Retrospective analysis of birth HIV PCR testing and follow-up of positive HIV PCR results in Nelson Mandela Bay Health District
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
Socio-ecological, contextual effects in Raven’s Colour Progressive Matrices scores: Developing an index for guiding test selection and interpretation
- Authors: August, Justin Oswin
- Date: 2020
- Subjects: Ecological Systems Theory
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46401 , vital:39563
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. Given that the Raven’s Coloured Progressive Matrices (CPM)is purported to be culture-free and not heavily dependent on verbal and language skills;it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth areain South Africa that wereclassified into low, medium and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process.The item analysisconductedfurther indicated that learners from a low opportunity school performed significantly lower than the other two schoolsin the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity wherea“one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2020
- Authors: August, Justin Oswin
- Date: 2020
- Subjects: Ecological Systems Theory
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46401 , vital:39563
- Description: With the changing landscape in South Africa to a full democracy, increased research has been undertaken in the psychometric field on local and national normative studies regarding various assessment measures. Given that the Raven’s Coloured Progressive Matrices (CPM)is purported to be culture-free and not heavily dependent on verbal and language skills;it has been extensively normed throughout the world for various population groups. While norms for normal populations of children have been developed in South Africa, these studies were based on race and gender predominantly and without taking into consideration the effects of socio-ecological factors on test performance. The research study aimed to understand the influence of socio-ecological factors on the expression of cognitive scores amongst a geographically diverse sample of South African learners. Through this study, research on the interplay between context and cognition was to be located within the Ecological Systems model of Bronfenbrenner. A secondary aim of the study was to develop an index that will guide test selection and interpretation of assessment results, taking into account the influence of socio-ecological factors and providing a conceptual framework for future test development. The study employed a quantitative methodology on a South African sample consisting of primary school children aged between the ages of 6 years to 11 years. The sample was drawn from schools in the Port Elizabeth areain South Africa that wereclassified into low, medium and high opportunity, based on context. The results indicated that the type of school had a significant impact on test performance, suggesting that contextual factors were influential in this process.The item analysisconductedfurther indicated that learners from a low opportunity school performed significantly lower than the other two schoolsin the sample. The index development provides a foundation for further research that would enhance the interpretation of test results. In the South African context, this is considered important, given our political history and our diversity wherea“one size fits all” approach is not possible.
- Full Text:
- Date Issued: 2020
Strategies for the facilitation of implementation of best practice guidelines in operating theatres at public hospitals
- Owolabi, Olukemi Olufunmilayo
- Authors: Owolabi, Olukemi Olufunmilayo
- Date: 2020
- Subjects: Operating rooms—Safety measures
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46422 , vital:39594
- Description: Best practice guidelines (BPGs) are the use of scientific evidence to direct patient care and guide clinical care to integrate best patient outcomes. The implementation of BPGs in operating theatre nursing improves patient safety and quality of care and enhances patient outcomes. Although BPGs are crucial, the implementation thereof is not well operationalised in clinical practice, especially in an area such as the operating theatres in public hospitals in the Nelson Mandela Bay Health District(NMHD)in the Eastern Cape Province. The study thus developed strategies that could be used to facilitate the implementation of best practice guidelines in the operating theatres at public hospitals in the NMBHD. Understanding registered nurses’ knowledge, attitudes, and practices (KAP) with regard to implementing BPGs in the operating theatre is important, as it will assist in the development of strategies to facilitate the implementation of BPGs.The study was conducted in three phases. Phase One comprised of a quantitative approach. Data collection was achieved by means of a self-administered questionnaire which was distributed to registered nurses in the operating theatres of public hospitals in the NMBHD. The purpose of the questionnaire was to establish their knowledge, attitude and practice with regard to best practice guidelines and the implementation thereof. Recommendations made by participants for strategies to facilitate the implementation of BPGs in operating theatres were also explored. Descriptive and inferential statistics were utilised to analyse and describe the data. Descriptive statistics were used to describe the profile of the sample, including the demographic data measures of central tendency, for example the mean and standard deviation (SD) and correlation techniques.Chi²analysis was performed to test for significance of the associations between the registered nurses’ demographic variables and their KAP. Data were categorised into three levels, namely lower (score < quartile 1 i.e. bottom 25%). Middle (quartile1 ≤ score ≤quartile i.e. in the middle 50%) and higher (score > quartile 3 i.e. top 25%).Findings from this research study revealed the limited knowledge, attitude and practice of OT nurses about BPGs. During Phase Two an integrative literature review approach was followed in order to identify the best available evidence with regard to the facilitation of the implementation of best practice guidelines in operating theatres. Lastly, Phase Three: strategies that could be used to facilitate the implementation of best practice guidelines in operating theatres were developed. The researcher developed the conceptual framework using the six elements of Dickoff, James and Weidenbach (1968:422). The conceptual framework informed the development of strategies. The strategies are a synthesis of the conclusions drawn from the research findings (phase one and two) and the conceptualization thereof. The strategies were reviewed by six-panel members. Each panel member was supplied with the format for evaluation of the strategies which was based on the criteria established by Chinn and Kramer (2018:156) the results of which included in chapter 7. The researcher ensured that the data obtained was valid and reliable, necessary to assist the researcher to produce quality research. Ethical considerations were maintained throughout. In general, the results of this thesis indicate that the developed strategies that could be used to facilitate the implementation of best practice guidelines, in operating theatres at public hospitals in the NMBHDare unique and could be implemented in theatres in public hospitals. The researcher succeeded in achieving the purpose for this study, because the strategies which are understandable, clear, simple, applicable and significant to operating theatre unit has been developed for use by operating theatre nurses, to facilitate the implementation of best practice guidelines in operating theatres at public hospitals in the NMBHD.
- Full Text:
- Date Issued: 2020
- Authors: Owolabi, Olukemi Olufunmilayo
- Date: 2020
- Subjects: Operating rooms—Safety measures
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46422 , vital:39594
- Description: Best practice guidelines (BPGs) are the use of scientific evidence to direct patient care and guide clinical care to integrate best patient outcomes. The implementation of BPGs in operating theatre nursing improves patient safety and quality of care and enhances patient outcomes. Although BPGs are crucial, the implementation thereof is not well operationalised in clinical practice, especially in an area such as the operating theatres in public hospitals in the Nelson Mandela Bay Health District(NMHD)in the Eastern Cape Province. The study thus developed strategies that could be used to facilitate the implementation of best practice guidelines in the operating theatres at public hospitals in the NMBHD. Understanding registered nurses’ knowledge, attitudes, and practices (KAP) with regard to implementing BPGs in the operating theatre is important, as it will assist in the development of strategies to facilitate the implementation of BPGs.The study was conducted in three phases. Phase One comprised of a quantitative approach. Data collection was achieved by means of a self-administered questionnaire which was distributed to registered nurses in the operating theatres of public hospitals in the NMBHD. The purpose of the questionnaire was to establish their knowledge, attitude and practice with regard to best practice guidelines and the implementation thereof. Recommendations made by participants for strategies to facilitate the implementation of BPGs in operating theatres were also explored. Descriptive and inferential statistics were utilised to analyse and describe the data. Descriptive statistics were used to describe the profile of the sample, including the demographic data measures of central tendency, for example the mean and standard deviation (SD) and correlation techniques.Chi²analysis was performed to test for significance of the associations between the registered nurses’ demographic variables and their KAP. Data were categorised into three levels, namely lower (score < quartile 1 i.e. bottom 25%). Middle (quartile1 ≤ score ≤quartile i.e. in the middle 50%) and higher (score > quartile 3 i.e. top 25%).Findings from this research study revealed the limited knowledge, attitude and practice of OT nurses about BPGs. During Phase Two an integrative literature review approach was followed in order to identify the best available evidence with regard to the facilitation of the implementation of best practice guidelines in operating theatres. Lastly, Phase Three: strategies that could be used to facilitate the implementation of best practice guidelines in operating theatres were developed. The researcher developed the conceptual framework using the six elements of Dickoff, James and Weidenbach (1968:422). The conceptual framework informed the development of strategies. The strategies are a synthesis of the conclusions drawn from the research findings (phase one and two) and the conceptualization thereof. The strategies were reviewed by six-panel members. Each panel member was supplied with the format for evaluation of the strategies which was based on the criteria established by Chinn and Kramer (2018:156) the results of which included in chapter 7. The researcher ensured that the data obtained was valid and reliable, necessary to assist the researcher to produce quality research. Ethical considerations were maintained throughout. In general, the results of this thesis indicate that the developed strategies that could be used to facilitate the implementation of best practice guidelines, in operating theatres at public hospitals in the NMBHDare unique and could be implemented in theatres in public hospitals. The researcher succeeded in achieving the purpose for this study, because the strategies which are understandable, clear, simple, applicable and significant to operating theatre unit has been developed for use by operating theatre nurses, to facilitate the implementation of best practice guidelines in operating theatres at public hospitals in the NMBHD.
- Full Text:
- Date Issued: 2020
The development of a set of guidelines for the revision of psychological tests and the use of revised psychological tests
- Authors: Cronje, Johan Herman
- Date: 2020
- Subjects: Psychological tests
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46350 , vital:39567
- Description: The psychological testindustry has produced a wide variety of psychological tests that are used by professionals to facilitate measurement and decision-making. Tests are updated and revised periodically in order to remain current, valid and reliable in what is a competitive psychometric industry. Despite the prevalence of test revisions, especially in recent years, a number of authors have commented on the lack of comprehensive guidelines for test revision. Guidelines shouldcover aspects such as what the different types of revision are, when to embark on a revision, whatprocessto followand how test users should use revised tests. Test revision differs from test construction in a number of ways. There are external factors that affect the regularity with which a test should be revised. Test revision also involves more role players than test construction, including the opinions of those test users who may be resistant to any change in the previous test edition. Finally, revised tests sometimes have to contend with requirements from the test publisher who purchased the test or distribution rights from the developer. Test revision is expensive and time consuming, which leaves little scope for experimentation or trial-and-error. The availability of expertise, as well as the human and financial resources required to complete test revisionscan make such projects unaffordable, especiallyforprofessionals indeveloping countries, such as South Africa.It may be more feasible for such professionalsto collaborate with international revision projects. By doing so they cangain experience in test revision, contribute indigenous information that could shapethe revision ofan international test, increase opportunities to engage with international users, and potentially source international funding for research in their own country. The current studydevelopeda comprehensive and practical set of 30 guidelines to assist those involved in test revision. These guidelines were peer-reviewed and refined. Finally, the guidelines were field-tested using a case study of a recently revised ivdevelopmentaltest, the Griffiths III. Professionals from South Africa, including the present researcher,formed part of the international team for the extensive revision of the Griffiths III, which makes this test an ideal case study from both the perspectives of the developed test revision guidelines as well as collaboration of professionals from a developing country in an international test revision. The knowledge gainedfrom the development of guidelines and international collaboration in test revision is reflected on.
- Full Text:
- Date Issued: 2020
- Authors: Cronje, Johan Herman
- Date: 2020
- Subjects: Psychological tests
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46350 , vital:39567
- Description: The psychological testindustry has produced a wide variety of psychological tests that are used by professionals to facilitate measurement and decision-making. Tests are updated and revised periodically in order to remain current, valid and reliable in what is a competitive psychometric industry. Despite the prevalence of test revisions, especially in recent years, a number of authors have commented on the lack of comprehensive guidelines for test revision. Guidelines shouldcover aspects such as what the different types of revision are, when to embark on a revision, whatprocessto followand how test users should use revised tests. Test revision differs from test construction in a number of ways. There are external factors that affect the regularity with which a test should be revised. Test revision also involves more role players than test construction, including the opinions of those test users who may be resistant to any change in the previous test edition. Finally, revised tests sometimes have to contend with requirements from the test publisher who purchased the test or distribution rights from the developer. Test revision is expensive and time consuming, which leaves little scope for experimentation or trial-and-error. The availability of expertise, as well as the human and financial resources required to complete test revisionscan make such projects unaffordable, especiallyforprofessionals indeveloping countries, such as South Africa.It may be more feasible for such professionalsto collaborate with international revision projects. By doing so they cangain experience in test revision, contribute indigenous information that could shapethe revision ofan international test, increase opportunities to engage with international users, and potentially source international funding for research in their own country. The current studydevelopeda comprehensive and practical set of 30 guidelines to assist those involved in test revision. These guidelines were peer-reviewed and refined. Finally, the guidelines were field-tested using a case study of a recently revised ivdevelopmentaltest, the Griffiths III. Professionals from South Africa, including the present researcher,formed part of the international team for the extensive revision of the Griffiths III, which makes this test an ideal case study from both the perspectives of the developed test revision guidelines as well as collaboration of professionals from a developing country in an international test revision. The knowledge gainedfrom the development of guidelines and international collaboration in test revision is reflected on.
- Full Text:
- Date Issued: 2020
The perceptions and experiences of tenants living in a social housing initiative in Port Elizabeth
- Authors: Konstabel, Desiree
- Date: 2020
- Subjects: Social settlements
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46410 , vital:39579
- Description: Social housing aims to redress the housing crisis that South Africa is currently facing given the backlog that was left in the provision of free basic housing. Research conducted on the low to the middle-income group from which South African social housing tenants originate, suggests that this income bracket experiences social, physical and mental health challenges. They are three times more likely to suffer from depression than their counterparts in developed countries. Little to no literature has been published focusing on tenants who represent low to middle-income groups living in social housing in South Africa. Furthermore, the researcher did not come across literature highlighting the perceptions and experiences of tenants, who represent these low to middle-income groups, and who live in social housing in South Africa. In the context of South African social housing, there is a gap in the literature about the perceptions and experiences of tenants living in a social housing initiative.Guided by the Social Constructionism and Sense of Community theoretical frameworks, the goal of this qualitative research study waste gain a better understanding about the perceptions and experiences of tenants living in a social housing initiative in South Africa. An exploratory and descriptive research design was employed, focusing on the tenants of one social housing initiative. A non-probability purposive sampling procedure was followed. Convenience sampling was applied and followed up by volunteer sampling techniques. The sample size consisted of 9 social housing tenants. Individual, semi-structured interviews were conducted by an independent interviewer and used to collect data and analyse themes. Trustworthiness and ethical considerations were adhered to on all levels.This research contributes to a greater understanding of the perceptions and experiences of tenants living in a social housing initiative. The study revealed that most tenants experienced an increased sense of safety in the social housing initiative as compared to the surrounding community. The study further revealed that lower-income tenants have concerns about the long-term affordability of rentals in social housing. Among others, the study recommends that social workers advocate for inclusive social and economic policies to promote greater inclusion of vulnerable groups from low-income backgrounds.
- Full Text:
- Date Issued: 2020
- Authors: Konstabel, Desiree
- Date: 2020
- Subjects: Social settlements
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/46410 , vital:39579
- Description: Social housing aims to redress the housing crisis that South Africa is currently facing given the backlog that was left in the provision of free basic housing. Research conducted on the low to the middle-income group from which South African social housing tenants originate, suggests that this income bracket experiences social, physical and mental health challenges. They are three times more likely to suffer from depression than their counterparts in developed countries. Little to no literature has been published focusing on tenants who represent low to middle-income groups living in social housing in South Africa. Furthermore, the researcher did not come across literature highlighting the perceptions and experiences of tenants, who represent these low to middle-income groups, and who live in social housing in South Africa. In the context of South African social housing, there is a gap in the literature about the perceptions and experiences of tenants living in a social housing initiative.Guided by the Social Constructionism and Sense of Community theoretical frameworks, the goal of this qualitative research study waste gain a better understanding about the perceptions and experiences of tenants living in a social housing initiative in South Africa. An exploratory and descriptive research design was employed, focusing on the tenants of one social housing initiative. A non-probability purposive sampling procedure was followed. Convenience sampling was applied and followed up by volunteer sampling techniques. The sample size consisted of 9 social housing tenants. Individual, semi-structured interviews were conducted by an independent interviewer and used to collect data and analyse themes. Trustworthiness and ethical considerations were adhered to on all levels.This research contributes to a greater understanding of the perceptions and experiences of tenants living in a social housing initiative. The study revealed that most tenants experienced an increased sense of safety in the social housing initiative as compared to the surrounding community. The study further revealed that lower-income tenants have concerns about the long-term affordability of rentals in social housing. Among others, the study recommends that social workers advocate for inclusive social and economic policies to promote greater inclusion of vulnerable groups from low-income backgrounds.
- Full Text:
- Date Issued: 2020
Anthropometric, physiological and biochemical parameters in relation to perceived stress and lifestyle diseases among correctional services staff in the Amathole Region, Eastern Cape, South Africa
- Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
- Date Issued: 2020-01
- Authors: Matshikiza, Ondela Innocent https://orcid.org/0000-0002-9326-6697
- Date: 2020-01
- Subjects: Correctional personnel , Lifestyles -- Diseases
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22082 , vital:51981
- Description: Background: The prevalence of overweight and obesity has risen significantly in the past three decades, with marked variations across countries in the levels and trends in overweight and obesity with distinct regional patterns. Physical inactivity has increased in South Africa as the country develops, with increasing urbanization and modernization, technology, and low physical activities at workplaces. Correctional Services staff tend to suffer from chronic diseases such as cardiovascular diseases, type 2 diabetes mellitus, orthopaedic conditions, high cholesterol, overweight, and obesity due to insufficient physical activity engagement. Aims and objectives: The study aimed to assess the anthropometric, physiological, biochemical parameters in relation to stress and lifestyle diseases of correctional services staff in the Amathole region, Eastern Cape, South Africa. Methods: A cross-sectional study was conducted among 81 Correctional Services Staff in the Amathole Region, Eastern Cape, South Africa. The employees' health status, anthropometric, physiological, biochemical parameters, and perceived stress were assessed. Data were analyzed using SPSS version 25.0. Data were expressed as mean +/- SD for quantitative variables or numbers and percentages for categorical variables. An independent sample T-test was used to assess statistical differences between males and female correctional service staff. Pearson correlation was used to determine the relationship strength and linearity of the anthropometric, physiological, and biochemical parameters. A direct logistic regression was employed to predict the indicator variable. Results: The results showed that just over two-thirds (67%) of the participants reported not being ready for exercise. Nearly 94% of the study population were categorized as either overweight, obese, severely obese, or morbidly obese. Approximately three-quarters (74%) of the respondents reported moderate to high- perceived stress levels. Approximately 40% of the population were at risk determined by the Waist to Hip Ratio. Furthermore, waist circumference, 43% and 77% of the study population were categorized as obese, male and female participants, respectively. Over three-quarters, (79%) of the study population were diagnosed with elevated high pressure, stage 1 and 2 hypertension, or a hypertensive crisis. A minimum of 18% and 17.3% of the study population were diagnosed with Pre-diabetic and Type 2 diabetes mellitus, respectively. An analysis of gender group differences showed overweight, obesity, and Body Fat Percentages were prevalent among females. The results further showed a positive increase in abdominal fat accumulation with age; thus, the Weight Circumference of the participants was significantly high. The prevalence of overweight and obesity was common among male and female correctional services staff, with a significantly lower Body Fat Percentage for males compared to females. However, upon further investigation, males' Waist to Hip Ratio was significantly higher than for female correctional services staff. Perceived stress scores for male participants were significantly lower compared to female participants. An analysis of staff member group differences showed that support staff's body fat percentage was significantly lower than top management and middle management groups. There was also a statistical difference in the Waist to Hip Ratio for the three managerial groups. More than three-quarters of the correctional services staff were classified with moderate (65.4%) to highstress levels (8.6%). Direct logistic regression was performed to assess the influence of several independent variables on the likelihood that participants would be classified as Obese. The results indicated that 80.2% of the participants were correctly classified before the model was conducted. Another direct logistic regression analysis was employed to predict stress among Correctional Services Staff found that age made a statistically significant contribution to the model, while the most robust predictor to report high stress was not getting enough exercise. Conclusion: Overweight and obesity are prevalent among Correctional Services Staff, putting them at risk for developing lifestyle-related diseases. Workplace health promotion is significant in preventing non-communicable diseases among Correctional Services Staff to reduce medical costs, increase disability incidents, reduce morbidity, mortality and improve work productivity. The role of physical exercise in the development of stress and decreasing obesity is central to addressing these issues in the workplace. , Thesis (MA) -- Faculty of Health Sciences, Human Movement Science, 2020
- Full Text:
- Date Issued: 2020-01
Perceptions of patients about poor attitudes and behaviours of midwives in the maternity sections in a public hospital of East London South Africa
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwifery , Nursing ethics , Nurse and patient
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26918 , vital:66099
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPA) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-11
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwifery , Nursing ethics , Nurse and patient
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26918 , vital:66099
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPA) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-11
Perceptions of patients about poor attitudes and behaviours of midwives in the maternity sections in a public hospital of East London South Africa
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwives , Maternity nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23521 , vital:58085
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-11
- Authors: Lawrence, N W
- Date: 2019-11
- Subjects: Midwives , Maternity nursing
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23521 , vital:58085
- Description: Midwives are largely responsible for maternity care in hospitals. As such, they play a significant role in ensuring the health and well-being of pregnant women and newborn babies. To perform that duty effectively, midwives need to be professional in their conduct. However, there are reports that midwives have displayed poor attitudes and behaviour in South Africa. The main research question was “what are the perceptions of patients about attitudes and behaviours of midwives in the maternity section in a public hospital in East London, South Africa?” The aim of the study was to explore the reasons behind poor attitudes and behaviour of midwives in midwifery practice and suggest interventions that can be introduced to promote professional attitudes and behaviour by midwives in a public hospital in East London. This study used a qualitative approach to collect data. The research instrument that was used for this study was semi-structured interviews. The sample of 20 participants which was purposively selected consisted of women that have used the East London public hospital maternity section. Data was collected using coding and themes emanating from the data generated. Midwives are valued and play a very significant role in providing maternal care. Be that as it may, midwives exhibit poor attitudes and behaviours such as being rude, lack sympathy, and lack of empathy. On the other hand, midwives act professionally and are supportive of patients. There is, therefore, a need for the provision of professional etiquette training services, stress counseling, use of work development strategies and performance management systems, technical training, linkage system of traditional and modern midwives, and the use of internet platforms to increase interaction between midwives and those that need maternity care services. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-11
Treatment adherence among tuberculosis patients in Nelson Mandela District, Eastern Cape Province
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-09
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
- Full Text:
- Date Issued: 2019-09
A co-constructed practice model for supporting parents of children in conflict with the law
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
A comprehensive support programme for professional nurses performing HIV counselling and testing at primary health care clinics in the rural Eastern Cape
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
A nutrition education tool for practical application of the food based dietary guidelines for primary school teachers in Nelson Mandela Bay
- Authors: Joubert, Tayla Kate
- Date: 2019
- Subjects: Nutrition -- Education
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/44616 , vital:38152
- Description: Background: The South Africa Food-Based Dietary Guidelines (SAFBDG) was developed to promote better food choices for a healthy lifestyle and are included in the school syllabus. Schools remain viable platforms for nutrition education with teachers playing significant roles, but research has shown that teachers do not necessarily know about the SAFBDG and how to incorporate these into the teaching programme. Aim: The aim of this study was to develop a tool in the form of a nutrition education guide for primary school teachers, aimed at the practical application of the SAFBDG, in order to enhance the nutrition knowledge, attitudes and dietary practices of the teachers. Research design and methodology: A quasi-experimental, one group, quantitative design was employed. Forty-six teachers were conveniently chosen from schools in previously disadvantaged areas of Nelson Mandela Bay. The study design consisted of four phases. Phase one consisted of a pre-test where the teachers’ nutrition knowledge, nutrition attitudes, dietary practices, staff wellness and physical activity were determined by means of a standardised questionnaire. A nutritional assessment was also conducted in phase one. In phase two, the nutrition guide, which was Curriculum Assessment Policy Statement compliant for grades four to seven, was developed. In phase three, the guide was used in a workshop to train the teachers that attended phase one of the study, on how to use the nutrition education guide. In phase four, a post-test was conducted after the training to evaluate the effectiveness of the training and to determine whether there has been an increase in the teachers’ nutrition knowledge. Data from the questionnaires were analysed on Microsoft Excel 2016 MSO (16.0.4639.1000). Ethical approval for this study was obtained from the Faculty Postgraduate Studies Committee (FPGSC) of the Faculty of Health Sciences, Nelson Mandela University (Ethics clearance reference number: H18-HEA-DIET-005) and all ethical principles were upheld according to the Belmont report and the Declaration of Helsinki. Results: Of the 46 teachers who participated 36 (78 %) were obese. The mean waist circumference and waist-to-hip ratio was 109.99 and 0.887 respectively (± 17.32 and ± 0.089). The teachers obtained a relatively high mean overall score in the pre-test of 69 % (± 10.78). Only 42 % of the teachers had heard of the SAFBDG before the study. There was an overall statistical significant increase in knowledge of 6 % (p = 0.03) from the pre-test to the post-test. The dietary practice was obtained through a food frequency questionnaire (FFQ), which showed under-reporting. The most neglected food groups were legumes, dairy and vegetables/ fruit. Hypertension was the highest self-reported condition, with just under a quarter of the teachers having hypertension (high blood pressure). There was no statistical significance between the teachers’ BMI and their nutrition knowledge as well as no statistical significance between their BMI and their physical activity level. Conclusion and recommendations: Even though the teachers obtained a relatively high mean overall score in their pre-test, there were still gaps in their nutrition knowledge. These gaps in the teachers’ knowledge results in insufficient nutrition knowledge being provided to the learners, leading to poor dietary practices and misconceptions regarding different foods among the learners as well as the teachers. By providing training for the teachers, it will not only improve their nutrition knowledge but potentially also help to improve their lifestyle. With enhanced nutrition knowledge, the teachers can communicate sufficient information to their learners. The DoBE need to advocate for a healthier school environment in which the SAFBDG are implemented more extensively in the curriculum as well as part of school food policies.
- Full Text:
- Date Issued: 2019
- Authors: Joubert, Tayla Kate
- Date: 2019
- Subjects: Nutrition -- Education
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/44616 , vital:38152
- Description: Background: The South Africa Food-Based Dietary Guidelines (SAFBDG) was developed to promote better food choices for a healthy lifestyle and are included in the school syllabus. Schools remain viable platforms for nutrition education with teachers playing significant roles, but research has shown that teachers do not necessarily know about the SAFBDG and how to incorporate these into the teaching programme. Aim: The aim of this study was to develop a tool in the form of a nutrition education guide for primary school teachers, aimed at the practical application of the SAFBDG, in order to enhance the nutrition knowledge, attitudes and dietary practices of the teachers. Research design and methodology: A quasi-experimental, one group, quantitative design was employed. Forty-six teachers were conveniently chosen from schools in previously disadvantaged areas of Nelson Mandela Bay. The study design consisted of four phases. Phase one consisted of a pre-test where the teachers’ nutrition knowledge, nutrition attitudes, dietary practices, staff wellness and physical activity were determined by means of a standardised questionnaire. A nutritional assessment was also conducted in phase one. In phase two, the nutrition guide, which was Curriculum Assessment Policy Statement compliant for grades four to seven, was developed. In phase three, the guide was used in a workshop to train the teachers that attended phase one of the study, on how to use the nutrition education guide. In phase four, a post-test was conducted after the training to evaluate the effectiveness of the training and to determine whether there has been an increase in the teachers’ nutrition knowledge. Data from the questionnaires were analysed on Microsoft Excel 2016 MSO (16.0.4639.1000). Ethical approval for this study was obtained from the Faculty Postgraduate Studies Committee (FPGSC) of the Faculty of Health Sciences, Nelson Mandela University (Ethics clearance reference number: H18-HEA-DIET-005) and all ethical principles were upheld according to the Belmont report and the Declaration of Helsinki. Results: Of the 46 teachers who participated 36 (78 %) were obese. The mean waist circumference and waist-to-hip ratio was 109.99 and 0.887 respectively (± 17.32 and ± 0.089). The teachers obtained a relatively high mean overall score in the pre-test of 69 % (± 10.78). Only 42 % of the teachers had heard of the SAFBDG before the study. There was an overall statistical significant increase in knowledge of 6 % (p = 0.03) from the pre-test to the post-test. The dietary practice was obtained through a food frequency questionnaire (FFQ), which showed under-reporting. The most neglected food groups were legumes, dairy and vegetables/ fruit. Hypertension was the highest self-reported condition, with just under a quarter of the teachers having hypertension (high blood pressure). There was no statistical significance between the teachers’ BMI and their nutrition knowledge as well as no statistical significance between their BMI and their physical activity level. Conclusion and recommendations: Even though the teachers obtained a relatively high mean overall score in their pre-test, there were still gaps in their nutrition knowledge. These gaps in the teachers’ knowledge results in insufficient nutrition knowledge being provided to the learners, leading to poor dietary practices and misconceptions regarding different foods among the learners as well as the teachers. By providing training for the teachers, it will not only improve their nutrition knowledge but potentially also help to improve their lifestyle. With enhanced nutrition knowledge, the teachers can communicate sufficient information to their learners. The DoBE need to advocate for a healthier school environment in which the SAFBDG are implemented more extensively in the curriculum as well as part of school food policies.
- Full Text:
- Date Issued: 2019
A nutrition education tool for practical application of the food based dietary guidelines for primary school teachers in Nelson Mandela Bay
- Authors: Joubert, Tayla Kate
- Date: 2019
- Subjects: Malnutrition -- South Africa -- Port Elizabeth , Nutrition—Evaluation Nutrition -- Evaluation Nutrition -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/45019 , vital:38226
- Description: The South Africa Food-Based Dietary Guidelines (SAFBDG) was developed to promote better food choices for a healthy lifestyle and are included in the school syllabus. Schools remain viable platforms for nutrition education with teachers playing significant roles, but research has shown that teachers do not necessarily know about the SAFBDG and how to incorporate these into the teaching programme. The aim of this study was to develop a tool in the form of a nutrition education guide for primary school teachers, aimed at the practical application of the SAFBDG, in order to enhance the nutrition knowledge, attitudes and dietary practices of the teachers. A quasi-experimental, one group, quantitative design was employed. Forty-six teachers were conveniently chosen from schools in previously disadvantaged areas of Nelson Mandela Bay. The study design consisted of four phases. Phase one consisted of a pre-test where the teachers’ nutrition knowledge, nutrition attitudes, dietary practices, staff wellness and physical activity were determined by means of a standardised questionnaire. A nutritional assessment was also conducted in phase one. In phase two, the nutrition guide, which was Curriculum Assessment Policy Statement compliant for grades four to seven, was developed. In phase three, the guide was used in a workshop to train the teachers that attended phase one of the study, on how to use the nutrition education guide. In phase four, a post-test was conducted after the training to evaluate the effectiveness of the training and to determine whether there has been an increase in the teachers’ nutrition knowledge. Data from the questionnaires were analysed on Microsoft Excel 2016 MSO (16.0.4639.1000). Ethical approval for this study was obtained from the Faculty Postgraduate Studies Committee (FPGSC) of the Faculty of Health Sciences, Nelson Mandela University (Ethics clearance reference number: H18-HEA-DIET-005) and all ethical principles were upheld according to the Belmont report and the Declaration of Helsinki. Results of the research 46 teachers who participated 36 (78 %) were obese. The mean waist circumference and waist-to-hip ratio was 109.99 and 0.887 respectively (± 17.32 and ± 0.089). The teachers obtained a relatively high mean overall score in the pre-test of 69 % (± 10.78). Only 42 % of the teachers had heard of the SAFBDG before the study. There was an overall statistical significant increase in knowledge of 6 % (p = 0.03) from the pre-test to the post-test. The dietary practice was obtained through a food frequency questionnaire (FFQ), which showed under-reporting. The most neglected food groups were legumes, dairy and vegetables/ fruit. Hypertension was the highest self-reported condition, with just under a quarter of the teachers having hypertension (high blood pressure). There was no statistical significance between the teachers’ BMI and their nutrition knowledge as well as no statistical significance between their BMI and their physical activity level. Even though the teachers obtained a relatively high mean overall score in their pre-test, there were still gaps in their nutrition knowledge. These gaps in the teachers’ knowledge results in insufficient nutrition knowledge being provided to the learners, leading to poor dietary practices and misconceptions regarding different foods among the learners as well as the teachers. By providing training for the teachers, it will not only improve their nutrition knowledge but potentially also help to improve their lifestyle. With enhanced nutrition knowledge, the teachers can communicate sufficient information to their learners. The DoBE need to advocate for a healthier school environment in which the SAFBDG are implemented more extensively in the curriculum as well as part of school food policies.
- Full Text:
- Date Issued: 2019
- Authors: Joubert, Tayla Kate
- Date: 2019
- Subjects: Malnutrition -- South Africa -- Port Elizabeth , Nutrition—Evaluation Nutrition -- Evaluation Nutrition -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/45019 , vital:38226
- Description: The South Africa Food-Based Dietary Guidelines (SAFBDG) was developed to promote better food choices for a healthy lifestyle and are included in the school syllabus. Schools remain viable platforms for nutrition education with teachers playing significant roles, but research has shown that teachers do not necessarily know about the SAFBDG and how to incorporate these into the teaching programme. The aim of this study was to develop a tool in the form of a nutrition education guide for primary school teachers, aimed at the practical application of the SAFBDG, in order to enhance the nutrition knowledge, attitudes and dietary practices of the teachers. A quasi-experimental, one group, quantitative design was employed. Forty-six teachers were conveniently chosen from schools in previously disadvantaged areas of Nelson Mandela Bay. The study design consisted of four phases. Phase one consisted of a pre-test where the teachers’ nutrition knowledge, nutrition attitudes, dietary practices, staff wellness and physical activity were determined by means of a standardised questionnaire. A nutritional assessment was also conducted in phase one. In phase two, the nutrition guide, which was Curriculum Assessment Policy Statement compliant for grades four to seven, was developed. In phase three, the guide was used in a workshop to train the teachers that attended phase one of the study, on how to use the nutrition education guide. In phase four, a post-test was conducted after the training to evaluate the effectiveness of the training and to determine whether there has been an increase in the teachers’ nutrition knowledge. Data from the questionnaires were analysed on Microsoft Excel 2016 MSO (16.0.4639.1000). Ethical approval for this study was obtained from the Faculty Postgraduate Studies Committee (FPGSC) of the Faculty of Health Sciences, Nelson Mandela University (Ethics clearance reference number: H18-HEA-DIET-005) and all ethical principles were upheld according to the Belmont report and the Declaration of Helsinki. Results of the research 46 teachers who participated 36 (78 %) were obese. The mean waist circumference and waist-to-hip ratio was 109.99 and 0.887 respectively (± 17.32 and ± 0.089). The teachers obtained a relatively high mean overall score in the pre-test of 69 % (± 10.78). Only 42 % of the teachers had heard of the SAFBDG before the study. There was an overall statistical significant increase in knowledge of 6 % (p = 0.03) from the pre-test to the post-test. The dietary practice was obtained through a food frequency questionnaire (FFQ), which showed under-reporting. The most neglected food groups were legumes, dairy and vegetables/ fruit. Hypertension was the highest self-reported condition, with just under a quarter of the teachers having hypertension (high blood pressure). There was no statistical significance between the teachers’ BMI and their nutrition knowledge as well as no statistical significance between their BMI and their physical activity level. Even though the teachers obtained a relatively high mean overall score in their pre-test, there were still gaps in their nutrition knowledge. These gaps in the teachers’ knowledge results in insufficient nutrition knowledge being provided to the learners, leading to poor dietary practices and misconceptions regarding different foods among the learners as well as the teachers. By providing training for the teachers, it will not only improve their nutrition knowledge but potentially also help to improve their lifestyle. With enhanced nutrition knowledge, the teachers can communicate sufficient information to their learners. The DoBE need to advocate for a healthier school environment in which the SAFBDG are implemented more extensively in the curriculum as well as part of school food policies.
- Full Text:
- Date Issued: 2019
A proposed baseline South African antimicrobial stewardship curriculum for the Bachelor of Pharmacy programme
- Authors: Khan, Yasmine
- Date: 2019
- Subjects: Pharmacy -- Study and teaching -- South Africa , Pharmacy -- Practice -- South Africa Drug utilization -- Dissertations Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/35752 , vital:33805
- Description: Antimicrobial stewardship refers to the healthcare practice which ensures the judicious and appropriate prescribing of antimicrobial agents. The primary purpose of antimicrobial stewardship entails minimising the progression of antimicrobial resistance; the rise of which is recognised as a threat to global health and safety. The pharmacist is recognised nationally and internationally as a key role player in the implementation of antimicrobial stewardship. Education of healthcare practitioners in antimicrobial stewardship is a recognised strategic enabler for the containment of antimicrobial resistance in South Africa. The primary aim of the study was to develop a proposed baseline antimicrobial stewardship curriculum which is suitable for implementation into the Bachelor of Pharmacy programmes offered by South African schools of pharmacy. The aims and objectives of the study were achieved through the conduction of four study phases: the content analysis, academic review, expert consultation and curriculum development. The content analysis investigated the structure and content of international antimicrobial stewardship curricula, and the national policy governing antimicrobial stewardship implementation in South Africa. Frequency distributions of trends from the reviewed literature informed the development of the initial draft antimicrobial stewardship curriculum for pharmacy students. In terms of content, the principles which emerges with high frequency, which were thus emphasised in the initial draft curriculum, included: the strategic objectives (governance, surveillance, antimicrobial stewardship and infection prevention); strategic enablers (education, communication, legislation and research); dose optimisation; audit and feedback; formulary restriction; collaboration; pre-authorisation; and de-escalation. Available literature did not provide extensive detail regarding the curriculum structure utilised internationally, particularly with regards to the number of contact hours dedicated to the curriculum content and the year level at which antimicrobial stewardship was incorporated in the degree programme (variable between studies). From the content analysis it was evident that a mixed methods pedagogy and use of multiple assessment techniques were recommended. The academic review phase allowed for further insight to be obtained into the content and structure of antimicrobial stewardship curriculum content which was presented in the pre-existing Bachelor of Pharmacy degree programmes. Furthermore, the academic review required that nominated participants from each school of pharmacy indicate which antimicrobial prescribing principles should be incorporated in the proposed baseline antimicrobial stewardship curriculum. The results of the academic review phase were collated with the content analysis in order to develop the updated draft antimicrobial stewardship curriculum. It was interesting to note that large variation in content and structure related to antimicrobial stewardship which was presented by the various schools of pharmacy in South Africa. In terms of curriculum content, recommendations made by academic professionals informed the development of relative importance groupings, which allowed for the various antimicrobial stewardship principles to be tiered according to importance for inclusion in the proposed baseline antimicrobial stewardship curriculum. The large variation in antimicrobial stewardship curriculum structure posed as a challenge for the development of the proposed baseline curriculum, requiring that the structure remain flexible in order for feasible incorporation into the pre-existing Bachelor of Pharmacy degree programmes offered by the various schools of pharmacy in South Africa. The expert consultation phase explored the perceptions of multiple key health disciplines who serve as part of antimicrobial stewardship teams in South Africa with regards to the role of the pharmacist in antimicrobial stewardship; and the minimum level of antimicrobial stewardship knowledge and skills which pharmacy students should possess prior to entry into practice. The results of the expert consultation phase were collated with the results of the content analysis and academic review phase in order to develop the final proposed baseline antimicrobial stewardship curriculum. The findings of the expert consultation phase indicated great variability regarding the perceived role of the pharmacist in antimicrobial stewardship within and between health disciplines. Furthermore, the relative perceived importance of various antimicrobial stewardship strategies and antimicrobial prescribing principles were explored, which informed the tiering of content in the final proposed antimicrobial stewardship curriculum.
- Full Text:
- Date Issued: 2019
- Authors: Khan, Yasmine
- Date: 2019
- Subjects: Pharmacy -- Study and teaching -- South Africa , Pharmacy -- Practice -- South Africa Drug utilization -- Dissertations Drug utilization -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/35752 , vital:33805
- Description: Antimicrobial stewardship refers to the healthcare practice which ensures the judicious and appropriate prescribing of antimicrobial agents. The primary purpose of antimicrobial stewardship entails minimising the progression of antimicrobial resistance; the rise of which is recognised as a threat to global health and safety. The pharmacist is recognised nationally and internationally as a key role player in the implementation of antimicrobial stewardship. Education of healthcare practitioners in antimicrobial stewardship is a recognised strategic enabler for the containment of antimicrobial resistance in South Africa. The primary aim of the study was to develop a proposed baseline antimicrobial stewardship curriculum which is suitable for implementation into the Bachelor of Pharmacy programmes offered by South African schools of pharmacy. The aims and objectives of the study were achieved through the conduction of four study phases: the content analysis, academic review, expert consultation and curriculum development. The content analysis investigated the structure and content of international antimicrobial stewardship curricula, and the national policy governing antimicrobial stewardship implementation in South Africa. Frequency distributions of trends from the reviewed literature informed the development of the initial draft antimicrobial stewardship curriculum for pharmacy students. In terms of content, the principles which emerges with high frequency, which were thus emphasised in the initial draft curriculum, included: the strategic objectives (governance, surveillance, antimicrobial stewardship and infection prevention); strategic enablers (education, communication, legislation and research); dose optimisation; audit and feedback; formulary restriction; collaboration; pre-authorisation; and de-escalation. Available literature did not provide extensive detail regarding the curriculum structure utilised internationally, particularly with regards to the number of contact hours dedicated to the curriculum content and the year level at which antimicrobial stewardship was incorporated in the degree programme (variable between studies). From the content analysis it was evident that a mixed methods pedagogy and use of multiple assessment techniques were recommended. The academic review phase allowed for further insight to be obtained into the content and structure of antimicrobial stewardship curriculum content which was presented in the pre-existing Bachelor of Pharmacy degree programmes. Furthermore, the academic review required that nominated participants from each school of pharmacy indicate which antimicrobial prescribing principles should be incorporated in the proposed baseline antimicrobial stewardship curriculum. The results of the academic review phase were collated with the content analysis in order to develop the updated draft antimicrobial stewardship curriculum. It was interesting to note that large variation in content and structure related to antimicrobial stewardship which was presented by the various schools of pharmacy in South Africa. In terms of curriculum content, recommendations made by academic professionals informed the development of relative importance groupings, which allowed for the various antimicrobial stewardship principles to be tiered according to importance for inclusion in the proposed baseline antimicrobial stewardship curriculum. The large variation in antimicrobial stewardship curriculum structure posed as a challenge for the development of the proposed baseline curriculum, requiring that the structure remain flexible in order for feasible incorporation into the pre-existing Bachelor of Pharmacy degree programmes offered by the various schools of pharmacy in South Africa. The expert consultation phase explored the perceptions of multiple key health disciplines who serve as part of antimicrobial stewardship teams in South Africa with regards to the role of the pharmacist in antimicrobial stewardship; and the minimum level of antimicrobial stewardship knowledge and skills which pharmacy students should possess prior to entry into practice. The results of the expert consultation phase were collated with the results of the content analysis and academic review phase in order to develop the final proposed baseline antimicrobial stewardship curriculum. The findings of the expert consultation phase indicated great variability regarding the perceived role of the pharmacist in antimicrobial stewardship within and between health disciplines. Furthermore, the relative perceived importance of various antimicrobial stewardship strategies and antimicrobial prescribing principles were explored, which informed the tiering of content in the final proposed antimicrobial stewardship curriculum.
- Full Text:
- Date Issued: 2019
A psychobiographical study of Joseph Stalin
- Authors: Matsolo, Vuyiswa
- Date: 2019
- Subjects: Stalin, Joseph -- 1878-1953 , Developmental psychology Self-actualization (Psychology) Psychology -- Biographical methods
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/41570 , vital:36530
- Description: Joseph Stalin was the dictator of the Soviet Union from 1929 to 1953. Stalin ruled by terror and millions of people died during his term as leader. Stalin was known as an evil man, however, he was also hailed as a hero who was able to transform Russia into a major super power. Stalin died in 1953 at the age of 74, after suffering a massive stroke. The aim of the current study was to explore and describe the personality development of Stalin, by applying Alfred Adler’s theory of Individual Psychology and Theodore Millon’s Biopsychosocial Model of Personality to the context of his life experiences. The research design is a psychobiography, which is a single case study, and non-probability purposive sampling was used to select Stalin. The data consisted of primary and secondary data sources that described Stalin’s life experiences, and Yin’s (1994) guidelines for data collection were followed for data collection, which include using multiple sources of evidence, creating a case study database, and keeping and maintaining a reliable chain of evidence. The data was analysed in accordance to Miles and Huberman’s (1994a) model of data analysis. The findings of the study indicated that Stalin’s striving for significance was largely influenced by the social environment and cultural context in which he lived. These factors influenced his need for perfection and superiority, which became prevalent in his behaviour within his childhood years and throughout his quest for power in the Soviet Union. Stalin presented with Adler’s active-destructive lifestyle, which aligns with Millon’s antisocial personality pattern which focuses more on meeting the needs of the self at the expense of others.
- Full Text:
- Date Issued: 2019
- Authors: Matsolo, Vuyiswa
- Date: 2019
- Subjects: Stalin, Joseph -- 1878-1953 , Developmental psychology Self-actualization (Psychology) Psychology -- Biographical methods
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/41570 , vital:36530
- Description: Joseph Stalin was the dictator of the Soviet Union from 1929 to 1953. Stalin ruled by terror and millions of people died during his term as leader. Stalin was known as an evil man, however, he was also hailed as a hero who was able to transform Russia into a major super power. Stalin died in 1953 at the age of 74, after suffering a massive stroke. The aim of the current study was to explore and describe the personality development of Stalin, by applying Alfred Adler’s theory of Individual Psychology and Theodore Millon’s Biopsychosocial Model of Personality to the context of his life experiences. The research design is a psychobiography, which is a single case study, and non-probability purposive sampling was used to select Stalin. The data consisted of primary and secondary data sources that described Stalin’s life experiences, and Yin’s (1994) guidelines for data collection were followed for data collection, which include using multiple sources of evidence, creating a case study database, and keeping and maintaining a reliable chain of evidence. The data was analysed in accordance to Miles and Huberman’s (1994a) model of data analysis. The findings of the study indicated that Stalin’s striving for significance was largely influenced by the social environment and cultural context in which he lived. These factors influenced his need for perfection and superiority, which became prevalent in his behaviour within his childhood years and throughout his quest for power in the Soviet Union. Stalin presented with Adler’s active-destructive lifestyle, which aligns with Millon’s antisocial personality pattern which focuses more on meeting the needs of the self at the expense of others.
- Full Text:
- Date Issued: 2019
A psychobiographical study of Theodore Robert Bundy: an object relations approach
- Authors: Landsberg, Melissa
- Date: 2019
- Subjects: Developmental psychology , Object relations (Psychoanalysis) Psychology -- Biographical methods Psychology -- United States -- Biographical methods Serial murderers -- United States -- Biography Criminals -- United States -- Biography
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/40456 , vital:36167
- Description: The following research study aimed to explore and describe the life and personality development of Theodore Robert Bundy (1946-1989), a serial murderer who confessed to committing more than 30 homicides across different states of America between 1974 and 1978. By examining his distinctive set of cognitions and behaviours through a psychobiographical lens, Bundy’s use of primitive defense mechanisms and level of personality pathology could moreover be identified. In doing so, insights into the psychological motivations behind his aberrant actions could be acquired. This was attained through the application of Kernberg’s (1966) Object Relations Theory to Bundy’s lived experiences. Bundy was chosen as the research subject, based on his infamous reputation and interest value through employing a purposive sampling technique, and subsequently took the form of a qualitative, single case study. Data was collected through the triangulation of multiple primary and secondary sources available in the public domain. This data collection was furthermore processed and analysed through the use of Alexander’s (1988) textual indicators of psychological saliency, and the employment of Miles and Huberman’s (1994) three-step approach to qualitative data analysis (that is, data reduction, data display, and conclusion drawing and verification). The research findings confirmed Bundy’s pathological use of primitive defense mechanisms linked to Kernberg’s description of lower-level pathologies. It additionally emphasised the significance and utility of psychobiographical studies, and highlighted the value of Kernberg’s theory in understanding personality development. Recommendations were then made for future research endeavors to guide individuals that are interested in conducting similar studies that fall within the same genre of study.
- Full Text:
- Date Issued: 2019
- Authors: Landsberg, Melissa
- Date: 2019
- Subjects: Developmental psychology , Object relations (Psychoanalysis) Psychology -- Biographical methods Psychology -- United States -- Biographical methods Serial murderers -- United States -- Biography Criminals -- United States -- Biography
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/40456 , vital:36167
- Description: The following research study aimed to explore and describe the life and personality development of Theodore Robert Bundy (1946-1989), a serial murderer who confessed to committing more than 30 homicides across different states of America between 1974 and 1978. By examining his distinctive set of cognitions and behaviours through a psychobiographical lens, Bundy’s use of primitive defense mechanisms and level of personality pathology could moreover be identified. In doing so, insights into the psychological motivations behind his aberrant actions could be acquired. This was attained through the application of Kernberg’s (1966) Object Relations Theory to Bundy’s lived experiences. Bundy was chosen as the research subject, based on his infamous reputation and interest value through employing a purposive sampling technique, and subsequently took the form of a qualitative, single case study. Data was collected through the triangulation of multiple primary and secondary sources available in the public domain. This data collection was furthermore processed and analysed through the use of Alexander’s (1988) textual indicators of psychological saliency, and the employment of Miles and Huberman’s (1994) three-step approach to qualitative data analysis (that is, data reduction, data display, and conclusion drawing and verification). The research findings confirmed Bundy’s pathological use of primitive defense mechanisms linked to Kernberg’s description of lower-level pathologies. It additionally emphasised the significance and utility of psychobiographical studies, and highlighted the value of Kernberg’s theory in understanding personality development. Recommendations were then made for future research endeavors to guide individuals that are interested in conducting similar studies that fall within the same genre of study.
- Full Text:
- Date Issued: 2019
A Psychobiography of Martin Luther King, jr.
- Authors: Perils, Carlyn Meredith
- Date: 2019
- Subjects: King, Martin Luther, -- Jr., -- 1929-1968 , Psychology -- Biographical methods Politicians -- Psychology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43160 , vital:36753
- Description: This psychobiography focuses on the leadership style of Martin Luther King, Jr., a leader in the United States civil rights movement. King fought against racism, imperialism, poverty and political disenfranchisement, preached a philosophy of non-violence, and aimed to bring about reconciliation among classes, races, and nations. Transformational leaders stimulate and inspire followers to both achieve remarkable outcomes and, in the process, develop their own leadership capacity. This study makes use of a qualitative research method and is a longitudinal psychobiographical case study. The study aimed to explore, describe, and interpret the leadership style demonstrated by King according to the four leadership dimensions in transformational leadership theory. This psychobiographical study is exploratory-descriptive in nature. King was chosen as a research subject via purposive non- random sampling based on the interest value and significance of his life. Data on King’s leadership style was collected from both primary and secondary sources. Data was analysed according to Alexander’s (1988) method and Miles and Huberman’s (1994) approach. To ensure a trustworthy study, the four criteria of credibility, transferability, dependability and conformability were considered. The research did not cause any “distress or harm” to the subject. The subject is long deceased, and a large amount of psychobiographical research was based on “archival” information which was publicly available. Thus reporting such information posed minimal risk of criminal or civil liability being brought against the subject. King was found to demonstrate leadership style associated with idealized influence and inspirational motivation to a much higher extent than individualized consideration or intellectual stimulation. This finding contributes to a more specific understanding of the style of leadership King displayed. The insights gained from this study can be used to guide improvements in leadership practice, in terms of the development of leaders in industry.
- Full Text:
- Date Issued: 2019
- Authors: Perils, Carlyn Meredith
- Date: 2019
- Subjects: King, Martin Luther, -- Jr., -- 1929-1968 , Psychology -- Biographical methods Politicians -- Psychology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43160 , vital:36753
- Description: This psychobiography focuses on the leadership style of Martin Luther King, Jr., a leader in the United States civil rights movement. King fought against racism, imperialism, poverty and political disenfranchisement, preached a philosophy of non-violence, and aimed to bring about reconciliation among classes, races, and nations. Transformational leaders stimulate and inspire followers to both achieve remarkable outcomes and, in the process, develop their own leadership capacity. This study makes use of a qualitative research method and is a longitudinal psychobiographical case study. The study aimed to explore, describe, and interpret the leadership style demonstrated by King according to the four leadership dimensions in transformational leadership theory. This psychobiographical study is exploratory-descriptive in nature. King was chosen as a research subject via purposive non- random sampling based on the interest value and significance of his life. Data on King’s leadership style was collected from both primary and secondary sources. Data was analysed according to Alexander’s (1988) method and Miles and Huberman’s (1994) approach. To ensure a trustworthy study, the four criteria of credibility, transferability, dependability and conformability were considered. The research did not cause any “distress or harm” to the subject. The subject is long deceased, and a large amount of psychobiographical research was based on “archival” information which was publicly available. Thus reporting such information posed minimal risk of criminal or civil liability being brought against the subject. King was found to demonstrate leadership style associated with idealized influence and inspirational motivation to a much higher extent than individualized consideration or intellectual stimulation. This finding contributes to a more specific understanding of the style of leadership King displayed. The insights gained from this study can be used to guide improvements in leadership practice, in terms of the development of leaders in industry.
- Full Text:
- Date Issued: 2019
A systematic review of operationalizations of culture in post traumatic stress
- Ramasodi, Precious, Cronje, Johan
- Authors: Ramasodi, Precious , Cronje, Johan
- Date: 2019
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43037 , vital:36729
- Description: Research which looks at the influence of culture on posttraumatic experience has explored the culture construct through many differing lenses. This is because of the complex nature of culture. Since investigators may delineate culture in any number of ways there are a host of ways in which culture can be operationalised. The presence of differing operationalisations of culture in the literature is not necessarily a hindrance to the furtherance of knowledge. However, researchers may find it beneficial to employ similar operational terms in order for studies to be compared and amalgamated. The present study reviewed literature studies published between 1980 and 2018 that explored Post Traumatic Stress Disorder(PTSD) in different cultural cohorts. Thirty qualitative and quantitative research reports were assessed and six different operational terms were found. These were namely: geographic location, nationality, race, language, religion and ethnicity. Many articles in the pooled articles employed more than one operational to delineate the target population. The key themes which emerged from the pooled articles were the impact of differences between researcher and study participants, the differences in symptom expression and the stigma of the posttraumatic disorder.
- Full Text:
- Date Issued: 2019
- Authors: Ramasodi, Precious , Cronje, Johan
- Date: 2019
- Subjects: Post-traumatic stress disorder
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43037 , vital:36729
- Description: Research which looks at the influence of culture on posttraumatic experience has explored the culture construct through many differing lenses. This is because of the complex nature of culture. Since investigators may delineate culture in any number of ways there are a host of ways in which culture can be operationalised. The presence of differing operationalisations of culture in the literature is not necessarily a hindrance to the furtherance of knowledge. However, researchers may find it beneficial to employ similar operational terms in order for studies to be compared and amalgamated. The present study reviewed literature studies published between 1980 and 2018 that explored Post Traumatic Stress Disorder(PTSD) in different cultural cohorts. Thirty qualitative and quantitative research reports were assessed and six different operational terms were found. These were namely: geographic location, nationality, race, language, religion and ethnicity. Many articles in the pooled articles employed more than one operational to delineate the target population. The key themes which emerged from the pooled articles were the impact of differences between researcher and study participants, the differences in symptom expression and the stigma of the posttraumatic disorder.
- Full Text:
- Date Issued: 2019
A systematic review on South African literature on hegemonic masculinity
- Authors: Pieterse, Carl
- Date: 2019
- Subjects: Masculinity , Men -- Psychology Hegemony
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43225 , vital:36761
- Description: The application and use of hegemonic masculinity as a theory and concept in South African literature is confusing and ambiguous. This confusion often results in hegemonic masculinity being equated to the concepts of dominant masculinity or traditional masculinity. Recently, research has suggested that studies on hegemonic masculinity contaminated the concept, whereas only a few have added new and acceptable knowledge. The concept of hegemonic masculinity has an almost hegemonic foundation in global literature, often resulting in the misuse of the concept. The aim of the study was to identify, analyse, and report on the themes and trends in South African literature that represents the understudied populations that create and maintain hegemonic masculinity. A systematic review process was utilised to identify and summarise the data, while thematic analysis was used to identify, analyse, and report on the patterns in the data. The results revealed five major themes that contribute toward the complex and paradoxical ways in which hegemonic masculinity was created and maintained by both individuals and society. In conclusion, the study discovered the complex nexus of paradoxes that exist in South African society and ultimately how they are used to create and maintain heteronormative standards of living by means of alignment with hegemonic masculinity. The study recommends that future research should focus on intersectionality as a lens through which hegemonic masculinity is studied.
- Full Text:
- Date Issued: 2019
- Authors: Pieterse, Carl
- Date: 2019
- Subjects: Masculinity , Men -- Psychology Hegemony
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/43225 , vital:36761
- Description: The application and use of hegemonic masculinity as a theory and concept in South African literature is confusing and ambiguous. This confusion often results in hegemonic masculinity being equated to the concepts of dominant masculinity or traditional masculinity. Recently, research has suggested that studies on hegemonic masculinity contaminated the concept, whereas only a few have added new and acceptable knowledge. The concept of hegemonic masculinity has an almost hegemonic foundation in global literature, often resulting in the misuse of the concept. The aim of the study was to identify, analyse, and report on the themes and trends in South African literature that represents the understudied populations that create and maintain hegemonic masculinity. A systematic review process was utilised to identify and summarise the data, while thematic analysis was used to identify, analyse, and report on the patterns in the data. The results revealed five major themes that contribute toward the complex and paradoxical ways in which hegemonic masculinity was created and maintained by both individuals and society. In conclusion, the study discovered the complex nexus of paradoxes that exist in South African society and ultimately how they are used to create and maintain heteronormative standards of living by means of alignment with hegemonic masculinity. The study recommends that future research should focus on intersectionality as a lens through which hegemonic masculinity is studied.
- Full Text:
- Date Issued: 2019
Adult circumcision practices of traditional surgeons and nurses in relation to the initiates’ health outcomes/morbidity in the Eastern Cape
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
- Full Text:
- Date Issued: 2019
- Authors: Dalasa, Siyamthemba
- Date: 2019
- Subjects: Circumcision -- Social aspects
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/17029 , vital:40834
- Description: BACKGROUND Despite the adverse outcomes associated with traditional male circumcision, the practice remains prevalent, especially in the Eastern Cape, South, Africa. This study seeks to assess the practices of traditional surgeons and nurses in relation to the prevention and control of infections and their understanding of human physiological mechanisms during circumcision processes. METHOD This study has adopted a qualitative design, which involved conducting 115 semistructured interviews among traditional surgeons, traditional nurses and traditionally circumcised men, and one focus group discussion among traditional nurses. The data generated were transcribed and subjected to thematic content analysis. RESULTS The analysis revealed that both traditional surgeons and nurses demonstrated both poor aseptic techniques and a lack of knowledge of how the human body functions. Their lack of knowledge of basic human physiology meant that they trivialised sepsis in the penile wound. In addition, the seclusion lodges for circumcision and initiates living were unclean and uninhabitable. CONCLUSION The poor aseptic techniques of traditional surgeons and nurses, as well as the uncleanliness of their environment during traditional male circumcision procedures, could expose initiates to infections and morbidity. Environmental health officers should regularly supervise traditional surgeons and nurses in order to prevent the adverse health outcomes associated with the traditional male circumcision practice.
- Full Text:
- Date Issued: 2019