Analysis of early-phase contact tracing during the coronavirus disease 2019 outbreak in Mangaung Metro, Free State
- Monyobo, Priscilla Kesaletseng
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Monyobo, Priscilla Kesaletseng
- Date: 2022-09
- Subjects: Contact tracing (Epidemiology) , Health services administration
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27006 , vital:66215
- Description: Background and Aim Contact tracing is a critical public health measure for controlling and preventing the spread of infectious diseases. Although the principles underlying this strategy are not novel, understanding the changes in infectiousness of COVID-19 is indeed novel. As are the capacity and operating procedures required to support disease investigation in Mangang Metro during the SARS-CoV-2 (COVID-19) pandemic. On 16 March 2020, the first coronavirus disease case in the area, which led to a larger outbreak, occurred in Mangaung Metro, Free State province, South Africa. To date, Mangaung Metro remains the epicentre of the COVID-19 pandemic and the primary driver of the caseload in the Free State province. The aim of this study was to analyse contact tracing data in Mangaung Metro during the early phase of the COVID-19 outbreak (16 March 2020 – 30 June 2020) in order to measure the viral transmissibility of COVID-19 in the early stages of the outbreak, specifically in the context of Mangaung Metro. Methods A descriptive systematic analysis of index COVID-19 cases and their contacts in Mangaung Metro was conducted. The review period ran from 16 March to 30 June 2020, during which there was a total of 1 001 cases in Mangaung Metro. Data was captured on an Excel spreadsheet using the contact line list variables from the established National Institute of Communicable Disease contact line list framework. The inferential statistics were based on a time series analysis to compare the impact of contact tracing stratified by symptomatology and the root cause of the cases to the overall cases in Mangaung Metro. The study determined whether isolation, quarantine, and contact tracing were able to control outbreaks in the early phase using characteristics of disease transmission and parameters particularised to the COVID- 19 pathogen. Results As of 30 June 2020, the Free State province had a total of 2 072 COVID-19 cases. Mangaung Metro contributed 1 001 cases (48 percent) of the total number of cases in the study period. Between March and June 2020, 3 553 contacts were traced in Mangaung Metro. This number translates to at least three investigated and traced contacts per index or laboratory confirmed positive case. From the traced contacts, 1 080 samples were collected and sent for laboratory testing. In April 2020, the greatest number of samples were collected. This high rate in sample collection is posited to be the result of the high rate of contacts traced, as well as the initial clinical guidelines followed for contact tracing. Most positive contacts were discovered in March 2020. One of the possible reasons for the high detection of COVID-19 confirmed positive contacts during the early stages of the outbreak was the focus and importance of contact tracing while the caseload remained relatively low. However, as the outbreak progressed in the Mangaung Metro context, the number and relative percentage of positive cases detected through contact tracing decreased. In total, the positive contacts recorded in March 2020 amounted to 92 (51.3 percent), 18 in April (10.5 percent), 41 in May (22.9percent), and 28 in June (15.6 percent). The March 2020 tracking rate was the highest at 73.2percent, with an average contact tracing rate of 15.5 percent by the end of June 2020. Of all the contacts traced, 7.9 percent involved healthcare workers in the Free State. Conclusion The study’s findings show that contact tracing was an effective control measure during the early stages of the COVID-19 outbreak in Mangung Metro district. Furthermore, the impact was greatest when the caseload was low and the burden on the healthcare system less severe. Mangaung Metro demonstrated the capability of tracing more contacts in the early-early phase of the outbreak; however, as the outbreak progressed to the latent early phase, the caseload increased and fewer contacts were traced. The consequence of contact tracing not being as effective during the latent early phase relates to the increase in both exposed and untraceable contacts, which in turn fueled the increase of new cases. This further impacted the at-risk and vulnerable population, especially the elderly, who were at an increased risk if not traced in a timely manner, possibly resulting in mortality. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/27275 , vital:66532
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Clinical governance implementation challenges in the Department of Health, Mpumalanga, South Africa
- Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
- Authors: Maduna, Patrick Hawkins https://orcid.org/0000-0002-4926-1661
- Date: 2022-09
- Subjects: Clinical competence , Evidence-based medicine , Health services administration
- Language: English
- Type: Doctoral theses , text
- Identifier: http://hdl.handle.net/10353/23600 , vital:58194
- Description: Clinical governance (CG) is the system through which health authorities are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence flourishes. South Africa is one of the countries where CG has not been successfully implemented. This study sought to explore the CG implementation challenges in the Mpumalanga province, South Africa. The study objectives included the seven pillars of CG. The study was a qualitative and exploratory, using purposive sampling technique to select study participants. A total of twenty-two (22) individuals were selected for the study. Semi-structured interviews were used for data collection. Each interview was transcribed verbatim by the researcher. Confidentiality was ensured through the coding of interviewee names. The content analysis technique was used for data analysis, using the study objectives as themes. The study found general lack of understanding of the concept of CG, poor performance of clinical audits, sub-standard clinical performance and effectiveness, poor clinical risk management, poor patient and public involvement in patient care, lack of evidence-based practice and research, inadequate training and development of healthcare workers, and sub-standard health information management across the department. The researcher recommends that the CG policy be prioritised by the Mpumalanga DOH, that systems be put in place to facilitate policy implementation, and that the departmental staff establishments at all levels, prioritise healthcare professionals in key leadership positions. In conclusion, there are numerous challenges that confront the Mpumalanga Department of Health regarding the implementation of clinical governance, requiring urgent attention. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-09
Data management and dispensary: missing link contributing to antiretroviral loss to follow-Up in Lejweleputswa District
- Moatlhodi, Charlotte Motshele
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
- Date Issued: 2022-09
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
- Date Issued: 2022-09
Clinicians knowledge and perceptions of point of care testing (poct) in selected hospitals in the free state, South Africa
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
- Authors: Watkins, Edgar Jeffrey
- Date: 2022-08
- Subjects: Point-of-care testing , Preventive health services , Medical technology
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27264 , vital:66487
- Description: Point of care testing (POCT) improves access and equity to health diagnostic services in resource-limited settings like South Africa, where some health facilities do not have on-site laboratories. With recent technological advancements, most traditional laboratory tests can now be conducted on-site at primary health clinics (PHC), hospital wards and clinics. One advantage of the POCT device is that it can be used by a non-medical laboratory expert at the patient’s bed side during hospitalizations or near the patient in the doctor’s consultation rooms. This results in a shorter turnaround time for the availability of test results when compared to that from a specimen sent to a traditional clinical laboratory. Despite the benefits of POCT, many clinicians (doctors and nurses) avoid utilizing POCT for quality assurance reasons. Clinicians believe the results from a POCT device may not be as reliable as the results from tests performed by a medical laboratory scientist in the traditional clinical laboratory. This study used a concurrent mixed method research design to explore clinicians' POCT knowledge and attitudes in a subset of hospitals in the Free state of South Africa. The study population comprised of consenting medical professionals from the ten (10) selected Free State district hospitals (study sites). The findings demonstrated that hospitals in urban areas have easier access to laboratory services. There were two (2) urban study sites that had on-site laboratories which achieved faster Turn-Around-Time (TAT). The participants indicate that they are aware of POCT and routinely use it, but there are far fewer POCT tests available than laboratory tests. When diagnostic options are scarce, point-of-care testing (POCT) can provide a more accurate diagnosis than traditional methods. The improved health care provision and reduced incidence of health complications is the end result. According to the participants, having access to POCT diagnostic services has shown promise in addressing challenges that sometimes present with laboratory-based methods, particularly in settings with limited access to hospitals or when laboratories cannot be accessed. Further, clinicians argue that errors in the usage of POCT may occur due to the quality of these POCTs and improper documentation of the test results by the clinicians. Therefore, poor utilization of POCT by clinicians can be improved if implemented with pre-set strict selection goals and processes to ensure that the right POCT is selected for the right purpose that would reduce resource expenditure by the hospitals and improve patient experiences and health outcomes. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
Dietary preference and perceptions of the health implications: A qualitative study on perspectives from outpatients and health care providers at Nontyatyambo Community Health Centre, Eastern Cape, South Africa
- Authors: Chocko, Ronnie J A V
- Date: 2022-08
- Subjects: Diet , Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26764 , vital:65990
- Description: Introduction and background. Poor dietary choices are resulting in an increase of mortality and morbidity rates globally. Epidemiological studies reveal that diets high in animal-sourced foods (ASF) lead to an increased risk of developing cardio-metabolic diseases (CMD). On the other hand, plant-based foods (PBF) have been shown to reduce this risk. Making well informed dietary choices plays an important role in reducing the burden of these diseases. To this end, this study further explores the role that diet plays in maintaining good health by exploring current dietary preferences, perceptions of the health implications of these dietary choices and perceptions of the benefits of PBFs vs ASFs of people in a local South African context. Methodology. This qualitative study was conducted at Nontyatyambo Community Health Centre, Mdantansane, Buffalo City Metropolitan district in the Eastern Cape province of South Africa. A sample of 42 participants was enrolled for the study. A question/interview guide was used to collect data through key-in-depth interviews and focus group discussions. Two audio recorders were used to record the verbal responses of participants. The recorded interviews were transcribed and translated to English. The transcribed data was systematically and thematically analyzed. Results. It was found that all participants in this study were following an omnivorous dietary pattern. A number of participants expressed that they did not like vegetables. In this study, most participants felt that PBFs were healthier than ASFs. Even though they felt PBFs were healthier, none followed exclusively plant-based diet. Conclusion. Transforming dietary patterns to contain more plant-based foods may be a critical factor in reversing harmful effects on public health and the environment. This calls for urgent public health intervention to improve nutritional uptake as a strategy to reduce potential CMD. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
- Authors: Chocko, Ronnie J A V
- Date: 2022-08
- Subjects: Diet , Nutrition
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26764 , vital:65990
- Description: Introduction and background. Poor dietary choices are resulting in an increase of mortality and morbidity rates globally. Epidemiological studies reveal that diets high in animal-sourced foods (ASF) lead to an increased risk of developing cardio-metabolic diseases (CMD). On the other hand, plant-based foods (PBF) have been shown to reduce this risk. Making well informed dietary choices plays an important role in reducing the burden of these diseases. To this end, this study further explores the role that diet plays in maintaining good health by exploring current dietary preferences, perceptions of the health implications of these dietary choices and perceptions of the benefits of PBFs vs ASFs of people in a local South African context. Methodology. This qualitative study was conducted at Nontyatyambo Community Health Centre, Mdantansane, Buffalo City Metropolitan district in the Eastern Cape province of South Africa. A sample of 42 participants was enrolled for the study. A question/interview guide was used to collect data through key-in-depth interviews and focus group discussions. Two audio recorders were used to record the verbal responses of participants. The recorded interviews were transcribed and translated to English. The transcribed data was systematically and thematically analyzed. Results. It was found that all participants in this study were following an omnivorous dietary pattern. A number of participants expressed that they did not like vegetables. In this study, most participants felt that PBFs were healthier than ASFs. Even though they felt PBFs were healthier, none followed exclusively plant-based diet. Conclusion. Transforming dietary patterns to contain more plant-based foods may be a critical factor in reversing harmful effects on public health and the environment. This calls for urgent public health intervention to improve nutritional uptake as a strategy to reduce potential CMD. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-08
Catatonia a manifestation of serious mental Illness: prevalence, presentation, management, and outcomes in a mental health unit
- Authors: Zingela, Zukiswa
- Date: 2022-07
- Subjects: Mental Health , Catatonia , Psychomotor disorders
- Language: English
- Type: Doctoral's theses , text
- Identifier: http://hdl.handle.net/10948/60400 , vital:64706
- Description: Catatonia is a psychomotor abnormality that may be caused by severe physical or mental illness or by substances. It has a wide-ranging prevalence from less than 10% to just over 60%, worldwide. This thesis investigated multiple aspects of catatonia in an acute mental health unit setting. Critical aspects examined include the psychological experience of catatonia and assessment, prevalence, presentation, management, and treatment outcomes of catatonia. The research design was a prospective descriptive triangulation study that used a mixed quantitative and qualitative approach. The theoretical framework applied in this thesis was a positivist paradigm approach to explore the quantitative data collected, with application of deductive reasoning, supported by statistical analysis to detect correlations between catatonia and demographic and clinical data. The research explored the experience of a person with catatonia from the beginning to the end of the catatonic episode, inclusive of neglected areas such as the patient’s psychological and experiences. Sources of information included participant reports, clinical notes, and assessments conducted using screening tools for catatonia. Key knowledge gaps on catatonia were identified as target areas for this thesis. These are the prevalence of catatonia in a South African setting; the use of assessment tools like the Bush Francis Catatonia Screening Instrument (BFCSI), the Bush Francis Catatonia Rating Scale (BFCRS), and the Diagnostic and Statistical Manual (5th Edition; DSM-5) in this setting; interventions for catatonia; treatment outcomes; and the subjective experiences of catatonia, as described by patients. To date, there have been five publications produced from this thesis. The first paper was on the protocol for the research and was published in the British Medical Journal (BMJ) Open and presented the literature review, research design, and methodology for the planned Abstract ii research on catatonia (which has ultimately been presented in this current thesis). This paper also identified the aforementioned critical knowledge gaps. The second paper was published in the Biomedicine Central (BMC) International Journal of Mental Health Systems. This paper described a 6-month prevalence rate of catatonia of 11.9%, and concluded that the BFCSI and BFCRS had the highest inter-rater reliability (IRR) and pick-up rate when screening for catatonia, while the DMS-5 had low IRR, and the lowest correlation with the BFCSI and BFCRS. The 12-month prevalence rate was found to be 18.3% and was described in the third paper which was published in the PLOS One Psychiatry. Both lorazepam and electroconvulsive therapy (ECT) were found to be the most widely used treatment at the study site, with good response rates and outcomes. The results were published in the 4th paper in SAGE Open. The fifth paper was on the subjective and psychological experience and published in the BMC Psychology journal. It described the psychological and subjective experience of catatonia as narrated by participants which is characterised by intense experiences of fear, anxiety, and sadness that manifested as extreme withdrawal, combined with obedience or submission. This research has yielded new knowledge with potential applications at a regional, national, and global level. New knowledge yielded includes the need for screening of patients for catatonia across all acute settings, the need for training of both medical and nursing personnel in the assessment of catatonia, the effectiveness of screening and assessment tools, effective interventions for catatonia and outcomes. The descriptions of catatonia at an emotional, cognitive, and behavioural level also highlight the need to develop psychological strategies and targeted psychological interventions to complement the current management strategies. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Zingela, Zukiswa
- Date: 2022-07
- Subjects: Mental Health , Catatonia , Psychomotor disorders
- Language: English
- Type: Doctoral's theses , text
- Identifier: http://hdl.handle.net/10948/60400 , vital:64706
- Description: Catatonia is a psychomotor abnormality that may be caused by severe physical or mental illness or by substances. It has a wide-ranging prevalence from less than 10% to just over 60%, worldwide. This thesis investigated multiple aspects of catatonia in an acute mental health unit setting. Critical aspects examined include the psychological experience of catatonia and assessment, prevalence, presentation, management, and treatment outcomes of catatonia. The research design was a prospective descriptive triangulation study that used a mixed quantitative and qualitative approach. The theoretical framework applied in this thesis was a positivist paradigm approach to explore the quantitative data collected, with application of deductive reasoning, supported by statistical analysis to detect correlations between catatonia and demographic and clinical data. The research explored the experience of a person with catatonia from the beginning to the end of the catatonic episode, inclusive of neglected areas such as the patient’s psychological and experiences. Sources of information included participant reports, clinical notes, and assessments conducted using screening tools for catatonia. Key knowledge gaps on catatonia were identified as target areas for this thesis. These are the prevalence of catatonia in a South African setting; the use of assessment tools like the Bush Francis Catatonia Screening Instrument (BFCSI), the Bush Francis Catatonia Rating Scale (BFCRS), and the Diagnostic and Statistical Manual (5th Edition; DSM-5) in this setting; interventions for catatonia; treatment outcomes; and the subjective experiences of catatonia, as described by patients. To date, there have been five publications produced from this thesis. The first paper was on the protocol for the research and was published in the British Medical Journal (BMJ) Open and presented the literature review, research design, and methodology for the planned Abstract ii research on catatonia (which has ultimately been presented in this current thesis). This paper also identified the aforementioned critical knowledge gaps. The second paper was published in the Biomedicine Central (BMC) International Journal of Mental Health Systems. This paper described a 6-month prevalence rate of catatonia of 11.9%, and concluded that the BFCSI and BFCRS had the highest inter-rater reliability (IRR) and pick-up rate when screening for catatonia, while the DMS-5 had low IRR, and the lowest correlation with the BFCSI and BFCRS. The 12-month prevalence rate was found to be 18.3% and was described in the third paper which was published in the PLOS One Psychiatry. Both lorazepam and electroconvulsive therapy (ECT) were found to be the most widely used treatment at the study site, with good response rates and outcomes. The results were published in the 4th paper in SAGE Open. The fifth paper was on the subjective and psychological experience and published in the BMC Psychology journal. It described the psychological and subjective experience of catatonia as narrated by participants which is characterised by intense experiences of fear, anxiety, and sadness that manifested as extreme withdrawal, combined with obedience or submission. This research has yielded new knowledge with potential applications at a regional, national, and global level. New knowledge yielded includes the need for screening of patients for catatonia across all acute settings, the need for training of both medical and nursing personnel in the assessment of catatonia, the effectiveness of screening and assessment tools, effective interventions for catatonia and outcomes. The descriptions of catatonia at an emotional, cognitive, and behavioural level also highlight the need to develop psychological strategies and targeted psychological interventions to complement the current management strategies. , Thesis (PhD) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Colistin utilisation and clinical outcomes at a public hospital in Bloemfontein, South Africa
- Matshediso, Gaalebale Prudence
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice Town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
A survey of food safety practices and microbial risk related to ready-to-eat chicken food outlets from a university campus in South Africa
- Authors: Michau, Willem P
- Date: 2022-04
- Subjects: Microbial exopolysaccharides -- South Africa , Food -- Safety measures
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58925 , vital:60248
- Description: A survey of food safety practices and microbial risk related to ready-to-eat chicken in food outlets from a university campus in South Africa was investigated. The objective of the study was to determine the food safety practices and hygiene knowledge of food handlers in food outlets at a South African university campus. Six food outlets out of the thirteen university food outlets that were similar in type were selected for the study. These six food outlets were selected based on establish criteria but did not comply with HACCP principles. To assess the possible contamination risk related to hygiene practices and processing of ready-to-eat chicken, Total Viable Count, Escherichia coli, Salmonella and Staphylococcus aureus counts were determined using standard methods. A validated questionnaire was used to assess the educational levels of each of the 27 participating food handlers; as well as the determination of the food handlers’ personal and general hygiene. Microbial levels of each food handler hand, aprons, as well as the microbial contamination levels of direct food contact surfaces, and ready-to-eat chicken at each facility were evaluated using standard methods. Several risky non-conforming personal and general hygiene practices were detected during the study. Appropriate corrective actions such as an intensive food hygiene training programme accompanied by a food management system should be implemented in all food facilities. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Michau, Willem P
- Date: 2022-04
- Subjects: Microbial exopolysaccharides -- South Africa , Food -- Safety measures
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58925 , vital:60248
- Description: A survey of food safety practices and microbial risk related to ready-to-eat chicken in food outlets from a university campus in South Africa was investigated. The objective of the study was to determine the food safety practices and hygiene knowledge of food handlers in food outlets at a South African university campus. Six food outlets out of the thirteen university food outlets that were similar in type were selected for the study. These six food outlets were selected based on establish criteria but did not comply with HACCP principles. To assess the possible contamination risk related to hygiene practices and processing of ready-to-eat chicken, Total Viable Count, Escherichia coli, Salmonella and Staphylococcus aureus counts were determined using standard methods. A validated questionnaire was used to assess the educational levels of each of the 27 participating food handlers; as well as the determination of the food handlers’ personal and general hygiene. Microbial levels of each food handler hand, aprons, as well as the microbial contamination levels of direct food contact surfaces, and ready-to-eat chicken at each facility were evaluated using standard methods. Several risky non-conforming personal and general hygiene practices were detected during the study. Appropriate corrective actions such as an intensive food hygiene training programme accompanied by a food management system should be implemented in all food facilities. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
An exploration of burnout among health Professions academics employed in Health sciences faculties at a south African university
- Authors: Burger, Jeanine
- Date: 2022-04
- Subjects: Health care personnel -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58665 , vital:59979
- Description: The label of ‘stress factories’ is becoming a way to collectively refer to higher education institutions due to the changing academic landscape. Academics within health professions face key stressors related to excessive workloads, and insufficient resources resulting in burnout. Some of the most pertinent consequences of burnout include deterioration in physical and mental health, incline in absenteeism and a negative impact on the well-being and performance of students, patients, and organisations. There is a lack of research conducted on health professions academics in South Africa. The overall aim of this study was, therefore, to explore burnout among health professions academic staff who worked within the Community and Health Sciences (CHS) and Dentistry faculties (collectively referred to as Health sciences faculties) at a historically disadvantaged university. The study adopted an online survey design. Participants were selected using simple random sampling. Frequency tables were used to summarise and describe the participants, while correlation analysis was used to test associative relationships. ANOVA was used to test group differences and Scheffé tests were used for posthoc analysis. Ethics clearance was obtained from the Bio-Medical Research Ethics Committee of UWC. Permission to conduct the study was given by the Registrar of UWC. Informed consent was sought from participants for their voluntary participation. Their identities were kept anonymous and responses confidential. Overall findings from the current study indicated that this sample of Health Professional Academics (HPAs) experienced moderate to high levels of burnout, as measured by the Oldenburg Burnout Inventory. No demographic factors were found to correlate with the total score of burnout. Two variables were significantly related to exhaustion, namely the level of qualification and whether participants were studying at the time of completing the survey. Furthermore, nurses and participants currently studying towards a PhD reported significantly higher levels of burnout than the rest of the sample of HPAs. The impact of this study shows HPAs’ experience of moderate to high levels of burnout require interventions to decrease job demands and increase job resources. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Burger, Jeanine
- Date: 2022-04
- Subjects: Health care personnel -- South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58665 , vital:59979
- Description: The label of ‘stress factories’ is becoming a way to collectively refer to higher education institutions due to the changing academic landscape. Academics within health professions face key stressors related to excessive workloads, and insufficient resources resulting in burnout. Some of the most pertinent consequences of burnout include deterioration in physical and mental health, incline in absenteeism and a negative impact on the well-being and performance of students, patients, and organisations. There is a lack of research conducted on health professions academics in South Africa. The overall aim of this study was, therefore, to explore burnout among health professions academic staff who worked within the Community and Health Sciences (CHS) and Dentistry faculties (collectively referred to as Health sciences faculties) at a historically disadvantaged university. The study adopted an online survey design. Participants were selected using simple random sampling. Frequency tables were used to summarise and describe the participants, while correlation analysis was used to test associative relationships. ANOVA was used to test group differences and Scheffé tests were used for posthoc analysis. Ethics clearance was obtained from the Bio-Medical Research Ethics Committee of UWC. Permission to conduct the study was given by the Registrar of UWC. Informed consent was sought from participants for their voluntary participation. Their identities were kept anonymous and responses confidential. Overall findings from the current study indicated that this sample of Health Professional Academics (HPAs) experienced moderate to high levels of burnout, as measured by the Oldenburg Burnout Inventory. No demographic factors were found to correlate with the total score of burnout. Two variables were significantly related to exhaustion, namely the level of qualification and whether participants were studying at the time of completing the survey. Furthermore, nurses and participants currently studying towards a PhD reported significantly higher levels of burnout than the rest of the sample of HPAs. The impact of this study shows HPAs’ experience of moderate to high levels of burnout require interventions to decrease job demands and increase job resources. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Attention-deficit/hyperactivity disorder and substance abuse: prevalence and effect of past pharmacotherapy in young adults
- Authors: Coetze, Corne
- Date: 2022-04
- Subjects: Attention-deficit hyperactivity disorder , Substance abuse
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58783 , vital:60121
- Description: Background: Attention-Deficit/Hyperactivity Disorder (ADHD) frequently occurs in patients with SUD. Several studies demonstrated that ADHD constitutes a significant risk factor for the development of SUDs and suggest that childhood ADHD pharmacotherapy might help prevent the development of SUD. Furthermore, substance use patterns seem to differ between individuals with and without ADHD. Aim: The primary aim of this study was to establish the prevalence of ADHD in SUD in a South African treatment-seeking population, substance use patterns, and to determine the effect of past pharmacotherapy on later life’s functional impairment in adult ADHD treatment-seeking patients with a SUD. Method: Adult treatment-seeking SUD patients (n=360) were recruited from rehabilitation facilities and screened using the ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1). ADHD diagnosis was confirmed (n=52) by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). Adults with ADHD without SUD (n=48) were recruited from clinicians, retail pharmacies and the general public. Life-time substance use was assessed using a self-report questionnaire. Tobacco use was assessed by the Fagerström Test for Nicotine Dependence (FTND). ADHD-related functional impairment was assessed by the Weiss Functional Impairment Rating Scale (WFIRS). Information on present and life-time use of ADHD medication was obtained. Clinical outcomes between those with and without a history of pharmacotherapy were compared. Results: ADHD is highly prevalent in South African adult treatment-seeking SUD patients. High rates of untreated and unrecognised ADHD were found. Individuals with SUD+ADHD were significantly associated with higher tobacco use. Data indicated increased levels of cannabis consumption among SUD+ADHD individuals, especially among SUD+ADHD females. Furthermore, we found that patients with ADHD were significantly associated with polysubstance use. Our results showed a history of childhood ADHD pharmacotherapy to be associated with less functional ADHD-related impairment across all functional domains and a decreased risk for substance use in later life. Abstract Conclusion: High rates of untreated and unrecognised ADHD were found among treatment-seeking SUD patients. ADHD patients appeared to self-medicate to cope with their symptoms. Childhood ADHD pharmacotherapy might be associated with a decreased risk for substance use in adulthood and lower ADHD-related impairment. Despite study limitations, these findings underline the importance of early ADHD detection and treatment, which might prevent substance use. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Coetze, Corne
- Date: 2022-04
- Subjects: Attention-deficit hyperactivity disorder , Substance abuse
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58783 , vital:60121
- Description: Background: Attention-Deficit/Hyperactivity Disorder (ADHD) frequently occurs in patients with SUD. Several studies demonstrated that ADHD constitutes a significant risk factor for the development of SUDs and suggest that childhood ADHD pharmacotherapy might help prevent the development of SUD. Furthermore, substance use patterns seem to differ between individuals with and without ADHD. Aim: The primary aim of this study was to establish the prevalence of ADHD in SUD in a South African treatment-seeking population, substance use patterns, and to determine the effect of past pharmacotherapy on later life’s functional impairment in adult ADHD treatment-seeking patients with a SUD. Method: Adult treatment-seeking SUD patients (n=360) were recruited from rehabilitation facilities and screened using the ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1). ADHD diagnosis was confirmed (n=52) by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). Adults with ADHD without SUD (n=48) were recruited from clinicians, retail pharmacies and the general public. Life-time substance use was assessed using a self-report questionnaire. Tobacco use was assessed by the Fagerström Test for Nicotine Dependence (FTND). ADHD-related functional impairment was assessed by the Weiss Functional Impairment Rating Scale (WFIRS). Information on present and life-time use of ADHD medication was obtained. Clinical outcomes between those with and without a history of pharmacotherapy were compared. Results: ADHD is highly prevalent in South African adult treatment-seeking SUD patients. High rates of untreated and unrecognised ADHD were found. Individuals with SUD+ADHD were significantly associated with higher tobacco use. Data indicated increased levels of cannabis consumption among SUD+ADHD individuals, especially among SUD+ADHD females. Furthermore, we found that patients with ADHD were significantly associated with polysubstance use. Our results showed a history of childhood ADHD pharmacotherapy to be associated with less functional ADHD-related impairment across all functional domains and a decreased risk for substance use in later life. Abstract Conclusion: High rates of untreated and unrecognised ADHD were found among treatment-seeking SUD patients. ADHD patients appeared to self-medicate to cope with their symptoms. Childhood ADHD pharmacotherapy might be associated with a decreased risk for substance use in adulthood and lower ADHD-related impairment. Despite study limitations, these findings underline the importance of early ADHD detection and treatment, which might prevent substance use. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Birthing process preparedness of first-time mothers in the public obstetric units of the Nelson Mandela Bay health district (NMBHD).
- Authors: Dlamini, Xolani
- Date: 2022-04
- Subjects: Birthparents , Nelson Mandela Bay Health District
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58815 , vital:60126
- Description: The birthing process is a challenging, unpredictable yet a beautiful life event for birthing women, requiring reasonable birthing process preparedness on birthing woman to enhance her cooperation during the birthing process. Often first-time mothers lack their own frame of reference regarding the birthing process to improve their birthing process preparedness. As an alternative they are reliant on that of other people with birthing process experiences or on what they are told by midwives. The purpose of this study was to understand how was the preparedness of the birthing process of first-time mothers in the public obstetric units of the NMBHD. Thus, an indication of how ready were they, when the labour started. The objectives of the study were as follows, to: • explore and describe the birthing process preparedness of first-time mothers in the public obstetric units of the NMBHD and • formulate recommendations for midwives and nurse managers that would aid them in facilitating the birthing process preparedness of first-time mothers in public obstetric units in the NMBHD. The study adopted a qualitative research design with exploratory, descriptive and contextual approach. The research population were first-time mothers who had booked and delivered in any of the obstetric units in the NMBHD. The convenience, non-probability sampling methods were used in selecting the first-time mothers who met the inclusion criteria. Envisaged sample size was 21 participants but also depending on data saturation. Sixteen participants were ultimately interviewed but only fifteen of those interviews were used. The data collection method used was one-on-one semi-structured interviews which were captured on a digital voice-recorder. The thematic method of data analysis was used to analyse data from the interviews. Three main themes emerged from the data analysis: • Theme 1: Participants shared their experiences regarding the birthing process and their birthing process preparedness. • Theme 2: Participants expressed having had varied experiences from factors that had influenced their birthing preparedness. iv • Theme 3: Participants provided suggestions for midwives to facilitate their birthing process preparedness. Recommendations were made for midwives and managers, nursing education, research and limitations of the study were outlined. To comply with trustworthiness, this study adopted Lincoln and Guba’s Model of trustworthiness. The ethical principles that guided this study with human participants were the principles of respect for persons, beneficence, non-maleficence and justice. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Dlamini, Xolani
- Date: 2022-04
- Subjects: Birthparents , Nelson Mandela Bay Health District
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58815 , vital:60126
- Description: The birthing process is a challenging, unpredictable yet a beautiful life event for birthing women, requiring reasonable birthing process preparedness on birthing woman to enhance her cooperation during the birthing process. Often first-time mothers lack their own frame of reference regarding the birthing process to improve their birthing process preparedness. As an alternative they are reliant on that of other people with birthing process experiences or on what they are told by midwives. The purpose of this study was to understand how was the preparedness of the birthing process of first-time mothers in the public obstetric units of the NMBHD. Thus, an indication of how ready were they, when the labour started. The objectives of the study were as follows, to: • explore and describe the birthing process preparedness of first-time mothers in the public obstetric units of the NMBHD and • formulate recommendations for midwives and nurse managers that would aid them in facilitating the birthing process preparedness of first-time mothers in public obstetric units in the NMBHD. The study adopted a qualitative research design with exploratory, descriptive and contextual approach. The research population were first-time mothers who had booked and delivered in any of the obstetric units in the NMBHD. The convenience, non-probability sampling methods were used in selecting the first-time mothers who met the inclusion criteria. Envisaged sample size was 21 participants but also depending on data saturation. Sixteen participants were ultimately interviewed but only fifteen of those interviews were used. The data collection method used was one-on-one semi-structured interviews which were captured on a digital voice-recorder. The thematic method of data analysis was used to analyse data from the interviews. Three main themes emerged from the data analysis: • Theme 1: Participants shared their experiences regarding the birthing process and their birthing process preparedness. • Theme 2: Participants expressed having had varied experiences from factors that had influenced their birthing preparedness. iv • Theme 3: Participants provided suggestions for midwives to facilitate their birthing process preparedness. Recommendations were made for midwives and managers, nursing education, research and limitations of the study were outlined. To comply with trustworthiness, this study adopted Lincoln and Guba’s Model of trustworthiness. The ethical principles that guided this study with human participants were the principles of respect for persons, beneficence, non-maleficence and justice. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Determining and its effects on perceptual motor skills of soccer players
- Authors: Van Niekerk, Tyra-lee
- Date: 2022-04
- Subjects: Soccer players , Perceptual-motor processes
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58961 , vital:60251
- Description: Objectives: The influence of detraining on the perceptual motor skills of soccer players has been theorized, but not verified empirically (Farrow & Robertson, 2017). The aim of this study was to examine detraining and its effects on the perceptual-motor skills of soccer players by employing a three-week period of no training, immediately post-season. Method: To further examine the effects that three weeks of no training would have on the perceptual-motor and perceptual-cognitive abilities of soccer players, sixteen male club university soccer players (aged 21.10±2.69 years with 12.40±3.18 years of playing experience) participated in this single-cohort longitudinal observation study. The measurements were performed in the following order with sprint testing encompassing the 40-Meter Sprint Test, aerobic performance testing by use of Intermittent Yo-Yo Test (YYIR2), perceptual-motor testing which consisted of the Loughborough Soccer Passing Test and perceptual-cognitive testing undertaken by means of Video-based assessment. Results: A three-week period of no training showed no negligible effects of detraining on sprint performance (F(2, 30) = 1.43, p = .255, ƞp2 = .09), perceptual-motor performance (F(1, 15) = 2.52, p = .133, ƞp2 = .14) nor effects of detraining regarding perceptual-cognitive aptitudes (F(2, 30)= 0.28, p= .813, ƞp 2= .01 ). Results of the study did, however, suggest the potential for increasing aerobic performance (F(1, 15) = 6.17, p = .025, ƞp2 = .29). Additionally, the study results inferred that within Video-based assessment, university club soccer players may develop a response bias due to familiarity or repeated exposure to the testing procedures. Conclusions: Results from the study fail to comprehensively show the effects of detraining on male club university soccer players in all aspects of the perceptual-skill framework, after three weeks of no training. The researcher further discusses the effects of familiarity, repeated exposure and the robustness of these perceptual-cognitive and perceptual-motor abilities as possible reasons for the results returned. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Van Niekerk, Tyra-lee
- Date: 2022-04
- Subjects: Soccer players , Perceptual-motor processes
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58961 , vital:60251
- Description: Objectives: The influence of detraining on the perceptual motor skills of soccer players has been theorized, but not verified empirically (Farrow & Robertson, 2017). The aim of this study was to examine detraining and its effects on the perceptual-motor skills of soccer players by employing a three-week period of no training, immediately post-season. Method: To further examine the effects that three weeks of no training would have on the perceptual-motor and perceptual-cognitive abilities of soccer players, sixteen male club university soccer players (aged 21.10±2.69 years with 12.40±3.18 years of playing experience) participated in this single-cohort longitudinal observation study. The measurements were performed in the following order with sprint testing encompassing the 40-Meter Sprint Test, aerobic performance testing by use of Intermittent Yo-Yo Test (YYIR2), perceptual-motor testing which consisted of the Loughborough Soccer Passing Test and perceptual-cognitive testing undertaken by means of Video-based assessment. Results: A three-week period of no training showed no negligible effects of detraining on sprint performance (F(2, 30) = 1.43, p = .255, ƞp2 = .09), perceptual-motor performance (F(1, 15) = 2.52, p = .133, ƞp2 = .14) nor effects of detraining regarding perceptual-cognitive aptitudes (F(2, 30)= 0.28, p= .813, ƞp 2= .01 ). Results of the study did, however, suggest the potential for increasing aerobic performance (F(1, 15) = 6.17, p = .025, ƞp2 = .29). Additionally, the study results inferred that within Video-based assessment, university club soccer players may develop a response bias due to familiarity or repeated exposure to the testing procedures. Conclusions: Results from the study fail to comprehensively show the effects of detraining on male club university soccer players in all aspects of the perceptual-skill framework, after three weeks of no training. The researcher further discusses the effects of familiarity, repeated exposure and the robustness of these perceptual-cognitive and perceptual-motor abilities as possible reasons for the results returned. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Early maladaptive schemas among re-offenders in Gqeberha 102
- Authors: Mantshiyose, Asisipho
- Date: 2022-04
- Subjects: Recidivism -- Gqeberha
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58904 , vital:60246
- Description: high crime rate in South Africa showed an increase in 2018 with recidivism being the highest contributing factor. The increase in recidivism rates is a result of many factors, including the ineffectiveness of rehabilitation programmes. In an attempt to combat the increase in recidivism, its causes have been examined from a number of perspectives, especially social factors. However, very few studies have focussed on psychological factors when studying crime in South Africa. International studies have found personality factors to be a contributing factor towards recidivism. Concordantly, international studies have also established a correlation between early maladaptive schemas, a core component of personality, and crime. This study aimed to explore early maladaptive schemas among reoffenders in Gqeberha, South Africa. The objective of the study was to establish the prevalence of EMS in a sample of repeat offenders from the National Institute for Crime Prevention and the Reintegration of Offenders (NICRO) in Gqeberha. The study used a quantitative methodology and a sample size of 14 participants was utilised. Convenience sampling was utilised to identify reoffenders. The data was collected by administering a short demographical questionnaire and the Young Schema Questionnaire (YSQ). Descriptive statistics and Spearman’s correlations were utilised to analyse the data. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Mantshiyose, Asisipho
- Date: 2022-04
- Subjects: Recidivism -- Gqeberha
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58904 , vital:60246
- Description: high crime rate in South Africa showed an increase in 2018 with recidivism being the highest contributing factor. The increase in recidivism rates is a result of many factors, including the ineffectiveness of rehabilitation programmes. In an attempt to combat the increase in recidivism, its causes have been examined from a number of perspectives, especially social factors. However, very few studies have focussed on psychological factors when studying crime in South Africa. International studies have found personality factors to be a contributing factor towards recidivism. Concordantly, international studies have also established a correlation between early maladaptive schemas, a core component of personality, and crime. This study aimed to explore early maladaptive schemas among reoffenders in Gqeberha, South Africa. The objective of the study was to establish the prevalence of EMS in a sample of repeat offenders from the National Institute for Crime Prevention and the Reintegration of Offenders (NICRO) in Gqeberha. The study used a quantitative methodology and a sample size of 14 participants was utilised. Convenience sampling was utilised to identify reoffenders. The data was collected by administering a short demographical questionnaire and the Young Schema Questionnaire (YSQ). Descriptive statistics and Spearman’s correlations were utilised to analyse the data. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
Exploring psychologists’ perceptions on how they integrate their own cultural belief systems within the therapeutic relationship in the Eastern Cape province, South Africa
- Authors: Potso, Thando
- Date: 2022-04
- Subjects: Psychologist -- Eastern Cape , Cultural competence , South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58936 , vital:60249
- Description: While there is extensive research exploring the influence of a client’s cultural beliefs on the therapeutic process; there is still a scarcity of information on how the cultural beliefs held by a psychologist may affect or influence the therapeutic process. Psychologists are trained to work with clients objectively by suspending their own beliefs, ideas, and values. Despite this, it would be interesting to explore how South African psychologists’ personal belief systems are navigated within the therapeutic space. Given the diversity of cultures within the South African context, it becomes important to explore and understand psychologists’ cultural belief systems, as they may influence the therapeutic relationship but to also, understand how they assimilate these belief systems into the therapeutic relationships with diverse clients. Drawing on the qualitative methodology, the study sought to draw participants using a purposive sampling technique. Participants were sourced through different databases, such as the Eastern Cape database of registered and practicing psychologists. Participants who agreed to partake in the study were sent an email with the interview schedule and the link to either MS Teams or Zoom, depending on their preference. The collected data was transcribed and then analysed using thematic analysis through which three themes and six sub-themes were identified and discussed. The identified themes are as follows; 1) Culture as perceived by psychologists, 2) Cultural beliefs in therapy and, 3) The therapeutic alliance. The study found that shared cultural beliefs between psychologists and clients facilitated rapport building. It allowed the therapeutic process to move in a positive direction. The study applied the principles of ethics and trustworthiness. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04
- Authors: Potso, Thando
- Date: 2022-04
- Subjects: Psychologist -- Eastern Cape , Cultural competence , South Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10948/58936 , vital:60249
- Description: While there is extensive research exploring the influence of a client’s cultural beliefs on the therapeutic process; there is still a scarcity of information on how the cultural beliefs held by a psychologist may affect or influence the therapeutic process. Psychologists are trained to work with clients objectively by suspending their own beliefs, ideas, and values. Despite this, it would be interesting to explore how South African psychologists’ personal belief systems are navigated within the therapeutic space. Given the diversity of cultures within the South African context, it becomes important to explore and understand psychologists’ cultural belief systems, as they may influence the therapeutic relationship but to also, understand how they assimilate these belief systems into the therapeutic relationships with diverse clients. Drawing on the qualitative methodology, the study sought to draw participants using a purposive sampling technique. Participants were sourced through different databases, such as the Eastern Cape database of registered and practicing psychologists. Participants who agreed to partake in the study were sent an email with the interview schedule and the link to either MS Teams or Zoom, depending on their preference. The collected data was transcribed and then analysed using thematic analysis through which three themes and six sub-themes were identified and discussed. The identified themes are as follows; 1) Culture as perceived by psychologists, 2) Cultural beliefs in therapy and, 3) The therapeutic alliance. The study found that shared cultural beliefs between psychologists and clients facilitated rapport building. It allowed the therapeutic process to move in a positive direction. The study applied the principles of ethics and trustworthiness. , Thesis (MA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-04