Health SA Gesondheid最新文献

Background: Adherence to daily oral pre-exposure prophylaxis (PrEP) is challenging. Long-acting injectable cabotegravir (CAB-LA), administered every two months, may improve adherence.

Aim: To assess willingness to switch from oral PrEP to CAB-LA among adult PrEP users.

Setting: PrEP users were recruited from two public-sector primary health care clinics in Durban, South Africa.

Methods: A cross-sectional survey assessed oral PrEP use and related challenges. After providing information on CAB-LA, participants' willingness to switch was evaluated. Descriptive statistics summarized data, and logistic regression identified factors associated with willingness to switch.

Results: Of 126 participants, the median age was 28 years (IQR: 32-33), 88.1% were women, 96.0% identified as black African, and 83.3% were isiZulu speakers. Most were heterosexual (86.5%), 72.2% had tertiary education, and 38.1% were employed. Median oral PrEP duration was 365 days. While 92.1% reported oral PrEP fit their lifestyle, only 51.6% adhered consistently. Awareness of CAB-LA was low (8.7%), but 74.0% were willing to switch to improve adherence. Concerns about CAB-LA included injection site reactions (53.9%), systemic side effects (57.2%), and cost (82.6%). Longer-term oral PrEP users (> 1 year) had lower odds of willingness to switch (aOR: 0.36; 95% CI: 0.15-0.85; p = 0.019).

Conclusion: Although oral PrEP was lifestyle-compatible, adherence was inconsistent. Most participants expressed willingness to switch to CAB-LA, but findings should be interpreted cautiously given study limitations. Targeted education may support longer-term oral PrEP users hesitant to switch.

Contribution: This study highlights adherence challenges with oral PrEP and supports interest in longer-acting injectable alternatives.

Background: Clinical placement constitutes an essential aspect of the radiation therapy (RT) undergraduate programme, but students have expressed that they often experience challenges during their training. There is limited guidance for RT lecturers and clinical tutors on how to support these students. Developing a model to promote their mental health during training was therefore essential.

Aim: This article outlines the development and evaluation process of a model aimed at promoting mental health support for RT students during their academic training programme.

Setting: This model is intended for RT lecturers and clinical tutors involved in teaching RT students throughout their training.

Methods: A qualitative, exploratory, descriptive, contextual and theory-generating study design was employed for the development of the model. The process of model development comprised four key steps: concept analysis, the formulation of relationship statements, model description and evaluation. The evaluation criteria used to assess the model included clarity, simplicity, generality, accessibility and significance.

Results: The central concept identified was: 'facilitation of a supportive learning environment'. The concept was defined, classified and placed into relationship statements leading to the development, description and evaluation of the model.

Conclusion: The model can be used by RT lecturers and clinical tutors to promote mental health support for RT students during their academic training.

Contribution: The contribution of the model is to strengthen the RT students' mental health and empower them to develop their clinical skills in a supportive and nurturing learning environment.

Background: The quality of inpatient health care services significantly influences patient satisfaction, shaping perceptions of hospital performance and health care accessibility.

Aim: This study examines patient satisfaction with inpatient services at Batara Siang Hospital, Indonesia, using the SERVQUAL model.

Setting: The study was conducted in the inpatient wards of Batara Siang Hospital, a public health care facility in Pangkep, Indonesia.

Methods: A cross-sectional observational study was conducted among 267 inpatients aged 25-50 years. Data were collected using a SERVQUAL-based questionnaire assessing five service quality dimensions, namely tangibility, reliability, responsiveness, assurance and empathy. Descriptive and multiple linear regression analyses were performed to determine the influence of each SERVQUAL dimension on overall patient satisfaction. Ethical approval was obtained from the Health Research Ethics Committee of Makassar Health Polytechnic.

Results: The study found that all five SERVQUAL dimensions significantly influenced patient satisfaction. Empathy had the strongest impact (β = 0.629, p < 0.001), followed by assurance (β = 0.502, p < 0.001), responsiveness (β = 0.479, p < 0.001), reliability (β = 0.315, p = 0.01) and tangibility (β = 0.305, p = 0.04). These dimensions collectively explained 67.7% of the variance in patient satisfaction, indicating the effectiveness of the SERVQUAL model in evaluating hospital service quality.

Conclusion: Enhancing empathy, assurance and responsiveness can significantly improve patient satisfaction. Hospitals should prioritise patient-centred communication, staff competency and responsiveness to optimise health care experiences and trust.

Contribution: This study provides valuable insights for health care administrators and policymakers, offering practical strategies to enhance inpatient service quality.

Background: The human papillomavirus (HPV) vaccination programme is the most effective strategy to reduce the burden of cervical cancer. However, little is known about the parents' knowledge and awareness of the programme, as they are important role players in its successful implementation.

Aim: To determine the awareness, knowledge and factors associated with HPV vaccination programme acceptability among parents of Grade 5 girls attending public primary schools.

Setting: The study was conducted in Sub-District 6, Tshwane Metropolitan Municipality in the Gauteng province, South Africa.

Methods: A descriptive, cross-sectional survey was conducted among 421 participants from 21 schools utilising a self-administered questionnaire. Frequency distribution and logistic regression were used to analyse data. STATA 17 SE software was used.

Results: About 321 questionnaires (N = 321) were returned, constituting a response rate of 76%. The levels of awareness (n = 279, 87%) and acceptability (n = 286, 89%) were high, with relatively lower, but still significant knowledge (n = 215, 67%). Black parents who were aware and knowledgeable about the programme were significantly more likely to accept the vaccination programme.

Conclusion: Despite high levels of programme awareness and acceptability among parents of eligible girls, there remained crucial knowledge gaps regarding programme specifics. Inadequate knowledge may contribute to parents' low submission of consent forms, resulting in sub-optimal vaccine uptake.

Contribution: Enhanced parental education on HPV vaccination and its proven effectiveness is essential to ensure optimal vaccine uptake, prevent infection and address vaccine hesitancy.

Background: Peer education is vital in higher education because it promotes behavioural change, human immunodeficiency virus (HIV) prevention, student wellness and academic success. However, limited research exists on the expert validation of such strategies, particularly within higher education institutions. This study addresses this gap by validating peer education strategies using a modified Delphi method.

Aim: This study aimed to validate strategies for peer education in higher education institutions through expert consensus using the Delphi method.

Setting: The study was conducted across South African higher education institutions, engaging stakeholders in student wellness and peer-led programmes.

Methods: A two-round modified Delphi method was employed to validate peer education strategies developed through a multiphased qualitative design. The strategies were informed by an integrative literature review and phenomenographic inquiry capturing the lived experiences of peer educators. A panel of 10 purposively selected experts from diverse higher education institutions evaluated the strategies through structured questionnaires using a five-point Likert scale. Consensus was defined as ≥ 70% agreement per item.

Results: Consensus was achieved across all strategic domains, including scope, evidence-based design, stakeholder inclusivity, clarity, applicability and editorial independence. Based on expert feedback, the strategies were refined to improve their practical applicability while ensuring stronger alignment with institutional structures and priorities.

Conclusion: The validated strategies provide a systematic, context-specific guide for the design and implementation of peer education programmes in higher education. They emphasise adaptability, stakeholder collaboration and institutional alignment to support programme sustainability and student well-being.

Contribution: This study offers validated strategies to strengthen the effectiveness, quality and impact of peer-led interventions in higher education.

Background: The Children's Visual Function Quality of Life (CVF-QoL) instrument assesses how visual impairment affects the quality of life related to visual function among rural school-going children in South Africa. Currently, there are no validated vision tools for Sepedi-speaking children.

Aim: This study aims to translate the CVF-QoL instrument into Sepedi.

Setting: Three rural schools in Sekhukhune district, Limpopo, South Africa.

Methods: This study utilised a forward-backward-forward translation method. Three independent translators were involved in translating the English versions of the CVF-QoL instrument into Sepedi. The translated Sepedi version was face-validated by learners aged 6-17 years. The final Sepedi versions were administered to children in two groups: version 1.1 for ages 6-9 years and version 2.1 for ages 10-17 years. The same learners completed the questionnaire again 10 days after the initial administration.

Results: Face validation indicated that both versions are clear and relevant. Version 1.1, administered to 41 learners aged 10-17, achieved a Cronbach's alpha of 0.930. Version 2.1 was given to 39 learners aged 6-9, scoring 0.762. Test-retest reliability showed scores of 0.927 for version 1.1 and 0.712 for version 2.1 after 10 days. Overall, the Cronbach scores for the Sepedi and English versions of 1.1 were 0.930 and 0.946; for version 2.1, the scores were 0.762 and 0.777.

Conclusion: Sepedi version of the CVF-QoL instrument, focused on rural South African children, is novel, valid and reliable.

Contribution: The translated tools can be used to evaluate the visual function of Sepedi-speaking children.

Background: The prevalence of psychological distress in South Africa requires updated estimates.

Aim: This article aims to determine the prevalence of and factors associated with non-specific psychological distress at a national level in South Africa in 2017.

Setting: The study utilised data from a 2017 nationally representative, cross-sectional, population-based household survey.

Methods: Interviews were conducted with 36 609 individuals, aged ≥15 years. Prevalence of psychological distress, using the Kessler-10 scale, was varied by demographics, health status, substance use and human immunodeficiency virus (HIV). Chi-square tests, univariate analyses and a multivariate logistic model were constructed. Collinearity between independent variables was assessed.

Results: Almost half (47%) of the respondents could be classified as psychologically distressed. Higher levels of psychological distress were observed for women (52.6%), among those aged 25 years - 49 years (53.8%), black Africans (84.2%), those with secondary school level of education (64.1%), unmarried people (73.7%) and those residing in urban areas (63.5%). The multivariate logistic regression model found significant differences for sex, self-reported health status, alcohol use, employment status and locality. Human immunodeficiency virus serostatus did not play a major role in psychological distress.

Conclusion: Special attention should be paid to women in the age group of 25 years - 49 years, the unemployed, those with poor general health and people living in urban areas to address the high prevalence of psychological distress in South Africa.

Contribution: This study adds to the literature on the psychological distress amongst those living in South Africa.

Background: Although electronic medical records (EMRs) have a significant impact on the health system, their development is in its infancy in Ethiopia because of factors that hinder the implementation of the system.

Aim: This study aims to explore the barriers to the implementation of EMRs.

Setting: The study setting was in Northwest Ethiopia.

Methods: This study employed a phenomenological qualitative research design to explore the lived experiences of health workers. Purposive sampling was used to recruit eight participants from five different health facilities, each holding diverse professional roles. Data were collected through in-depth interviews, which were audio-recorded and subsequently transcribed verbatim. The qualitative data were managed and analysed using ATLAS.ti software, following a thematic approach. The analysis adhered to the seven-step framework outlined in Colaizzi's method.

Results: A total of 24 codes, 10 subthemes and 4 major themes emerged from the analysis. Three of the major themes reflected challenges associated with EMRs, while one highlighted perceived benefits. The four major themes identified were software-related factors, system-related factors, institutional operational factors and benefits of EMRs.

Conclusion: From the users' perspective, the study finally comprehended that lack of EMRs training, lack of comprehensiveness of the system, a lack of interoperability, power interruption, system slowdowns and absence of incentives and rewards were barriers to the implementation of the EMRs system.

Contribution: This study helps to understand the key barriers to the implementation of EMRs, offering insights for addressing these challenges in future EMR adoption efforts.

Background: Patients have become more comfortable lodging complaints with professional regulatory bodies over the last several years, likely influenced by the trending nature of patient-centred care and consumerism in healthcare and increased access to information through social media.

Aim: To analyse the frequency and nature of reported ethical transgressions and penalties among registered South African healthcare professionals from 2014 to 2023.

Setting: The study took place in South Africa.

Methods: A list of all sanctioned cases was obtained from the Health Professions Council of South Africa (HPCSA) (data were unavailable for 2019). A mixed-methods approach of quantitative and qualitative content analyses was followed.

Results: The study analysed 1012 ethical transgressions among 452 registered medical practitioners, physiotherapists, psychologists, dietitians, dentists and occupational therapists. Fraudulent conduct accounted for the largest number (n = 507 [50.1%]) of transgressions across all professions. The most common penalty imposed was a fine of R1000 to R10000 (26% of total penalties). Both a fine and a suspension were imposed in 82% of cases. Completion of an ethics-based educational course accounted for only 3%.

Conclusion: Fraudulent conduct remains the highest reported ethical transgression among registered healthcare professionals in South Africa. Individualised education that remediates deficiencies in ethical behaviours through analysis and reflection could be beneficial in mitigating ethical misconduct among healthcare professionals.

Contribution: This study provides a comparative analysis of ethical transgressions and penalties among healthcare professionals in South Africa. It also offers insights into necessary areas of improvement of education and training and suggests a different approach to disciplinary action.

Background: Primary health care (PHC) nurses are crucial in reducing late antenatal booking and early detection of pregnancy-related conditions to enhance the best perinatal outcomes. Research confirms that early antenatal care is a key intervention to safe motherhood, aimed at preventing perinatal adverse events; however, cultural practices of pregnant women have a role to play in late antenatal booking.

Aim: This study explored and discussed the cultural practices of antenatal clients that contribute to late antenatal booking as related by PHC nurses.

Setting: This study was conducted at PHC facilities in Mpumalanga province, South Africa.

Methods: Following qualitative phenomenological design, PHC nurses' perceptions of cultural practices of antenatal clients contributing to delayed antenatal booking were explored and described. Purposeful sampling was followed to sample PHC nurses with three or more years of experience to respond to in-depth, open-ended questions. Colaizzi's thematic data analysis was used to facilitate emerging themes and sub-themes. Measures of trustworthiness were ensured for this study.

Results: Results show that PHC nurses believe that antenatal clients intentionally book late and use herbs and religious interventions. Furthermore, PHC nurses neglect the cultural practices of antenatal clients.

Conclusion: Primary health care nurses may encourage trusting relationships by making cultural adjustments and increasing cultural competency, which may increase early antenatal booking, reduce the use of harmful interventions and improve positive perinatal outcomes.

Contributions: This study contributed to an awareness of cultural inertia among PHC nurses, which may be averting clients from openness to health promotion provided at PHC facilities.