Health SA Gesondheid最新文献

Background: Continuing professional development (CPD) is an ongoing learning process that builds on initial training and education to improve competency. Low compliance rates of audiologists adhering to CPD have been reported by the Health Professions Council of South Africa. However, there is an absence of research on the uptake of CPD from the perspective of young audiologists working in the private sector.

Aim: This study aimed to explore the experiences and views of young audiologists working in the private sector on continuing professional development.

Setting: The study was conducted in KwaZulu-Natal province, South Africa.

Methods: The descriptive, qualitative approach entailed conducting 11 online, semi-structured interviews with audiologists working in the private sector. Semi-structured interviews consisted of open-ended questions, and the qualitative data were thematically analysed. The adult learning theory, andragogy, was used as both the conceptual and analytical framework.

Results: Five andragogy concepts were used to analyse the data, with eight sub-themes emerging related to: self-concept, adult learning experiences, readiness to learn, orientation to learning and internal motivation.

Conclusion: The experiences of audiologists in the private sector on CPD aligned with the concepts of andragogy. Audiologists' experiences need to be taken into consideration during the planning and implementation of CPD for it to be relevant, effective and purposeful.

Contribution: This study highlighted the experiences of audiologists on CPD working in the private sector with continuing professional development.

Background: In low- to middle-income countries, malnutrition is a major contributing factor in children failing to achieve their developmental potential. The prevention of malnutrition requires, among others, nutritious, diverse and safe foods in early childhood.

Aim: The study aimed to determine primary caregivers' choices and motivation for the foods they fed their children.

Setting: The study was conducted among early childhood development centres in the Xhariep District, Free State.

Methods: A qualitative study was undertaken. Twelve participants who met the inclusion criteria were conveniently sampled. Semi-structured interviews were conducted to find out the primary caregivers' choices and motivation for foods they fed their children until data saturation was reached.

Results: The mean age of the participants was 31 years. Nine of the participants relied on social grants as a source of income. The participants reported feeding their children mainly maize porridge, milk, juice, and water. Vegetables and meat were fed to the children once a week. Fruits were fed to the children at the beginning of the month.

Conclusion: The level of education, employment status, and community support influenced the primary caregivers' feeding practices. The content of the diets of their children was insufficient in vegetables and fruit, not only placing the children at risk of undernutrition but also at risk of obesity and micronutrient deficiencies. Primary caregivers ensured their children were fed, although limited foods were offered.

Contribution: This research creates awareness of the level of social progress and access to resources within rural communities in the Xhariep district, and gives the opportunity to extend this research to confirm these findings in other poverty-stricken areas.

Background: Antenatal iron deficiency and anaemia are associated with gestational hypertension and diabetes mellitus, but so are elevated iron stores and haemoglobin. In South Africa, pregnant women receive routine iron supplementation regardless of iron status.

Aim: This study aimed to assess associations of antenatal iron status and anaemia with blood pressure in pregnant women in urban South Africa. Secondary to this, associations with heart rate, fasting glucose and glucose tolerance were also investigated.

Setting: Johannesburg, South Africa.

Methods: A total of 250 pregnant women, aged 27 (24-32) years, were recruited using consecutive sampling. The authors measured biomarkers of iron status and anaemia at < 18 and ± 22 weeks', blood pressure and heart rate at ± 36 weeks', and fasting glucose and glucose tolerance between 24 and 28 weeks' gestation. Associations were determined using multivariable regression models adjusted for confounders.

Results: The odds of prehypertension in late pregnancy among women with anaemia at ± 22 weeks' gestation were three times higher than among women without anaemia (odds ratio [OR]: 3.01, 95% confidence interval [CI]: 1.22, 7.42). Participants with anaemia at ± 22 weeks' gestation had 2.15 times higher odds of having elevated mean arterial pressure than women without anaemia (OR: 2.15, 95% CI: 1.01, 4.60).

Conclusion: Anaemia at mid-pregnancy could be a predictor of hypertensive disorders in pregnancy. The cause of antenatal anaemia may need further investigation apart from iron deficiency. The effective management of anaemia in pregnant women living in urban South Africa remains a challenge.

Contribution: This study provides evidence about the health impact of pregnant women regarding antenatal supplementation practices in South Africa.

Background: Pro-inflammatory markers are linked with the development and progression of type 2 diabetes mellitus and arterial stiffening. Pulse Wave Velocity (PWV) and Augmentation Index (Aix) are non-invasive standard markers of arterial elasticity and predictors of cardiovascular mortality and morbidity.

Aim: To investigate the effects of metformin alone and in combination with glimepiride on arterial elasticity, pro-inflammatory cytokines in black type 2 diabetes mellitus patients.

Settings: Participants were enrolled from Sefako Makgatho Health Sciences University community, Gauteng, South Africa.

Methods: PWV and Aix were measured using the AtCor SphygmoCor^® system (AtCor Medical, Inc., Sydney, Australia). Cytokines levels were measured using Multiplexing with Bio-Plex Pro™ human inflammation panel I assay. Treatment naïve type 2 diabetes participants were divided into two groups: metformin (M) (n = 10) and metformin glimepiride (MS) (n = 14). The study participants were followed up at 4 and 8 months after treatment initiation.

Results: In the M and MS, IL-1β increased significantly at four months (58.19 ± 0.03 pg/ml, 58.35 ± 0.30 pg/ml) when compared to baseline (33.05 ± 18.56 pg/ml, 34.79 ± 18.77 pg/ml) then decreased significantly at eight months (29.25 ± 11.64 pg/ml, 32.54 ± 14.26 pg/ml) when compared to four months (58.19 ± 0.03 pg/ml, 58.35 ± 0.3 pg/ml) (p < 0.05). There were no significant changes in PWV, Aix, IL-1ra, IL-2, IL-6, IL-8, TNF-α and hs-CRP levels at both treatment intervals.

Conclusion: Metformin alone or in combination with glimepiride did not improve arterial elasticity and did not reduce pro-inflammatory cytokines levels in T2DM black South African patients.

Contribution: The context-based knowledge generated by the current study is expected to enhance the continuum of care for T2DM patients.

Background: Nurse prescribing and dispensing are central to ensuring universal health access in South Africa.

Objective: To describe the historical development of the legal enablements of nurse prescribing and dispensing in South Africa and highlight gaps in the current legislative framework.

Method: This is a discussion article.

Results: We emphasise significant deficiencies in the current legislative landscape that pose challenges to these vital nursing practices and call for urgent revisions of the legislative framework, particularly the revision of Section 56 of the Nursing Act (33 of 2005) and its related regulations, to formalise authorisation of specialist nurse prescribers in public and private practice. This will also entail an application to the South African Health Products Regulatory Authority (SAPHRA) for the scheduling of substances by authorised nurse prescribers in the defined professional nurse and specialist nurse categories by the Minister of Health.

Conclusion: There is a necessity for prompt legislative revisions to address identified deficiencies.

Contribution: The contribution of this article lies in its advocacy for changes to the regulatory framework to further enable nurses to deliver safe and comprehensive health care.

Background: Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa.

Aim: This study explored how the concept of cultural competence is perceived by patients.

Setting: Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three).

Methods: This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis.

Results: Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence.

Conclusion: Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients.

Contribution: Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

Background: The coronavirus disease 2019 (COVID-19) pandemic caused widespread psychological morbidity, especially among frontline workers. Oral health professionals (OHPs) are at increased risk of contracting and dying from COVID-19 because pf their proximity to infected patients. The objective of this study was to measure the level of COVID-19 fear and its predictors among South African OHPs.

Aim: To evaluate the severity of fear of COVID-19 among OHPs in South Africa.

Setting: Online platforms.

Methods: In this cross-sectional study, a Google Forms-based online survey was conducted. The fear scale of COVID-19 (FCV-19S) was used to assess the level of fear among OHPs. Statistical data analysis was performed using SPSS 28.0. The multivariate logistic regression model was developed to assess the predictors of COVID-19 fear.

Results: A total of 462 OHPs participated in this study. Approximately half of the participants, 212 (45.6%), indicated having severe fear of COVID-19. The regression model showed a significant association between COVID-19 fear and increased age, clinical experience, employment sector, professional group, positive COVID-19 test and COVID-19 vaccination.

Conclusion: The results indicate that South African OHPs had low levels of corona phobia. Females, older and vaccinated OHPs had the greatest odds of COVID-19 fear.

Contribution: This study provides insights into the severity of fear and anxiety experienced by OHPs in the time of the pandemic. The findings will aid in the development of appropriate interventions and programmes to deal with similar outbreaks in the future.

Background: Locum practice is a non-standard form of employment used to address the shortage of healthcare workers in hospitals. In Malawi, the locum practice is used to improvre the availability of healthcare workers and promote continuity of care. Despite this, little attention has been paid to the effective and efficient use of locum practice.

Aim: To explore the factors influencing locum practices in public and faith-based hospitals in Malawi.

Setting: Six public and faith-based hospitals in Malawi.

Methods: An exploratory descriptive design was used in the qualitative strand of this larger mixed-methods study. Data were collected through in-depth interviews with hospital managers (n = 15) and focus group discussions (FGD) with nurses, medical officers, and clinical officers (n = 29). All the interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data.

Results: Locum practice was characterised by challenges related to healthcare workers working beyond the prescribed hours, a lack of orientation for locu staff, inconsistent locum rates, and delayed payments. The consequences of these challenges are compromised quality and safety of patient care.

Conclusion: Locum practice is associated with numerous challenges in both public and faith-based hospitals in resource-limited settings. This could be attributed to the lack of regulation, supervision and monitoring of locum practice.

Contribution: The findings suggest the need for the development and adherence to guidelines and policies for managing locum practice. Further studies could explore measures to retain permanent staff as a way of reducing the demand for locum staff.

Background: The families living with tuberculosis (TB) patients play a vital role in the care of these patients. Little is known about the experiences of families living with family members who are infected with TB.

Aim: The aim of the study was to explore and describe the experiences of families having a member or members diagnosed with TB.

Setting: The study was conducted in the Ngaka Modiri Molema district in the North West province of South Africa.

Methods: This was a qualitative study using a descriptive phenomenological approach. Ten families with member(s) who had TB were purposively selected. Data were collected through face-to-face, semi-structured individual interviews that were recorded. Data were analysed using Colaizzi's seven steps.

Results: The following essential meanings emerged: family members' caregiving experiences, family members' challenging experiences, and family members' health literacy experiences.

Conclusion: Families had a lack of TB knowledge, which was associated with their poverty and with community health nurses not being committed to patient education. In poor, rural settings, nurses need to support families with adequate TB knowledge to limit the spread of TB and achieve the best treatment outcomes.

Contribution: Family involvement is vitally important in TB health promotion. Health promotion is a crucial tool for achieving comprehensive health and social growth. Wider interventions concentrating on families are beneficial for promoting health and preventing TB.

Background: Autism is a significant concern because of the increase in the prevalence of the disorder. University healthcare students might not all be adequately prepared to serve autistic individuals. Hence, there is a need in the South African context for information on healthcare practitioners' knowledge of general aspects, diagnosis and management of autism.

Aim: To determine current knowledge on autism among speech-language pathology and audiology (SLP & A) students at a South African Higher Education Institution.

Setting: The study was conducted among 65 second, third and fourth year students at the SLP & A Department of a South African Higher Education Institution.

Methods: A descriptive quantitative design utilising an online questionnaire was used to gather the quantitative and, to a lesser extent, qualitative data. Descriptive measures were used to analyse and summarise the data.

Results: Participants mainly understood autism's fundamental symptoms and comorbidities, early intervention, team management and speech-language therapist (SLT) duties. Students were found to have little awareness of autism's prevalence, causes, diagnosing experts, intervention methods and treatment. Participants felt uncomfortable treating autistic people owing to a lack of clinical exposure. Participants want further training.

Conclusion: Students reported the need for additional training on autism, including its identification, diagnosis, assessment and treatment. It is recommended that the study be replicated at other institutions to impact other curricula.

Contribution: This research article provides input for enhancing the curriculum for Health Science Departments in Higher Education Institutions.