South African Family Practice最新文献

Background:  Type 2 diabetes prevalence is steadily increasing worldwide, and South Africa is one of the countries in Africa with the highest prevalence of this disease, along with other non-communicable diseases. The adherence to treatment in male patients with type 2 diabetes is influenced by their attitudes towards medication and how they perceive their condition. To some extent, these factors impact the treatment outcomes for patients undergoing type 2 diabetes treatment. The purpose of this study was to investigate the perceptions of male patients with type 2 diabetes on their adherence to diabetic therapy. The study was conducted in the clinics of the City of Tshwane Metropolitan municipality in Gauteng.

Methods:  This study followed a qualitative, exploratory design. Data were gathered from 15 male patients who were purposefully sampled through in-person, one-on-one interviews with the principal investigator. The eight steps outlined by Tesch were used to analyse the participant data.

Results:  Emergent themes indicated that there were barriers to adherence to diabetic treatment and also factors that promoted adherence to diabetic treatment among the participants. Several factors were found to affect treatment uptake among the participants.

Conclusion:  Patients demonstrated various reactions to diabetic treatment, highlighting the need for reinforcing education at the time of diagnosis and treatment initiation. Additionally, regular patient follow-up may be essential to improve adherence among patients.Contribution: The study highlights the importance of health promotion and the need to develop materials for medication-specific counselling for patients receiving diabetic treatment, in order to promote adherence.

Background:  Active euthanasia is a controversial subject both globally and in South Africa. Recent legal cases have kept this topic in the public discourse. Yet, there remains a dearth of quality local research on this issue. This study aimed to explore the views of medical professionals towards active euthanasia to gain a better understanding of this phenomenon in South Africa.

Methods:  A descriptive-interpretive qualitative research design, using semi-structured in-depth interviews of purposively sampled South African medical professionals, was used to collect the data. The data were analysed using an inductive thematic analysis framework, which included familiarisation, coding, summarising, theme development and thematic review, revision and interpretation.

Results:  Four general themes, with sub-themes, were identified and inductively analysed: modern medical practice and euthanasia; the problem of suffering in end-of-life care; euthanasia is complex; palliative care in South Africa is poor. Some themes and sub-themes were common to all participants while other themes underscored more diverse views - often because of religious factors.

Conclusion:  Active euthanasia is a complex and nuanced issue. An understanding of the perceptions and attitudes of medical professionals will contribute to the overall discussion of this phenomenon in ethical, legal, social and political spheres in South Africa. This is of utmost importance given the relevance of this topic in South Africa in the 21st century.Contribution: This study highlights the complex nature of active euthanasia in South Africa among medical professionals while providing a greater understanding of its nuances and the strengths and weaknesses of arguments for or against it.

Background:  Initiatives to reduce patient safety incidents (PSI) and support healthcare professionals who may experience psychological trauma as a result are becoming increasingly common. However, little is known about the quality of the support provided by Tshwane District Health Services. Therefore, it is necessary to assess their assistance for the second victims in order to evaluate their effectiveness.

Methods:  A cross-sectional study was conducted, and 319 healthcare professionals from six primary health care institutions were invited to participate in the study. The sociodemographic information, work experience, emotional support, familiarity with the concept of the 'second victim' and involvement with PSIs were collected.

Results:  The mean age was 39.8 years, ranging from 22 years to 66 years. The majority of participants were females (n = 249; 78.1%), nurses (n = 153; 49.2%), and those with 5-9 years of experience (n = 82; 25.8%). Most participants (n = 168; 52.7%) were aware of the possibilities of emotional support, while less than half (n = 142; 44.5%) were familiar with the term 'second victim'. The cumulative incidence of adverse events in the institutions was 19.4%, and the majority of second victims (n = 39; 62.9%) emotionally felt the need to speak with someone about it, preferably outside of the workplace. Less than 5% of individuals received support that was initiated by existing structures at their workplace.

Conclusion:  Frameworks exist to assist second victims, although they are only known to some healthcare professionals. However, their current use in Tshwane health facilities is ineffective. After experiencing PSIs, second victims often rely on psychological assistance outside of the workplace.Contribution: Authorities need to determine the causes behind some healthcare professionals' lack of awareness regarding the support framework for second victims, as well as their growing tendency to rely on psychologists outside of the workplace, and corrective measures should be implemented.

Background:  Researchers increasingly receive invitations by email to publish. We analysed email publication invitations received by staff members of the Department of Biostatistics, University of the Free State (UFS), comparing emails relating to accredited and non-accredited journals.

Methods:  This cross-sectional study included all publication invitations received via UFS email accounts by staff members from May 2023 to July 2023. The researchers independently completed the data form, then checked and resolved any discrepancies.

Results:  Of the 93 distinct emails received from 88 journals, only 15 (16%) were received from a journal appearing on the Department of Higher Education and Training (DHET) accredited journal lists. These included South African Family Practice (SAFP) and the African Journal of Primary Health Care and Family Medicine (PHCFM). Emails from non-accredited journals were significantly (p  0.01) less likely to refer to a journal with a health sciences-related title (37% vs. 86%), indicate the publisher (36% vs. 93%), provide a link to the journal website (59% vs. 100%), state a full physical address (24% vs. 80%), refer to author instructions (21% vs. 47%) or request the recipient to share the email with colleagues (5% vs. 47%). Emails from non-accredited journals were significantly (p  0.01) more likely to contain grammatical errors (63% vs. 0%) and flattering remarks regarding the recipient or his or her research work (49% vs. 0%), and to indicate the journal's International Standard Serial Number (ISSN) (67% vs. 13%).

Conclusion:  Clear differences were found between email invitations from accredited versus non-accredited journals.Contribution: The findings provide insight into warning signals in email publication invitations.

Background:  Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves.

Methods:  A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached.

Results:  Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being.

Conclusion:  Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.

Background:  South Africa faced challenges while implementing coronavirus disease 2019 (COVID-19) measures such as mass vaccination. Some people rejected or were hesitant to receive government-recommended vaccines. This study explored COVID-19 vaccination hesitancy among unvaccinated individuals in a primary care setting in Pretoria, South Africa.

Methods:  This was an exploratory phenomenological study that included one-on-one interviews with 12 individuals at Temba Community Health Centre in Pretoria, South Africa.

Results:  The research revealed five themes: perceptions of COVID-19 disease, perceptions of COVID-19 vaccine, factors related to non-vaccination, information sources about the COVID-19 vaccine, and long-term vaccination decisions. There were seven linked sub-themes.

Conclusion:  Overall, participants had a good understanding of COVID-19 disease, but limited knowledge about the vaccine, causing hesitancy to get vaccinated. Reasons for not getting vaccinated included health-related concerns, safety concerns, personal experiences, and social and political factors. Safety and health-related concerns were prevalent, with adverse vaccine outcomes being the most common concern. Most participants had experienced a historic encounter with a vaccine-related death or illness.Contribution: Vaccine hesitancy should be viewed as a powerful concern from the community, and a key source of worry for the health authorities over any vaccine-related doubt.

With its unique position, primary health care (PHC) can provide health promotion and prevention services, including lifestyle behavioural counselling. Unhealthy lifestyle behaviours are very prevalent among patients attending PHC, with many patients unwilling to change or in the precontemplation stage. While patients in the contemplation stage are better managed using the 5As approach of motivational interviewing counselling, those unwilling or not ready for change necessitate a different approach, such as the 5Rs of motivational interviewing (MI) counselling. The 5Rs MI approach holds promise in motivating unwilling individuals to consider embarking on the journey of behavioural change. The 5Rs approach is not a stand-alone checklist of tasks implemented in isolation but is best integrated within a theoretical behavioural change framework. Of the four health-related behavioural change theoretical frameworks that are frequently used, the transtheoretical stages of the change model are the most used. This continued professional development article provides a summary review of the literature on behavioural change theories as they apply to lifestyle health behaviour change and presents the 5Rs approach as a feasible and practical approach to manage patients who are unwilling to change or in the precontemplation stage. This offers a beacon of hope for improved patient outcomes in a PHC system saddled with high prevalence of modifiable unhealthy lifestyle behaviours.

Background:  Burnout is a syndrome that is understood as emanating from chronic workplace stressors that have not been managed successfully. Little is known about the causes of burnout among nurses in South Africa. The study aimed to determine the prevalence of burnout and its impact on depression and assess the relationship between burnout and depression among nurses at a Johannesburg private hospital.

Methods:  Nurses at a private hospital in Johannesburg were asked about their exposure to depression and burnout using a closed-ended questionnaire as part of a quantitative, cross-sectional study design. A p-value 0.05 was considered statistically significant. The respondents were selected using the simple-random sampling method. The collected data were analysed using IBM-SPSS version 28.

Results:  The study involved 112 nurses, of whom 95 (84.8%) were females. Most of the nurses, that is, 56 (50.0%) were registered nurses. Emotional exhaustion (p = 0.001) and depersonalisation (p = 0.001) were significantly associated with depression. Work experience (p = 0.001) and depersonalisation (p = 0.002) had an impact on depression.

Conclusion:  The study revealed a high prevalence of burnout among nurses at a Johannesburg private hospital. The study found that depression was significantly associated with emotional exhaustion and depersonalisation. The study also found that work experience and depersonalisation have an impact on depression.Contribution: The study's recommendations can help mitigate burnout and improve the well-being of nurses, ultimately enhancing the quality of healthcare services provided at the hospital.

Background:  Understanding the intersection of epilepsy and pregnancy, including knowledge gaps and healthcare access for women with epilepsy (WWE), is critical. This study evaluated WWE knowledge gaps and information needs concerning epilepsy's impact on their sexual and reproductive health during pregnancy and examined healthcare system factors affecting their access to information, aiming to identify areas for improvement in educational and healthcare strategies to enhance health management for WWE.

Methods:  From July 2022 to June 2023, 111 WWE aged 18 to 40 years were recruited from the family medicine and internal medicine outpatient departments at Steve Biko Academic Hospital, Tembisa Tertiary Hospital (TTH), and Kalafong Hospital. Interviews assessed various aspects related to epilepsy in pregnancy and contraceptive use.

Results:  The study found strong links between WWE, their demographics, and their awareness of pregnancy-related epilepsy issues. Participants from TTH showed notably higher awareness (85.5%) of risks from epilepsy and AED during pregnancy (p  0.05). Age and education significantly influenced pregnancy planning and understanding of medication risks. Younger women (20-25 years) were more inclined towards future pregnancies, and those with more education were better informed about medication risks (p  0.05); and 68.5% had received counselling on AED and contraceptive interactions, yet only 16.2% knew AED could reduce contraceptive effectiveness.

Conclusion:  The study reveals significant knowledge gaps in WWE regarding the impact of epilepsy and AED on pregnancy, suggesting tailored educational and counselling initiatives to improve WWE health outcomes and quality of life, advancing chronic disease management and public health objectives.Contribution: The study highlights substantial knowledge gaps in epilepsy during pregnancy among WWE, urging tailored counselling and information to empower informed decisions.

Background:  Physicians often focus on possible cardiac causes in patients presenting with chest pain. However, this case highlights a patient who presented with chest pain caused by ingestion of a foreign body after an uneventful meal eaten an hour prior to presentation. The fishbone was discovered after imaging. The article aims to raise awareness regarding the potential origins of chest pain, highlighting that it may stem from non-cardiac conditions.

Methods:  The methodology employed in this study involved conducting a case study that meticulously examined the repercussions and management strategies associated with foreign body ingestion.

Results:  The case report delineates the scenario of a 27-year-old male patient who inadvertently ingested a fishbone during a routine meal. It details the swift decline in clinical status, the meticulous diagnostic procedures employed, the subsequent management strategies implemented and the ultimate discharge of the patient in a stable condition.

Conclusion:  This case highlights the importance of comprehensive history taking and considering a wide range of causes of chest pain when evaluating a patient. The foreign body ingested with the resulting cardiac complications could have been fatal if not promptly diagnosed.Contribution: This study contributed to advancing awareness surrounding foreign body ingestion, shedding light on potential complications and offering valuable insights into effective management strategies.