Health SA Gesondheid最新文献

Background: Evidence suggests that survivors of coronavirus disease 2019 (COVID-19) experience ongoing symptoms, which is known as long COVID, or post-COVID syndrome. Approximately 100 million people globally are experiencing long COVID symptoms. Post-COVID syndrome (PCS) has debilitating effects on functioning and quality of life, potentially qualifying it as a disability.

Aim: This study aimed to assess the impact of PCS on disability levels using the WHO Disability Assessment Schedule (WHODAS 2.0).

Setting: A digital cross-sectional survey was conducted through online platforms, including Facebook, WhatsApp, and Instagram.

Methods: A self-developed questionnaire was distributed via social media to collect demographic information, COVID-19 symptoms, and severity. The WHODAS 2.0 instrument was used to measure disability levels. A total of 101 participants completed the online survey.

Results: Most participants were aged between 21 years and 30 years (66%) and were female (60%). The most common acute COVID-19 symptoms were sore throat, fever, and headaches (84%). Post-COVID symptoms included brain fog and tiredness (82%). There was a statistically significant relationship between brain fog, depression, anxiety, and disability summary scores (p < 0.005). The mean WHODAS 2.0 score was 34%, indicating a moderate level of disability.

Conclusion: This study's results align with previous research, highlighting tiredness and neuropsychiatric symptoms as common among post-COVID patients. Post-COVID syndrome results in moderate disability when assessed using the WHODAS 2.0 with domains of Life Activities and Cognition mostly affected.

Contribution: Post-COVID syndrome should be recognised as a disabling health condition, with rehabilitation prioritised as a critical intervention to enhance functional capacity and quality of life.

Background: Millions of people worldwide are affected by major depressive disorder (MDD). However, those with MDD do not receive treatment. More studies have been conducted on the efficacy of medications rather than the subjective experiences of mental healthcare users (MHCUs).

Aim: This study was conducted to investigate the experiences of MHCUs regarding the quality of their MDD treatment and to suggest recommendations that are necessary to bring a positive change towards the quality of MDD treatment.

Setting: The study was conducted at a Tshwane District Hospital.

Methods: A qualitative, exploratory study was used in this study. Seventeen MHCUs were selected using purposive sampling. Data were collected using observations, interviews and focus group discussions, and the data were analysed using grounded theory.

Results: One theme emerged from this study: 'The holistic treatment approach'. Two sub-themes emerged: 'Administration of service delivery' and 'Challenges of service delivery'.

Conclusion: Research findings show that the current treatment of MDD is beneficial. However, challenges exist that negatively affect the quality of the MDD treatment and they need to be addressed urgently by relevant stakeholders.

Contribution: The study could contribute through: (1) providing recommendations that, if implemented, could assist the decision-makers and MHCPs in understanding the quality of MDD treatment from the MHCUs' perspective and utilise these for policy development and to make necessary treatment adjustments.

Background: The severe acute respiratory syndrome coronavirus type 2 virus (SARS-CoV-2) was highly infectious and had a high mortality rate. Globally, countries prioritised early disease detection through biological sample collection, analysis, and treatment. Understanding the physical and mental health outcomes that medical technologists experienced as a result of the increased risk of exposure is critical for making recommendations for the successful implementation of new workplace safety standards.

Aim: This study attempts to provide a better understanding of medical technologists' experiences and occupational exposure during the coronavirus disease 2019 (COVID-19) epidemic.

Setting: The study was carried out at a Gauteng public laboratory that is a component of South Africa's national health laboratory services.

Methods: The study design was qualitative, exploratory, descriptive and contextual. Ten medical technologists were chosen using a purposive sampling technique. The data were gathered via in-depth, semi-structured interviews, which were audio recorded, professionally transcribed and coded. Tesch's thematic coding method was used to perform a descriptive analysis.

Results: Three key themes were identified: health and safety, negative experiences, and positive self-satisfaction. Medical technologists were concerned about their safety and health while handling COVID-19 specimens because of the challenging work environment caused by the pandemic. This resulted in negative experiences, including stress and anxiety. Despite this, several individuals felt their contributions throughout the pandemic were notable.

Conclusion: The COVID-19 pandemic required additional resources, expertise, and training for medical technologists to safely collect and analyse biological samples.

Contribution: The study's findings present an opportunity to develop work-related risk management and support plans for future pandemics.

Background: A widespread global risk for children is homelessness, often caused by adverse childhood experiences (ACEs) and leading to dire living conditions. Children may be compelled to live and work on the streets because of economic, social and psychological factors. Knowledge of the patterns of ACEs and their association with homelessness remains unknown in South Africa.

Aim: The study explores the patterns of ACEs contributing to childhood homelessness in South Africa to identify immediate causes and underlying factors that sustain the issue.

Method: A qualitative document analysis was used as the primary method to review and interpret relevant academic publications. Thematic analysis was employed to analyse the data, providing a structured approach to organising, categorising and examining the material, enabling the identification of key patterns and themes that guided the study's interpretation.

Results: The study identified push and pull factors such as family dysfunction, substance use, street culture, peer influence and poverty that shape child displacement and contribute to pathways into homelessness.

Conclusion: It was evident that family challenges, abuse and poverty push children from unsafe homes, while peer influence and street culture pull them into prolonged street life. Addressing the push-pull factors associated with ACEs requires a multifaceted approach that addresses the reasons why children leave their homes.

Contribution: This article explores ACEs leading to child homelessness and offers insights for families, communities and policymakers to reduce the issue in South Africa.

Background: Hirschsprung disease (HD), a congenital condition marked by absent ganglion cells in the colon, causes serious digestive problems. It affects 1 in 5000 newborns worldwide, predominantly males. Delayed diagnosis and limited resources influence outcome. The clinical profile, management, and outcomes of HD at Universitas Academic Hospital Complex (UAHC), a tertiary hospital in central South Africa, were investigated.

Aim: The aim was to identify healthcare challenges and enhance patient care in a resource-restricted setting.

Setting: UAHC, Bloemfontein, South Africa.

Methods: A retrospective cross-sectional study of all 65 paediatric surgical patients treated for HD during 2010-2021 was conducted. Data extracted from electronic medical records were analysed regarding demographics, disease presentation, diagnostic methods, treatment approaches and postoperative outcomes.

Results: A total of 65 patients, mostly male (83.1%), with a median age at diagnosis of 87 days, were analysed. Symptoms included abdominal distension and difficulty passing stool; 30.8% developed Hirschsprung-associated enterocolitis (HAEC). Diagnostic methods mainly used rectal suction biopsies. Surgery often required multi-stage procedures due to late diagnosis and extensive disease. Postoperative complications were common (e.g. ileus, surgical site infections, HAEC and hypomotility). Many patients needed additional surgeries. Follow-up indicated not only a high survival rate but also significant loss to follow-up and long-term complications.

Conclusion: Managing HD in resource-limited settings presents major challenges, where late diagnosis and scarce diagnostic resources affect outcomes.

Contribution: Managing HD is challenging because of delayed diagnosis, limited resources, complications and loss to follow-up, necessitating better perioperative care. Early diagnosis and structured follow-up can improve outcomes.

Background: Identifying protective factors in mental health-related outcomes is crucial, offering insights into the vulnerabilities and strengths individuals harness against psychological distress. There has been limited focus on exploring complex mediation and moderation models, which can uncover the relationships between stressors, protective factors and wellbeing.

Aim: This study investigated the interrelationship between perceived stress, sense of coherence (SOC), and psychological distress.

Setting: South African university students (N = 322) completed the Perceived Stress Scale, Sense of Coherence Scale-13, Beck Hopelessness Scale-9 and Center for Epidemiological Studies Depression Scale-10.

Methods: Moderation analysis was conducted using the PROCESS macro to examine the role of SOC in moderating the relationship between perceived stress and psychological distress. Where moderation was not significant, mediation analysis was conducted.

Results: Sense of coherence demonstrated multiple roles in mental health, exhibiting direct effects on indicators of psychological distress. Sense of coherence moderated the relationship between perceived stress and hopelessness. Under heightened stress conditions, individuals with low to medium SOC displayed more profound feelings of hopelessness compared to those with high SOC. Mediation analysis showed that SOC served as a bridge between perceived stress and both depression and anxiety. The identification of a potential SOC threshold offers a novel perspective on assessing risk levels, suggesting that individuals with low to moderate SOC are particularly vulnerable under high stress.

Conclusion: The findings emphasise the need for targeted approaches to strengthen SOC as a resilience-enhancing factor.

Contribution: The study advances theoretical discussions on stress-buffering models and offers guidance for mental health practitioners working in high-stress environments.

Background: The study is based on the view that food contamination and limited knowledge of health and hygiene are some challenges Child and Youth Care Centres (CYCCs) face. The South Africa Nutrition Education Programme (NEP) was a conceptual framework within which the study is embedded. Despite the existence of relevant legislation and processes on food preparation, safety and healthy eating, South Africa's CYCCs are still characterised by practice limitations.

Aim: The study explores the use of expert panels in the review of newly developed guidelines for child and youth well-being.

Setting: South African Experts in the field of CYCC and Academia.

Methods: A qualitative approach was utilised to select three experts in Child and Youth Care, Child and Youth Care Education and Training and Food, Nutrition, and Community Research Education and Training. They were given 58 pages of guidelines to review and submit input. Thematic analysis was used to interpret the data.

Results: The study's findings included six main themes and related sub-themes. The main themes include nutrition terminology and words, healthy eating plans, menu planning, food safety and hygiene, food preparation and the layout of the guidelines. In general, the study findings can be highlighted as inclusion of low-cost, widely available, cost-effective meals, utilising SA-acceptable terminology and focussing on SA sources rather than global literature.

Conclusion: The guidelines are critical because CYCCs in South Africa currently lack such guidelines. Furthermore, the expert reviewers acknowledged that the guidelines were applicable and necessary in South African child and youth care facilities.

Contribution: Child and Youth Care Centres in South Africa will be able to incorporate the guidelines into their everyday food handling and preparation procedures.

Background: Effective clinical teaching in tertiary institutions relies heavily on clinical preceptors who supervise undergraduate students. While many health science disciplines have explored clinical supervisors' perceptions of their roles, limited evidence exists in optometry.

Aim: This study aimed to explore optometry clinical supervisors' views on their effectiveness as clinical teachers.

Setting: One-on-one interviews were conducted online via Zoom.

Methods: Interviews were conducted in English and transcribed verbatim. Using a social constructivist paradigm and the inductive approach of content analysis, the data were analysed. Twelve of 22 eligible clinical supervisors (aged 21 years -50 years; 75% female) participated in the study.

Results: Two main categories emerged: (1) Roles and responsibilities of optometry preceptors, and (2) Intervening conditions that facilitate or hinder effective supervision. Participants described the clinic as a nurturing learning environment, with supervisors modelling professional behaviour, prioritising learning, and fostering psychological safety. Supervisors supported students in developing higher-order thinking. Facilitating factors included collaboration with academic staff and institutional support. However, high workloads, lack of adequate remuneration, and human resource challenges were identified as barriers to effective supervision.

Conclusion: Optometry clinical supervisors were committed to delivering effective preceptorship and creating a supportive clinical learning environment. Addressing workload, remuneration, and administrative challenges could enhance the supervision experience and sustain high-quality clinical teaching.

Contribution: This study identifies key enablers and barriers to effective clinical supervision, offering insights to improve the clinical training experience for undergraduate optometry students.

Background: The National School Nutrition Programme (NSNP) provides meals to schools in low-income areas in South Africa, implemented by the Department of Basic Education (DBE) with food safety monitored by Municipal Health Services.

Aim: To assess compliance of school kitchens with general hygiene requirements (R638 of 2018) and detect food pathogens on food contact surfaces using amplified metagenomics.

Setting: The study was conducted in quintile 1 and 2 primary schools in Vryheid, KwaZulu-Natal.

Methods: A quantitative cross-sectional study assessed the safety compliance of food preparation and storage areas in 33 primary schools against national legislation standards. Fifteen samples of food contact surfaces were collected from four schools and analysed using Illumina sequencing to identify prevalent bacterial genera.

Results: None of the schools possessed a Certificate of Acceptability. Significant structural issues include poor pest control, inadequate sanitary facilities, a lack of food safety training and inadequate waste management. Taxonomic analysis revealed several dominant bacterial genera, including Pseudomonas, Stenotrophomonas, Acinetobacter and Pantoea, indicating potential routes for food contamination and subsequent risks for foodborne illnesses.

Conclusion: The study highlighted critical inadequacies in food preparation and storage areas requiring urgent intervention to ensure safe meal preparation. It emphasised the need for improved food safety monitoring and compliance in schools in low-income areas. Next-generation sequencing (NGS) techniques identified a broad spectrum of pathogens, offering a robust method for assessing environmental hygiene.

Contribution: This study provides insights into food safety risks in the NSNP, informing policies and interventions to improve food safety and reduce foodborne illnesses in schools.

Background: Managing occupational health hazards (OHH) in the nursing profession is crucial for improving nurses' quality of life. Nurses are facing OHH while delivering patient care. These hazards can lead to morbidity, mortality and compromised patient care.

Aim: The study explored and described the perceptions of nurse managers regarding the management of OHH among nurses at the Intermediate Hospital Onandjokwe.

Setting: The study was conducted in the state healthcare facility at the Intermediate Hospital Onandjokwe.

Methods: A qualitative approach with phenomenological, descriptive, exploratory and contextual designs was adopted. Non-probability purposive sampling was employed, and sample size was determined by data saturation. The study utilised an interviewer guide, field notes and an audio recorder as instruments for data collection. The data were analysed using a thematic approach. The criteria for ensuring data trustworthiness were applied, and fundamental ethical principles were followed.

Results: Three major themes and their corresponding sub-themes emerged from the data, such as: (1) perceived factors associated with the management of OHH, (2) experiences of OHH and (3) challenges faced by nurses in managing OHH.

Conclusion: The nurse managers perceived poor management of OHH in the hospital, which exposed nurses to physical, chemical, biological and psychosocial health hazards.

Contribution: The study supports the sustainable development goals by improving health and safety practices for nurses and enhancing their working conditions. It aligns with Vision 2023 by promoting a healthier, safer workforce to improve nurses' health and well-being.