Health SA Gesondheid最新文献

Background: The coronavirus disease 2019 (COVID-19) pandemic affected perinatal care services globally, leading to World Health Organization's (WHO) recommendation for six in-person and two virtual antenatal visits to reduce travel and antenatal visits. Changes were made to reduce infection risk, with online consultations becoming a popular interim measure.

Aim: The aim was to understand perinatal clients' experiences of perinatal care during the COVID-19 pandemic.

Setting: The study was conducted in five facilities of Bojanala district in the North West province, South Africa.

Methods: The study followed a qualitative, exploratory, contextual design using semi-structured, face-to-face interviews. Purposeful sampling was used to select 10 participants meeting the inclusion criteria, who were interviewed until data saturation was reached. Data were organised into themes using thematic analysis. Ethical considerations and measures of trustworthiness were adhered to.

Results: Three themes emerged altered routine, staff attitude and isolation during delivery. The nine sub-themes were pre-screening, entering the facility in turns, infection prevention and control, very slow queues, discontent about wearing masks, nurses' fear of infection, staying longer than 5 h in the queue only to receive less than 10 min of service, no visitors including spouses allowed for emotional support, and compulsory COVID-19 test.

Conclusion: South Africa should revisit policies and guidelines to support pregnant women during the difficult phases of unforeseen pandemics.

Contribution: Multidisciplinary involvement in the psychological support of antenatal clients and nurses during any pandemic is crucial to ensure mental well-being.

Background: Breast self-examination (BSE) is a safe, easy and affordable breast screening tool encouraged as an alternative screening method in low-resource settings. The late presentation of breast cancer among rural African women in South Africa is of great concern. No BSE model has been identified for promoting BSE awareness and practice among rural African women in South Africa.

Aim: To describe the process involved in developing and describing the model for promoting BSE among rural African women in South Africa.

Setting: Four municipal clinics in Kwa-Zulu Natal's iLembe District Municipality.

Methods: An exploratory qualitative study was conducted using semi-structured one-on-one interviews. Deductive thematic analysis was used to analyse the data. The model was then developed using Chinn and Kramer's four-step theory generation process: concept analysis, relationship statements, model description and model evaluation.

Results: A concept analysis was conducted in two phases. A central concept was identified in phase one, and in phase two, it was defined and classified. Based on the identified and defined central concepts, relationship statements were created, which added clarity and direction to the understanding of the phenomenon. The BSE model was described in terms of its purpose, structure and assumptions.

Conclusion: Using the BSE model, breast cancer campaigns and programmes can be tailored to the needs of geographically disadvantaged communities in rural South Africa.

Contribution: Using the BSE model, the model is proposed to improve the early detection of breast cancer.

Background: Needle stick injuries (NSIs) pose serious occupational risks for health professionals and students, with psychological and physical consequences. Despite increased awareness, NSIs persist. Research focussing on chiropractic students' perspectives on NSIs and related protocols is limited, in South Africa and internationally.

Aim: This study aimed to evaluate the knowledge, attitudes and perceptions of chiropractic students towards NSIs and related protocols.

Setting: This study was undertaken at the Chiropractic Department, University of Johannesburg.

Methods: A descriptive, cross-sectional, quantitative study involving an adapted anonymous online questionnaire was distributed to undergraduate Bachelor of Health Sciences and postgraduate Master of Health Sciences (BHSc and MHSc) chiropractic students. Data were analysed using frequencies, descriptive statistics and cross-tabulations to identify relationships in the data.

Results: The respondents (n = 107; 42% response rate) had a mean age of 22.83 years and were mostly females (76.6%), which showed high NSI knowledge (88.58%; s.d. = 9.455); however, postgraduates scored higher overall (p < 0.001). While both groups were well informed about risks and protocols, undergraduates emphasised the need for Hepatitis B vaccination (p = 0.021) and reporting of unused sterile needle injuries (p = 0.010), further highlighting variances between the cohorts.

Conclusion: Chiropractic students exhibited good NSI knowledge, postgraduates more so, but attitudes and reporting behaviours' varied. Enhanced, standardised education on the urgency of reporting NSIs is recommended to improve protocol and safety practices. Future research should explore long-term NSI protocol adherence.

Contribution: This study provides important baseline South African data on perspectives of NSI in a chiropractic student cohort.

Background: Cervical cancer is the second most common cancer among women in South Africa. Treatment is tailored but external beam radiation and brachytherapy with or without concomitant chemotherapy are commonly used.

Aim: This study aimed to pilot test a support programme for women receiving curative radiotherapy for cervical cancer.

Setting: The Radiation Oncology Department at an academic hospital in the Gauteng province.

Methods: An intervention design and pre-test post-test approach was used. The primary outcome was perceived social support and the secondary outcome was quality of life (QoL). Census sampling entered 56 women in the programme but only 15 completed it. The Berlin Social Support Scale (BSSS) and EORTC QOQ-CX24 served as data collection instruments. Descriptive statistics were used to analyse the data using a completer only approach.

Results: The majority of both the pre-intervention (n = 56) and post-intervention (n = 15) groups were older than 40 years (62.5%, n = 35 and 73.4%, n = 11, respectively). Most of the support categories except for 'support seeking' showed statistical significant differences before and after the programme. Symptom experience had the highest mean score of the symptoms scales both before and after the programme (M = 50.7 and 41.8, respectively).

Conclusion: Positive results were obtained in terms of support, but QoL did not show the same trend. However, it would be feasible to refine the programme and conduct a second pilot test.

Contribution: Our study seems to be the first of its kind and illustrates the positive influence a support programme can have on the lives of women receiving radiotherapy for cervical cancer.

Background: Oculocutaneous albinism (OCA) is a genetic disorder found worldwide. Skin cancer is a significant risk for people with albinism, particularly in Africa, where it is a major cause of death. Many patients delay seeking medical care until their skin lesions are in advanced stages.

Aim: The aim of this study was to describe the clinico-pathological profile of skin cancers in patients with albinism at their initial presentation to our dermatology outpatient department.

Setting: This study was conducted at the dermatology department of Universitas Academic Hospital, Bloemfontein, South Africa.

Methods: A retrospective descriptive study covering June 2009 to July 2019 was conducted. Only records of oculo-cutaneous albinism patients diagnosed with skin cancer during their initial visit were included.

Results: Eighty-six patients with albinism were recorded, 37% (n = 32) of whom had skin cancer at their first visit. Females (81%) were more affected than males (19%). The majority of skin cancers were squamous cell carcinomas (SCCs) (54%) and basal cell carcinomas (BCCs) (46%). No melanomas were found. Most SCCs were classified as aggressive (80.4%), compared to 30.8% of BCCs.

Conclusion: Almost 40% of OCA patients presented with skin cancer at their initial visit, highlighting the need for strengthening primary healthcare systems' efficiency in ensuring early referrals for OCA patients.

Contribution: Education, socioeconomic support and awareness campaigns are sine qua non actionable factors that could help encourage early medical evaluation for all OCA patients.

Background: Family members caring for people living with mental illness (PLWMI) are prone to grapple with caregiver burden. The caregivers often contend with a decline in their mental and physical well-being while executing their role. This exploration aimed to understand the needs of family caregivers of PLWMI.

Aim: An integrative review was conducted to analyse the existing literature on the needs of family caregivers for PLWMI.

Method: The review adhered to the instructions provided by Toronto and Remington, drawing upon the guidance of Whittemore and Knafl. The search used four electronic databases: PubMed, African journals, EBSCOhost and Scopus. After screening 3253 references, 18 studies (10 qualitative, 4 quantitative and 4 mixed methods) were included.

Results: The review identified various needs of PLWMI caregivers, including the need for support (financial, social, peer and psychological), psychoeducation, community acceptance of family caregivers, and comprehensive family caregiver health assessments.

Conclusion: This review recognises the significance of addressing the needs of the caregivers of PLWMI to alleviate the impact of caregiver role strain. Promoting nursing care that recognises the importance of caregiver-oriented practice in healthcare is essential. This can help address the needs of the caregivers, enhance their ability to cope with caregiver role strain and promote a better quality of life.

Contribution: This review may inform policymakers to ensure the need for mental health practice to demonstrate knowledge in caring for caregivers of PLWMI. Furthermore, there is a need to integrate the management of PLWMI with that of the caregivers.

Background: The abrupt start of the coronavirus disease 2019 (COVID-19) pandemic impacted educational systems globally, including nursing education institutions (NEIs). Teaching and learning in academic institutions were disturbed because of strict legislation measures, like lockdowns, that were implemented to curb the spread of COVID-19. These measures affected the quality of teaching and academic attainment.

Aim: This study aimed to explore and describe the experiences of nurse educators regarding teaching and learning during the COVID-19 pandemic at a NEI in the North West province (NWP). The study was conducted at a selected NEI, which comprises two campuses that are 178.1 km apart.

Method: A qualitative descriptive phenomenology approach was used. The nurse educators were purposively sampled, and 25 nurse educators participated in this study. Four focus group discussions (FGDs) were held to collect data through face-to-face semi-structured interviews. The data analysis followed Colaizzi's seven-stage process.

Results: Three themes emerged from data analysis: positive experiences and negative experiences regarding teaching and learning during the COVID-19 pandemic, and strategies for overcoming the challenges experienced by nurse educators during the COVID-19 pandemic.

Conclusion: The study findings revealed that nurse educators experienced positive and negative challenges regarding teaching and learning during the COVID-19 pandemic. Furthermore, there is a need for NEIs to employ teaching and learning innovations, including the use of technology, to be able to divert to online teaching and learning during future pandemics where face-to-face teaching is halted.

Contribution: The study findings may provide valuable insights for policymakers in higher education institutions (HEIs) to develop policies that incorporate innovative teaching methods. These methods will be relevant for future pandemics that may disrupt traditional face-to-face teaching and learning. As an enhancement of existing teaching practices, innovative approaches have proven to be effective and contribute to more inclusive education. By adopting these methods, HEIs can better support the achievement of Sustainable Development Goal 4, which aims to ensure quality and equitable education for all.

Background: The Cuban-South African medical collaboration, initiated in the early 1990s, aims to address the shortage of medical doctors, particularly in remote and rural South Africa, thereby contributing to achieving health-related outcomes for universal health coverage.

Aim: This study focusses on the perceptions of programme administrators of the systemic barriers in coordinating the Cuban-South African medical collaboration programme.

Setting: The main site for this study is the University of KwaZulu-Natal, Nelson Rohihlahla Mandela School of Medicine. It is the only medical university located in KwaZulu-Natal.

Methods: A qualitative exploratory design was employed to understand the barriers to coordinating the programme. Purposive sampling was used to select participants. Data collection was conducted through semi-structured interviews with participants at the medical school. Data were analysed using thematic analysis.

Results: The study revealed several barriers that hinder the smooth operation of the programme, such as incomplete documentation and delays in registration, delays in equipment distribution and transportation complications because of registration issues, language barriers, connectivity issues, and the need for provisions during load shedding and water shortages.

Conclusion: Addressing these barriers is crucial for improving the overall experience of the cohort students, who play a vital role in enhancing human resources for health, driving health reforms and supporting primary healthcare in South Africa.

Contribution: The study provides recommendations to enhance the programme's effectiveness. These measures are essential for ensuring the sustainability and success of the Cuban-South African medical collaboration programme.

Background: Adolescents with type 1 diabetes face unique challenges in adapting to closed-loop technology. Positive psychology interventions may aid in promoting psychological adjustment, enhancing well-being and supporting the effective use of this technology.

Aim: This study describes the development, content and evaluation of a positive psychology intervention, the Flourish Diabetes Programme, to facilitate adjustment to closed-loop technology among adolescents with type 1 diabetes.

Setting: The Flourish Diabetes Programme is an online, interactive intervention aimed at adolescents living with type 1 diabetes who use closed-loop technology.

Methods: The development of the programme was informed by qualitative research with adolescents, qualitative document analysis and the design and development model. The Delphi method was used to evaluate the intervention, where 11 experts provided feedback to refine and enhance the programme.

Results: Feedback from the Delphi panel informed the refinement and finalisation of the Flourish Diabetes Programme, contributing to an evidence-based and user-centred intervention.

Conclusion: The Flourish Diabetes Programme is a tailored online resource designed to support adolescents in adapting to closed-loop technology. Insights from the Delphi panel helped shape the programme into a practical tool for promoting positive adjustment.

Contribution: This intervention is the first step in developing effective, evidence-based resources to help adolescents with type 1 diabetes manage new medical technologies, specifically closed-loop systems, using positive psychological principles.

Background: Multiple substances have been applied to neonates' umbilical cords and have yielded detrimental results on neonates' health status.

Aim: The study aimed to explore and describe home-based care for umbilical cords of neonates by family caregivers.

Setting: The study was conducted at Waterval community, a village under Dr J.S Moroka local municipality in Nkangala district in the Mpumalanga province.

Methods: A qualitative exploratory, descriptive research study design was used to explore home-based care for neonates' umbilical cords. The target population was family caregivers who had been caring for the umbilical cords of neonates at home. Non-probability and purposive sampling were done, and individual in-depth interviews were used for data collection. The sample size of 18 participants was determined by data saturation. Thematic analysis was utilised to analyse the data.

Results: The following main themes emerged during data analysis: substances applied on the umbilical cord, beliefs associated with umbilical cord care, the effectiveness of health education provided on discharge from the community health centre and the healing process.

Conclusion: The findings of the study revealed that various harmful substances were applied to the umbilical cords of neonates, and these practices were influenced by cultural beliefs.

Contribution: The findings of the study brought to light that indeed, the application of substances that have not been recommended by the South African guidelines on neonates' umbilical cord does lead to delayed umbilical cord separation and healing and has the potential to cause neonatal infections.