. The reasons behind this reluctance include false beliefs around HIV and testing, the fear of discrimination, disruption of masculine norms and reluctance to access care at female-dominated health facilities. Further research is needed to explore ways to reach, educate and encourage men to test earlier for HIV. , Thesis (Masters) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-10
Experiences of patients on short term drug resistant tuberculosis regimen at Nelson Mandela District TB Specialist Hospital
- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Sempe, Thabo Benedict
- Date: 2021-08
- Subjects: Multidrug-resistant tuberculosis
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22940 , vital:53224
- Description: The purpose of this research study was to explore and describe the experiences of patients on short-term drug resistant TB treatment in a TB specialist hospital situated in Nelson Mandela District. Patients on XDR-TB treatment face many challenges which include side effects which they find hard to tolerate and they end up stopping the treatment. Socio-economic difficulties of concern include delayed social assistance from the government to support their families, particularly when they are breadwinners. A qualitative, descriptive, explorative contextual design was used in this research study. A non-probability convenience sampling method was employed. The target population for this study consisted of those DR-TB patients who were on short-term regimen and semi-structured individual interviews were conducted. There were twelve participants who voluntary participated in the research study although the first interview was a pilot study. Ethical principles were adhered to throughout the study. A total of seven themes and twenty-seven sub-themes arose during the data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout this research. The research findings showed that the participants shared positive experiences in as far as being able to easily access the health care service. Most participants were moved through a range of emotions which included shock. They felt heartbroken about the devastation and the disruptive nature of this illness to themselves and their family lives and, more seriously, were fearful of the morbidity and mortality thoughts which pervaded their thoughts but their health improved when drug resistant TB treatment was initiated. Many of the participants found it easy to disclose to their friends as they knew they could count on their support at the best and worst of times in their treatment journey. In conclusion the participants provided suggestions regarding their support needs on the journey to recovery from DR-TB. The researcher provided certain recommendations as far as the challenges expressed by the participants and these will contribute to strengthening the DR-TB adherence strategies. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
Knowledge and attitudes of women regarding cervical cancer and papanicolau smear screening in Caleb Motshabi, Bloemfontein
- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Gwavu, Zintle
- Date: 2021-08
- Subjects: Cervix uteri -- Cancer -- South Africa , Pap test
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21816 , vital:51795
- Description: The aim of the study was to explore the knowledge and attitudes of women in Caleb Motshabi location regarding cervical cancer and Papanicolaou (Pap) smear screening in order for district management to develop a health education programme on cervical cancer and the benefits of screening. Cervical cancer amongst women worldwide has been identified as the fourth most common cancer. A qualitative descriptive explorative contextual design was employed in this research study. A non-probability purposive sampling method was used. Women between the ages of 18-60 years’ old who reside in Caleb Motshabi location were the target population. Four focus group interviews were conducted. The groups consisted of four to six participants grouped together to discuss the matter. Ethical principles were maintained as well as the concept of trustworthiness throughout this study. Data analysis was done using Tesch’s approach to open coding in qualitative research. A total of seven themes and eight sub-themes arose during the analysis of the data and were completely discussed. The findings suggest that the majority of the participants were aware of cervical cancer and Pap smear, but they lacked knowledge of what cervical cancer is or its causes. Although some of the participants had done a Pap smear in their lifetime, knowledge about how and the reasons the procedure is done still lacked. The majority of participants had received information about Pap smear procedure from peers rather than from health care workers. A significant finding was the fact that the participants who had done the procedure were open to attending regular screenings since they had experience on how it is performed. In conclusion It was recommended that educational programmes relating to cervical cancer and Pap smear screening be intensified in the area. This can be done through increasing awareness programmes in the communities and during clinic visits. To try and increase the uptake of the Pap smear screening it was also recommended that mobile clinics should be introduced to encourage women in the communities. , Thesis (MPH) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-08
Psychosocial impact of mental illness on family caregivers of mental healthcare users in Mangaung District
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-08
- Authors: Leburu, Maria
- Date: 2021-08
- Subjects: Home care services -- South Africa -- Mangaung -- Psychological aspects , Caregivers -- South Africa -- Mangaung
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21770 , vital:51750
- Description: The purpose of this research study was to describe the psychosocial impact of mental illness on family caregivers of mental health care users in Mangaung district in order to explore strategies to empower mental health care users and their families to understand and to cope with mental illness problem. A qualitative, descriptive explorative and contextu al design was employed. A nonprobability, purposive sampling method was used to select participants. The target population was family caregivers from Mangaung district, whose ages were 18 years and above who were caring for mentally ill patients in their homes or admitted to a psychiatric institution. . Five focus group interviews were conducted but the first one was a pilot study. Ethical principles were maintained throughout the study as well as the concepts of trustworthiness were applied. Tesch’s approach to open coding in qualitative research was applied during data analysis. A total of six themes and twentynine sub-themes arose during data analysis and were fully discussed. Confidentiality and anonymity was ensured throughout the study. The findings suggested that most of the participants suffered psychosocial problems like stress, depression, stigma and financial constraints, although one participant indicated that she has accepted her situation of caregiving. In conclusion participants suggested that support groups should be established and awareness programmes should be put in place for community members to avoid stigmatising and laughing at caregivers, care users and family members. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-08
The implementation of National Core Standards with specific reference to clinical leadership: A case of Frere Hospital
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-06
- Authors: Rasi, Wandisa
- Date: 2021-06
- Subjects: Health facilities -- Standards , Health services administration -- Standards
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/21914 , vital:51842
- Description: BACKGROUND: Generally, many people in South Africa have difficulty accessing quality health services due to poor public service. Over 42 million citizens do not have health insurance and are growing sicker as they age. Health facilities, such as public health centers, are their only recourse. Health authorities in South Africa fail to monitor patient care effectively, as evidenced by their uninspiring record on patient experience. Anecdotes of poor patient experiences are extensive with the health ombudsman. The Office of Health Standards Compliance (OHSC) reports horrifying stories of patients sleeping on hospital floors due to the shortage of beds, patients unable to receive critical surgical treatment due to shortage of doctors, medical supplies and equipment failure or lack thereof. A few union protests have highlighted the poor quality of public healthcare. But it is not uncommon for South Africans to voice their displeasure over poor public healthcare. Health services are individualised and there is no specific interest group or community that is affected by this overall unpleasant experience. Indications of the growing public campaign against the deteriorating healthcare system may be as simple as the increasing number of medical legal claims. This study focuses on the implementation of national core standards with specific reference to clinical leadership. This study focuses on the implementation of national core standards with specific reference to clinical leadership. RESEARCH AIM: This research seeks to explore the effectiveness of the implementation of NCSs with specific reference to Clinical Leadership in Frere Hospital. It also wants to assess if the Frere hospital upholds the national core standards METHOD: qualitative research design was used in this study. Semi-structured, individual interviews were conducted. CONCLUSION: The researcher concluded that it is quite evident that the public health sector is complex and that environmental influence affect the ECDOH Functions within the health system. There is a relationship between clinical leadership and service delivery; now, to improve service delivery within the Frere hospital, strong leadership is needed to drive the change towards implementing the NCS. Ultimately, Frere hospital does not uphold the NCSs, and the staff needs to be educated on what is and how it can improve the hospital’s service delivery. RECOMMENDATIONS: Effective public leadership development, high performing and accountable leadership behavioural measurement at the most senior level at the Frere hospital is very empirical in driving effective delivery of services to patients. Effective Performance management, visible leadership role at all management levels. Performance appraisal system needs to be engineered to focus on performance and results. Recognition and Implementation of clinical leadership. Establish a culture and implementation of good governance principles in health institutions. Establish an institution based OHSC office that is visible and implement NCS through Batho Pele Principles. , Thesis (MPH) -- Faculty of Health Sciences, Public Health, 2021
- Full Text:
- Date Issued: 2021-06
A best practice guideline for the management of the quality of objective structured clinical examinations at a multi-campus public college of nursing
- Authors: Nyangeni, Thandolwakhe
- Date: 2021-04
- Subjects: Nursing assessment-- Management , Clinical Competence -- Management
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51466 , vital:43281
- Description: An Objective Structured Clinical Examination (OSCE) is a robust method of clinical assessment which, when properly planned and executed, results in a high quality and credible student assessment. However, concerns regarding its uniformity, fairness, objectivity and accuracy have been raised. Concerns regarding the management of the quality of OSCEs at a public College of Nursing in the Eastern Cape were raised by the College’s stakeholders. No best practice guideline had been developed regarding the management of the quality of OSCEs for this College. The aim of this study was therefore to develop a best practice guideline for the management of the quality of OSCEs at a public College of Nursing. The Transformative Pedagogy Theory proposed by Khedkar and Nair was used as a philosophical underpinning for this study. The Joanna Briggs Institute (JBI) model for evidence-based healthcare was used as a theoretical basis for this study. In Phase One, a qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of nurse educators regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. Semi-structured individual interviews were used to collect data from fourteen (n=14) nurse educators. Thereafter, a qualitative document analysis of fifteen (n=15) external moderators’ reports was conducted to explore the information external moderators shared regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. A document analysis checklist designed by the researcher was used to extract the data from external moderators’ reports. Tesch’s method of data analysis was utilised to analyse the data from the interviews while the data analysis process proposed by Dalglish, Khalid and McMahon was used to analyse the data from the external moderator’s reports. In Phase Two, an integrative literature review was conducted to search, select, extract, appraise and synthesise best practices regarding the management of the quality of OSCEs in health sciences education. The adapted integrative literature review steps, as proposed by de Souza, da Silva and de Carvalho, were utilised to guide this phase. Data of a total of thirteen (n=13) articles were extracted and synthesised. In Phase Three, the findings of Phase One and Phase Two were synthesised, as a basis for informing the development of a best practice guideline for the management of the quality of OSCEs. The National Institute for Health and Care (NICE) and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) frameworks were used as a basis for developing the best practice guideline for the management of the quality of OSCEs at a multi-campus public College of Nursing. The draft best practice guideline was reviewed by eight (n=8) expert reviewers who were experienced in conducting OSCE’s and best practice guideline development. Lincoln and Guba’s principles—namely credibility, transferability, dependability and confirmability were applied to ensure the trustworthiness of the interview data. Wesley’s criteria- namely triangulation, thick description and audit trail were used to ensure the trustworthiness of the document analysis. The principles as stipulated in the Belmont Report were applied in order to ensure the ethical soundness of this study. Findings of the interviews and the document analysis in Phase One revealed that, while there are measures currently in place to facilitate quality in the management of OSCEs in this College of Nursing, there are gaps such as uncertainty in the assessment practices being used and resource constraints that hinder the overall quality of OSCEs. The participants indicated the need for the development of a best practice guideline for the management of the quality of OSCEs at this College. Findings from the integrative literature review in Phase Two revealed three themes, namely: apply quality measures in the preparation and planning phase of OSCEs; apply quality measures in the implementation phase of OSCEs; and apply quality measures in the evaluation phase of OSCEs. For Phase Three, the developed best practice guideline included three recommendations regarding the quality measures that should be applied in each of the three phases of OSCEs. It is recommended for the developed best practice guideline to be further refined, piloted and implemented to be used by nurse educators and other relevant stakeholders Once implemented, the guideline is expected to enhance the management of the quality of OSCEs at the multi-campus College of Nursing and, ultimately, nursing and patient outcomes through quality nursing education and assessment. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Nyangeni, Thandolwakhe
- Date: 2021-04
- Subjects: Nursing assessment-- Management , Clinical Competence -- Management
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10948/51466 , vital:43281
- Description: An Objective Structured Clinical Examination (OSCE) is a robust method of clinical assessment which, when properly planned and executed, results in a high quality and credible student assessment. However, concerns regarding its uniformity, fairness, objectivity and accuracy have been raised. Concerns regarding the management of the quality of OSCEs at a public College of Nursing in the Eastern Cape were raised by the College’s stakeholders. No best practice guideline had been developed regarding the management of the quality of OSCEs for this College. The aim of this study was therefore to develop a best practice guideline for the management of the quality of OSCEs at a public College of Nursing. The Transformative Pedagogy Theory proposed by Khedkar and Nair was used as a philosophical underpinning for this study. The Joanna Briggs Institute (JBI) model for evidence-based healthcare was used as a theoretical basis for this study. In Phase One, a qualitative, explorative, descriptive and contextual design was used to explore and describe the experiences of nurse educators regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. Semi-structured individual interviews were used to collect data from fourteen (n=14) nurse educators. Thereafter, a qualitative document analysis of fifteen (n=15) external moderators’ reports was conducted to explore the information external moderators shared regarding the management of the quality of OSCEs at a multi-campus public College of Nursing. A document analysis checklist designed by the researcher was used to extract the data from external moderators’ reports. Tesch’s method of data analysis was utilised to analyse the data from the interviews while the data analysis process proposed by Dalglish, Khalid and McMahon was used to analyse the data from the external moderator’s reports. In Phase Two, an integrative literature review was conducted to search, select, extract, appraise and synthesise best practices regarding the management of the quality of OSCEs in health sciences education. The adapted integrative literature review steps, as proposed by de Souza, da Silva and de Carvalho, were utilised to guide this phase. Data of a total of thirteen (n=13) articles were extracted and synthesised. In Phase Three, the findings of Phase One and Phase Two were synthesised, as a basis for informing the development of a best practice guideline for the management of the quality of OSCEs. The National Institute for Health and Care (NICE) and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) frameworks were used as a basis for developing the best practice guideline for the management of the quality of OSCEs at a multi-campus public College of Nursing. The draft best practice guideline was reviewed by eight (n=8) expert reviewers who were experienced in conducting OSCE’s and best practice guideline development. Lincoln and Guba’s principles—namely credibility, transferability, dependability and confirmability were applied to ensure the trustworthiness of the interview data. Wesley’s criteria- namely triangulation, thick description and audit trail were used to ensure the trustworthiness of the document analysis. The principles as stipulated in the Belmont Report were applied in order to ensure the ethical soundness of this study. Findings of the interviews and the document analysis in Phase One revealed that, while there are measures currently in place to facilitate quality in the management of OSCEs in this College of Nursing, there are gaps such as uncertainty in the assessment practices being used and resource constraints that hinder the overall quality of OSCEs. The participants indicated the need for the development of a best practice guideline for the management of the quality of OSCEs at this College. Findings from the integrative literature review in Phase Two revealed three themes, namely: apply quality measures in the preparation and planning phase of OSCEs; apply quality measures in the implementation phase of OSCEs; and apply quality measures in the evaluation phase of OSCEs. For Phase Three, the developed best practice guideline included three recommendations regarding the quality measures that should be applied in each of the three phases of OSCEs. It is recommended for the developed best practice guideline to be further refined, piloted and implemented to be used by nurse educators and other relevant stakeholders Once implemented, the guideline is expected to enhance the management of the quality of OSCEs at the multi-campus College of Nursing and, ultimately, nursing and patient outcomes through quality nursing education and assessment. , Thesis (PhD) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
A case study of Jeffrey Dahmer
- Authors: Freeman, Chanté F
- Date: 2021-04
- Subjects: Serial murders -- Case studies , Personality development -- Psychological aspects
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51032 , vital:43202
- Description: Jeffrey Lionel Dahmer is an infamous serial killer and cannibal. He was described as a normal, but shy little boy, yet developed into an adult who brutally murdered, engaged in necrophiliac acts, dismembered and ate parts of his victims. This study took the form of an intrinsic case study with the aim to explore and describe the personality development of Jeffrey Dahmer. This exploration examined Dahmer’s known childhood experiences through the theoretical perspective of Otto Kernberg’s (1974, 1975, 1976) Object Relations Theory, in order to understand how Dahmer’s personality was formed. Data was collected from multiple resources, including books, authoritative biographies, academic articles, and internet sources available in the public domain. It was analysed using Miles, Huberman, and Saldaña’s (2014) three-step process namely, data condensation, data display, and conclusion drawing and verification. This study’s findings confirmed the formation of pathological behavioural patterns supported by primitive defence mechanisms, associated with Kernberg’s lower level pathologies. It reflected Dahmer’s pathological formation of psychic structures seen in a diffuse identity and impaired formation of the superego, that supported these patterns. Additionally, the research was valuable in enhancing the researcher’s insight into personality development according to Kernberg’s Object Relations Theory. This study may also be beneficial to practising clinicians and professionals as an example of the early identification of personality pathology. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04
- Authors: Freeman, Chanté F
- Date: 2021-04
- Subjects: Serial murders -- Case studies , Personality development -- Psychological aspects
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/51032 , vital:43202
- Description: Jeffrey Lionel Dahmer is an infamous serial killer and cannibal. He was described as a normal, but shy little boy, yet developed into an adult who brutally murdered, engaged in necrophiliac acts, dismembered and ate parts of his victims. This study took the form of an intrinsic case study with the aim to explore and describe the personality development of Jeffrey Dahmer. This exploration examined Dahmer’s known childhood experiences through the theoretical perspective of Otto Kernberg’s (1974, 1975, 1976) Object Relations Theory, in order to understand how Dahmer’s personality was formed. Data was collected from multiple resources, including books, authoritative biographies, academic articles, and internet sources available in the public domain. It was analysed using Miles, Huberman, and Saldaña’s (2014) three-step process namely, data condensation, data display, and conclusion drawing and verification. This study’s findings confirmed the formation of pathological behavioural patterns supported by primitive defence mechanisms, associated with Kernberg’s lower level pathologies. It reflected Dahmer’s pathological formation of psychic structures seen in a diffuse identity and impaired formation of the superego, that supported these patterns. Additionally, the research was valuable in enhancing the researcher’s insight into personality development according to Kernberg’s Object Relations Theory. This study may also be beneficial to practising clinicians and professionals as an example of the early identification of personality pathology. , Thesis (MA) -- Faculty of Health Sciences, 2021
- Full Text:
- Date Issued: 2021-04