Health SA Gesondheid最新文献

Background: Diabetes is a global public health concern. Approximately, 79% of people living with diabetes reside in low- and middle-income countries. Community healthcare workers (CHWs) provide basic care to communities, including people living with diabetes in South Africa; however, their contribution still needs to be explored.

Aim: To explore the perceptions of CHWs regarding their roles in diabetes care.

Setting: This study was conducted at primary healthcare clinics in the Tshwane District, located in the northern part of Gauteng province in South Africa, where CHWs form part of ward-based outreach teams.

Methods: Using a descriptive qualitative research design, four focus group interviews were conducted with 32 CHWs with 5 or more years of experience and involved in providing care to people living with diabetes. The Dynamic reading, Engaged code book development, Participatory coding, Inclusive reviewing and summarizing of categories, Collaborative analysis, Translating (DEPICT) approach for collaborative qualitative data analysis was used.

Results: The participants indicated that their roles focused on health education, specifically related to diet, lifestyle changes, medication, involving family and self-care, support and monitoring.

Conclusion: CHWs play an important role in the screening, continuous monitoring and referral of people living with diabetes. It is important that training and support for CHWs are aligned and informed by evidence and the needs of the communities they serve.

Contribution: The results may assist in the development of appropriate competencies, to inform programs and in-service training topics and regulate the practices of CHWs.

Background: In many countries, emergency departments (EDs) are overcrowded by self-referred, non-urgent patients, leading to strained resources. Understanding why patients with minor ailments choose secondary or tertiary EDs is vital.

Aim: This study aimed to describe patients' characteristics and reasons for self-referrals for non-urgent conditions to the ED of a tertiary hospital in Kimberley, South Africa.

Setting: The study was conducted at a tertiary hospital in Kimberley.

Methods: This descriptive cross-sectional study involved patients at Kimberley's Family Medicine ED (Gateway Centre). Participants completed a self-administered questionnaire with staff available to explain.

Results: A total of 331 participants were interviewed; the mean age was 40 years (ranging from 18-89 years); most were males (199; 60.1%), ≤ 45 years (226; 68.3%), single (171; 51.7%), unemployed (181; 54.7%), had no medical insurance (306; 92.5%) and had no access to a private doctor (298; 90.0%). Most had access to primary healthcare (PHC) clinics (291; 87.9%). They perceived their medical conditions as severe enough to visit the casualty department (310; 93.7%). They were more familiar with the services at the ED than their local clinics (169; 75.5%).

Conclusion: Non-urgent ED visits by self-referred patients result from complex medical, psychosocial, and economic factors. Despite access to PHC, patients often prefer the ED due to perceived severity and familiarity with hospital services.

Contribution: Patients' perceptions significantly influence their healthcare choices. Addressing these perceptions is key to reducing the burden on already strained emergency services.

Background: This qualitative study was prompted by limited literature and knowledge around the psychosocial barriers associated with father absence among young women in South Africa and the enablers for overcoming these barriers.

Aim: The aim was to explore the psychosocial barriers and enablers faced by young women because of father absence in South Africa.

Setting: The setting of this study was the Central Business District of Pretoria in the city of Tshwane, South Africa.

Methods: Following exploratory and descriptive qualitative research and Norman Garmezy's resilient theory, six young women who met the predetermined inclusion criteria were recruited through purposive sampling to participate in this study. Thematic analysis strategy proposed by Braun and Clarke was used to analyse the data that were collected through semi-structured interviews. The study followed relevant ethical principles and ensured trustworthiness through the principles of credibility, dependability, transferability and confirmability.

Results: The findings demonstrated that these women encounter several barriers, including emotional, financial and relationship issues, attributable to father absence from their early lives.

Conclusion: Despite the various barriers encountered by these women, they demonstrated the ability to overcome them, with their resilience found to be anchored in both individual and environmental factors such as family support, a strong belief in education and self-awareness.

Contribution: This study contributes to a pool of literature by adding the barriers and enablers for managing the challenges of growing up with an absent father and amplifying a call to provide psychosocial support to them and their families.

Background: Chronic kidney disease (CKD) is a significant public health concern in KwaZulu-Natal (KZN), exacerbated by a high burden of HIV, diabetes and hypertension, and compounded by socioeconomic barriers that limit access to preventative healthcare. With KZN accounting for 20% of South Africa's dialysis patients, strengthening CKD management at the primary healthcare (PHC) level is crucial.

Aim: The study used a qualitative phenomenological approach to explore healthcare providers' (HCPs) lived experiences with CKD management in PHC settings in KZN, focusing on perceived barriers, facilitators and implementation realities.

Method: A qualitative phenomenological approach was used to explore the lived experiences of HCPs managing CKD in PHC settings in KZN, South Africa. Through semi-structured interviews, the study examined perceived barriers, facilitators and real-world challenges influencing the implementation of CKD interventions and guideline adherence.

Results: The study uncovered five key themes reflecting HCPs experiences with CKD guideline implementation at the PHC level: inconsistent guideline awareness and adherence, inadequate training, challenges in early detection because of limited resources, the importance of team-based care and patient involvement, and broader systemic and community-level barriers. Participants underscored the need for improved training, resource allocation and integrated care approaches.

Conclusion: Implementation gaps stem from limited awareness, inadequate training and systemic barriers. Strengthening early detection, capacity building and team-based care is key to improving CKD management in PHC.

Contribution: The study offers practical insights into implementation challenges, guiding policymakers and PHC managers in enhancing CKD care in resource-limited settings.

Background: Special schools in South Africa play a dual role in education and healthcare for learners with disabilities, including those with spina bifida. However, the challenges faced by school staff in managing these learners are not well documented.

Aim: This study explored the challenges faced by staff in managing learners with spina bifida in special school settings and gathered their recommendations for improving care and management.

Setting: Special schools across two South African provinces.

Methods: A qualitative descriptive case study approach was employed. Data were collected using an open-ended interview guide with 41 purposively selected participants: 22 educators, 7 health staff, 7 allied health professionals, and 5 housemothers. Follow-up in-depth interviews were conducted with 15 of the 41 participants: 6 educators, 3 allied health professionals, 4 health staff and 2 housemothers to further explore key concerns and reconsiderations. Thematic analysis was used to analyse data.

Results: Staff reported significant challenges, including insufficient resources, a lack of clear health protocols, and poor academic outcomes for learners with spina bifida. Limited self-care skills and independence among learners, often exacerbated by parental neglect, were also highlighted. Participants emphasised the need for developmental support and stronger multidisciplinary collaboration.

Conclusion: Addressing the complex needs of learners with spina bifida in special schools required targeted resource allocation, robust health protocols, and integrated support systems.

Contribution: The study offers practical insights into improving the management and support of learners with spina bifida in special schools, contributing to policy and practice in low-and middle-income settings like South Africa.

Background: Retirement is a significant life transition that often brings changes in daily routines, including health screening and levels of physical activity.

Aim: The aim of this study was to determine the wellness profile of residents living in retirement villages.

Setting: This study was conducted in the City of Johannesburg.

Methods: This cross-sectional, descriptive and quantitative study included 108 retirees from 7 retirement villages. To determine the wellness profile, biokinetic wellness screening tests were performed, including blood pressure, heart rate, rate pressure product, height, weight, body mass index (BMI), handgrip strength, sit-and-reach test and Apley's back scratch test.

Results: The median age of the sample was 75 years. Significant variability was noted in the BMI measurement (25.35 kg/m²; IQR: 6.83), and the median rate pressure product (RPP) was 10 284 mmHg/min (IQR: 2962). Data revealed limited flexibility for Apley's scratch test (-34; -31) and sit-and-reach test (0.00).

Conclusion: Strength was greater among male participants, while better flexibility but higher heart rates were recorded among females. Tailored interventions emphasising cardiovascular health, weight management and physical performance are recommended among retirees.

Contribution: This resource will guide policymakers, community managers and healthcare professionals in designing targeted interventions and inform future research on ageing and wellness in urban settings.

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Background: Psychophysiological skin disorders' high prevalence necessitates establishing factors that enable the development of personal strength, self-esteem and receiving adequate support.

Aim: To investigate the relationship between self-esteem and post-traumatic growth (PTG), as well as whether aspects of perceived social support moderate or mediate the relationship between self-esteem and PTG in participants living with psychophysiological skin disorders.

Setting: The study was conducted in South Africa.

Methods: Quantitative, non-experimental, and correlational research design was utilised. 100 participants diagnosed with psychophysiological skin disorders, including atopic dermatitis, psoriasis, pruritus, and alopecia, were selected using a non-probability convenience sampling method. The Post-traumatic Growth Inventory (PTGI) and the Rosenberg Self-Esteem Scale (RSES) were used. Data was analysed using the Statistical Package of the Social Sciences (SPSS) version 28.

Results: Pearson product-moment correlation coefficients and multiple hierarchical regression analyses were performed to investigate the research objectives. A significant positive relationship was found in participants between self-esteem and PTG, with coefficients indicating a moderate to large effect size. As an aspect of perceived social support, emotional-informational support acts as a moderator between self-esteem and PTG. Further, tangible support as an aspect of perceived social support was found not to moderate or mediate the relationship between self-esteem and PTG.

Conclusion: The findings of the current study confirm that only emotional-informational support as an aspect of perceived social support moderates the relationship between self-esteem and PTG among participants living with psychophysiological skin disorders.

Contribution: This insight highlights the need for psychosocial interventions that prioritise emotional and informational support dimensions.

Background: Immunisation is crucial for preventing the spread of infectious diseases; yet, adherence remains a global challenge, particularly among children under 12. Understanding the multifaceted factors influencing vaccination adherence is essential for improving coverage rates and reducing the burden of vaccine-preventable diseases.

Aim: This study aimed to develop a support intervention for improvement in childhood immunisation adherence in South Africa.

Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a comprehensive search was conducted across multiple databases. The Patient (problem or population); Intervention; Comparison, control or comparator and Outcome(s) framework guided the research question formulation and search strategy. Included studies were published between 2013 and 2023, focusing on children under 12. Data were extracted and categorised into domains affecting immunisation adherence. Quality assessment was performed using the mixed methods appraisal tool.

Results: The review identified five major domains influencing immunisation adherence: socioeconomic factors, health system factors, vaccine beliefs and attitudes, cultural and social factors, and communication and information factors.

Conclusion: This review highlights the complex interplay of factors affecting childhood vaccination adherence. Critical areas for intervention include tailored communication strategies, addressing vaccine hesitancy, enhancing immunisation accessibility and leveraging digital technologies for vaccine promotion.

Contribution: These insights can guide evidence-based strategies to improve immunisation adherence and inform policy in the evolving landscape of global public health.

Background: Climate change is increasingly recognised as a critical public health challenge, a perspective reinforced by its inclusion as Sustainable Development Goal 13. Given its significant disease burden, climate change should be reframed as a leading health priority, demanding an immediate and coordinated response from the health sector.

Aim: The aim of the study was to assess the knowledge and attitudes of professional nurses in primary health care regarding climate change.

Setting: The study was conducted in Nkangala District, Mpumalanga province.

Methods: A non-experimental, descriptive and quantitative research design, employing a self-administered questionnaire, was used to collect data. A comprehensive sampling of the entire population was conducted in the Thembisile Hani Local Municipality, Nkangala District, Mpumalanga, because of the small population size.

Results: About 82% of the professional nurses in primary health care had knowledge regarding the effects of climate change, and 23% did not link climate change to diseases. Regarding nurses' attitudes and perceptions, approximately 66.2% strongly agreed that understanding the issue is crucial to providing effective patient care. In support, 29.8% agreed that it is essential to understand the issue to help patients, 3.3% were neutral, while 0.7% strongly disagreed and 0% disagreed.

Conclusion: The findings of the study highlighted the importance of educating registered nurses about the mental health effects of climate change. It also emphasised the need to formally include climate change in the nursing curriculum, as many nurses currently depend on informal education to understand its implications.

Contribution: The results of the study will contribute new knowledge regarding climate change, its impact on health and its implications for the nursing profession. In addition, the study emphasised the importance of incorporating climate change into the nursing curriculum.