Browsing Faculty of Community & Health Sciences by Title
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Puoane, Thandi; Hughes, Gail; Bradley, Hazel A. (Kamla-Raj Enterprises, 2005)[more][less]
Abstract: Obesity and associated non-communicable diseases such as Type 2 diabetes, hypertension, and ischaemic heart disease were previously thought to be diseases of affluent countries, but they are becoming increasingly prevalent in developing nations. Accessibility to cheap unhealthy food, global trade and market development influence nutrition transition towards diets with high fat and sugar contents. A decrease in physical activity due to urbanisation and other environmental factors such as crime and violence are thought to lead to an increased risk of obesity. Positive beliefs about body weight among black African women, together with the idea of association of thinness with HIV/AIDS virus infection are believed to fuel the obesity epidemic amongst this population This paper describes some of the contributory factors which black South African women are faced with in making choices about healthy living. A multisectoral approach will be needed to fight the epidemic of obesity and associated diseases. URI: http://hdl.handle.net/10566/243 Files in this item: 1
PuoaneObesity2005.pdf (29.48Kb) -
Kruger, Salome H; Puoane, Thandi; Senekal, Marjanne; Van Der Merwe, Theresa M (Nutrition Society, 2005)[more][less]
Abstract: OBJECTIVES: To review data on the prevalence, causes and health consequences of obesity in South Africa and propose interventions to prevent and treat obesity and related outcomes. METHODS: Data from existing literature were reviewed with an emphasis on changing eating and activity patterns, cultural factors, perceptions and beliefs, urbanisation and globalisation. Results of studies on the health consequences of obesity in South Africans are also reviewed. RESULTS: Shifts in dietary intakes and activity patterns to higher fat intakes and lower physical activity are contributing to a higher prevalence of obesity. Few overweight black women view themselves as overweight, and some associate thinness with HIV/AIDS. Glucose and lipid toxicity, associated with insulin resistance, play roles in the pathogenesis of the co-morbid diseases of obesity. Elevated free fatty acids in the black population predispose obese black patients to type 2 diabetes. CONCLUSION & RECOMMENDATIONS: Obesity prevention and treatment should be based on education, behaviour change, political support, intersectoral collaboration and community participation, local actions, wide inclusion of the population, adequately resourced programmes, infiltration of existing initiatives, evidence-based planning, and proper monitoring and evaluation. Interventions should have the following components: reasonable weight goals, healthful eating, physical activity and behavioural change. Genes and mutations affecting susceptibility to the development of co-morbidities of obesity and vulnerable periods of life for the development of obesity should be prioritised. Prevention should be managed in community services, identification of high-risk patients in primary healthcare services and treatment of co-morbid diseases in hospital services. URI: http://hdl.handle.net/10566/285 Files in this item: 1
PuoaneObesityChallenges2005.pdf (160.4Kb) -
Puoane, Thandi; Steyn, Kristela; Bradshaw, Debbie; Laubscher, Ria; Fourie, Jean; Lambert, Vicki; Mbanangwa, Nolwazi (Nature Publishing Group, 2002)[more][less]
Abstract: To ascertain the anthropometric profile and determinants of obesity in South Africans who participated in the Demographic and Health Survey in 1998. RESEARCH METHODS AND PROCEDURES: A sample of 13,089 men and women (age, _15 years) were randomly selected and then stratified by province and urban and nonurban areas. Height, weight, mid-upper arm circumference, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of abdominal obesity. Multivariate regression identified sociodemographic predictors of BMI and waist circumference in the data. RESULTS: Mean BMI values for men and women were 22.9 kg/m2 and 27.1 kg/m2, respectively. For men, 29.2% were overweight or obese (_25 kg/m2) and 9.2% had abdominal obesity (WHR _1.0), whereas 56.6% of women were overweight or obese and 42% had abdominal obesity (WHR _0.85). Underweight (BMI _18.5 kg/m2) was found in 12.2% of men and 5.6% of women. For men, 19% of the variation of BMI and 34% of the variation in waist circumference could be explained by age, level of education, population group, and area of residence. For women, these variables explained 16% of the variation of BMI and 24% of the variation in waist circumference. Obesity increased with age, and higher levels of obesity were found in urban African women. DISCUSSION: Overnutrition is prevalent among adult South Africans, particularly women. Determinants of overnutrition include age, level of education, ethnicity, and area of residence. URI: http://hdl.handle.net/10566/291 Files in this item: 1
PuoaneSurvey2002.pdf (63.15Kb) -
Igumbor, Ehimario U.; Puoane, Thandi; Gansky, Stuart A.; Plesh, Octavia (South Africa Academy of Family Physicians, 2012)[more][less]
Abstract: Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province. Method: cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P < 0.05. Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The common sites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain. Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province. URI: http://hdl.handle.net/10566/428 Files in this item: 1
IgumborPeriurbanHealthClinic2012.pdf (197.4Kb) -
Puoane, Thandi; Tsolekile, Lungiswa; Steyn, Nelia (International Society on Hypertension in Blacks, 2010)[more][less]
Abstract: OBJECTIVE: To assess beliefs about body size (fatness and thinness) and body image in Black girls aged 10–18 years living in Cape Town. DESIGN: Exploratory using qualitative methods. SETTING: Cape Town, South Africa. METHOD: Participants were Black African girls (n5240), aged 10–18 years, who attended 5 primary and 6 high schools in Black townships in Cape Town. The schools and the girls were randomly selected. This paper presents qualitative data from 6 focus groups among 60 girls regarding their beliefs about thinness and fatness, and the advantages and disadvantages of being overweight or thin. RESULTS: Beliefs regarding body image indicate that two thirds of the girls perceived fatness as a sign of happiness and wealth. Socially, fatness was accepted but one third of the girls had contradictory views about its advantages. Among obese girls who believed that being obese was preferable, the dominant reasons were that being fat allowed one to engage in sport activities that need strength and also makes one look respectable. On the other hand fatness was viewed as associated with diseases such as diabetes and hypertension and with increased difficulty in finding appropriate clothing sizes. Three quarters of the girls associated thinness with ill health particularly HIV and AIDS and tuberculosis. An advantage of thinness was being less prone to develop chronic non-communicable diseases. CONCLUSION: The study shows that opinions and beliefs about body image start in adolescence. It is therefore important to consider these perceptions when designing interventions for preventing obesity and other chronic non-communicable diseases during early childhood URI: http://hdl.handle.net/10566/293 Files in this item: 1
PuoanePerceptionsCapeTown2010.pdf (178.9Kb) -
Matoti-Mvalo, Tandi; Puoane, Thandi (MedPharm Publications, 2011)[more][less]
Abstract: OBJECTIVE: To explore the perception among black South African women that people who are thin are infected with HIV or have AIDS. SETTING: Khayelitsha, an urban township in Cape Town. SUBJECTS: 513 women aged 18-65 years. METHODS: This was an exploratory study employing both quantitative and qualitative research methodology. Data were collected in two phases. The first phase involved collecting quantitative data among 513 participants. During the second phase, qualitative data were collected in a purposely selected sub-sample of 20 women. For the qualitative data collection, participants were shown eight body figures, ranging from thin to obese, and asked to choose a figure representing the ideal figure, a preferred figure and a figure thought to symbolise health. They were also invited to choose a figure that they thought represented a person infected with HIV or who had AIDS. They had the option of saying that they did not associate any of the figures with people infected with HIV or who had AIDS. Weight and height measurements were also taken. After the quantitative analysis was completed, focus group discussions explored perceptions about body image and the relation to HIV among purposely selected participants. Data were summarised by content based on questions discussed. RESULTS: Sixty-nine per cent of the participants associated a thin figure with a person infected with HIV, or who had AIDS. Only 10.2% thought the thin figure symbolised health. Fifty per cent preferred a normal-weight figure, while 34.2% thought that normal weight symbolised health. Only 2% thought that people in the normal-weight category were infected with HIV or had AIDS.Thirty-four per cent preferred to be overweight and 31% thought that being overweight symbolised health. None of the participants thought the overweight figure represented people infected with HIV or who had AIDS. Only 8% preferred the obese figure. The results of the qualitative data analysis suggested that participants preferred to be overweight and at risk of acquiring cardiovascular diseases, rather than being thin and stigmatised as a person infected with HIV or who had AIDS. CONCLUSION: This study revealed that the stigma associated with HIV and AIDS may undermine strategies for prevention of chronic noncommunicable diseases among urban black South African women. URI: http://hdl.handle.net/10566/271 Files in this item: 1
PuoanePerceptions2011.pdf (304.5Kb) -
Biraguma, Juvenal; Rhoda, Anthea (Taylor & Francis, 2012)[more][less]
Abstract: Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital in the Rulindo district of Rwanda. Another aim was to determine these patients’ QoL. A cross-sectional descriptive quantitative research design was used. A time-constrained method was used to sample 185 adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital. The subjective PN screen and the World Health Organization Quality of Life Scale Brief Version were used to collect the data. Data were analysed using the Statistical Package for the Social Sciences. Student’s t-test and one-way analysis of variance were performed to determine if significant differences existed between QoL scores in participants with and without PN symptoms. The results indicated that 40.5% of respondents experienced PN. QoL in participants with PN showed significantly lower scores in the physical (p ¼ 0.013) and psychological (p ¼ 0.020) domains when compared with those who did not have PN. These results indicate a high prevalence of neuropathy among PLWH attending the outpatients’ clinic at Rutongo Hospital. In addition, patients with neuropathy had lower QoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them. URI: http://hdl.handle.net/10566/529 Files in this item: 1
BiragumaPeripheralNeuropathy2012.pdf (98.16Kb) -
Matheri, Joseph Mwangi; Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2009)[more][less]
Abstract: Purpose: To determine the levels of and potential contributing factors to participation in physical activity among young people with physical disabilities attending high school in Kenya. Methods: A cross-sectional survey, using a pre-piloted and validated self-administered questionnaire, was carried out in a purposively selected sample of 234 young people with physical disabilities drawn from three inclusive high schools in Kenya. The questionnaire comprising outcome measures for physical activity levels, barriers, and facilitators to physical activity participation was administered to the young people. Data was analyzed using the Statistical Package for Social Sciences (SPSS) and both descriptive and inferential statistics were done. Results: Almost half of the children in the sample were inactive. Key barriers to physical activity were found to be: fear avoidance and disability, lack of time and the need to rest. Finding ways to exercise that are enjoyable, and not being in good health were associated significantly to gender (p<0.05). Likewise, age was significantly associated with gaining peer acceptance, as was encouragement from family and having disability (p<0.05). Conclusion: The results indicate there is a need, for activity counselling and provision of local disability-friendly and/or conducive environments to increase physical activity participation in this sample. All stakeholders should be enlisted in making recommendations and designing physical activity programmes for young people with disabilities in their schools. URI: http://hdl.handle.net/10566/120 Files in this item: 1
MatheriActivityLevels2009.pdf (117.5Kb) -
Frantz, Jose M. (Stellenbosch University, 2006)[more][less]
Abstract: This study aimed to determine the physical activity levels and existence of risk factors associated with chronic diseases of lifestyle among high school learners. A crosssectional research design was used to obtain information about physical activity levels from 951 learners from two high schools in a local community in the Western Province of South Africa. Physical activity levels were obtained using the KUOPIO Ischaemic Heart Disease 24-hour physical activity record over a seven-day period. Anthropometrical and blood pressure measurements as well as behaviours including cigarette smoking and alcohol use were recorded as risk factors for chronic diseases of lifestyle. Statistical analyses were performed using the Statistical Package for Social Science (2000). Risk factors were identified as obesity, physical inactivity, smoking and hypertension. Variance of analysis (ANOVA) was used to statistically determine differences in groups. The results indicated that 32% of the learners were classified as being physically inactive and that 21% engaged in health risk behaviours. In addition, 35% of the learners had more than one risk factor for chronic diseases of lifestyle present. Since cardiovascular risk factors have been shown to persist into adulthood, health professionals should assume some responsibility for the prevention, detection, and intervention relevant to cardiovascular risk factors in adolescents. URI: http://hdl.handle.net/10566/398 Files in this item: 1
FrantzPhysicalInactivity2006.pdf (194.4Kb) -
Rowe, Michael; Frantz, Jose M.; Bozalek, Vivienne (South African Society of Physiotherapy, 2012)[more][less]
Abstract: The relevance of non-technical skills have long been acknowledged as important components of clinical learning, and there is evidence that integrating technology can facilitate their development by encouraging reflection, and by enhancing communication and reasoning. However, effectively integrating technology into learning practices must take the contextual needs of students into consideration. The aim of this study was to determine what online tools undergraduate physiotherapy students at one South African university are familiar with, and how they use them as part of their learning practices. The case study was conducted in a university physiotherapy department in the Western Cape during 2010. A cross-sectional, descriptive design used a survey to obtain quantitative and qualitative data from participants, and a plot study was conducted to test the reliability of the instrument. All ethical considerations were adhered to. Seventy six percent of participants had access to the internet at home, and 93% of them belonged to a social network, although fewer than half used it for their studying. Few students reported using the internet for more than information retrieval but reported wanting to use it for enhanced communication with lecturers. Almost all respondents believed that lectures were a useful way to learn. However, 61% added that integrating online learning activities with lectures could have value. Integrating technology into healthcare education has the potential to develop non-technical skills that are relevant for clinical practice. However, this group of students currently lack the experience and insight to use technology effectively as part of their learning practices. Educators must take cognisance of the educational and contextual needs of students if they wish to integrate technology into clinical teaching. URI: http://hdl.handle.net/10566/309 Files in this item: 1
RowePhysiotherapyStudents2012.pdf (530.7Kb) -
Igumbor, Ehimario U.; Puoane, Thandi; Gansky, Stuart A.; Plesh, Octavia (James Cook University, 2011)[more][less]
Abstract: Background: Despite the acknowledgement that chronic pain may be a problem for adults in rural settings, there is a lack of epidemiological investigations on its occurrence in rural South Africa. Objectives: To estimate the prevalence of chronic pain among adults in a rural community in South Africa and characterize the localization, severity, risk indicators and responses of pain sufferers. Methods: Cross-sectional analytical study using face-to-face interviews. Interviews elicited information on socio-demographic characteristics, general health status and presence of pain. Among those reporting pain, the duration, frequency, severity, activity limitation and impact was determined. Univariate statistics were used to describe the prevalence of chronic pain while bivariable χ2 tests and multivariable logistic regression models were used to assess the relationship of socio-demographic characteristics and reported health status with chronic pain. Results: A total of 394 adults were interviewed representing a response rate of 92.8%. Of these, 169 (42.9%; 95% CI: 37.4%-47.1%) reported suffering from chronic pain. The common sites were the back, knee, ankles, head and shoulders. The median pain score was 6 on a scale of 0-10 (IQR= 5-8) and the median number of sites of pain was 1 (IQR= 1-2). The type of pain slightly varied with age with younger adults reporting more back pain and headaches while older people reported more joint pain. Female gender (adjusted odds-ratio AOR= 2.2, 95% CI: 1.9-2.8) and being older than 50 years (AOR= 3.1, 95% CI:2.7-3.9) were identified as risk indicators for chronic pain in the sample. Respondents reported that they self-treated (88.3%); consulted with a doctor or nurse (74.3%); traditional-healer (24.5%) and spiritual-healer (4%). Most respondents (63.4%) reported only transient relief of their pain. Conclusions: Chronic pain is an important health problem in the surveyed community. Further comparative studies on the relationship with risk factors are needed meanwhile interventions targeting females and the elderly are recommended. URI: http://hdl.handle.net/10566/430 Files in this item: 1
IgumborChronicPain2011.pdf (180.6Kb) -
Bradley, Hazel A.; Puoane, Thandi (International Society on Hypertension in Blacks, 2007)[more][less]
Abstract: The project aimed to identify factors that contribute to hypertension and diabetes and to design and implement appropriate local interventions to prevent these non-communicable diseases and promote healthy lifestyles. This was a community-based participatory action research project in which researchers and community health workers (CHWs) were the main participants. The triple A approach to planning interventions was used, that is, the process of assessing the situation, analyzing the findings, and taking action based on this analysis. Both qualitative and quantitative methods were employed. Twenty-two CHWs working in site C, Khayelitsha, a deprived urban area of Cape Town, South Africa, participated in the study. Findings from the situational assessment indicated a lack of knowledge among CHWs and the community about hypertension and diabetes and the risk factors for these non-communicable diseases. Economic constraints and cultural beliefs and practices influenced the community’s food choices and participation in physical activity. On the basis of these findings, a training program was proposed that would provide CHWs with the skills to prevent hypertension and diabetes in their community. A program was developed and piloted by the project team. A health club that focuses on promoting healthy lifestyles is currently being piloted. This paper illustrates the unique involvement of CHWs in a successful participatory action research project on the prevention of hypertension and diabetes and promotion of health in a deprived urban setting. The project emphasizes the importance of involving local people in community-based initiatives to promote health and identifies that the primary role of health services is to develop appropriate skills in the local community, monitor activities, and facilitate a link with primary health services. URI: http://hdl.handle.net/10566/182 Files in this item: 1
BradleyPuoanePrevention2007.pdf (184.0Kb) -
Fakude, Lorraine; Julie, Hester (University of the Western Cape. Faculty of Community & Health Sciences, 2006)[more][less]
Abstract: Introduction: E-learning has been integrated into the curriculum of the School of Nursing (SON) because it supports the principles of the case-based approach adopted by the SON. Aim: The primary aim was to gather baseline data on e-learning by exploring the perceptions and experiences of the first pilot group of undergraduate nursing students who were exposed to this strategy. Methods: A descriptive cross -sectional quantitative design was used to collect data regarding the students’ understanding and value of e-learning, the benefits and skills gained, challenges experienced, by means of a structured, open-ended questionnaire. Convenience sampling was used because the questionnaire was distributed to the 87, third year undergraduate nursing students who completed the Primary Mental Health Care module in June 2006. Microsoft Excel software was used for the capturing and analysis of the data. Results: The findings indicate that 19.5% did not have an accurate theoretical understanding of e-learning in spite of being exposed to at least two sessions of KNG training. The data confirmed that e-learning affords convenience, flexibility and improved access to digital resources. Initial confusion and system down times were cited as important challenges. Conclusion: Although some students struggled initially, the majority (87.8%) succeeded finally in mastering e-learning and regarded the experience as valuable in that 90% rated it as beneficial enough to be recommended to other students. URI: http://hdl.handle.net/10566/81 Files in this item: 1
Julie_Reflections2006.pdf (244.7Kb) -
Rhoda, Anthea; Mpofu, Ratie; DeWeerdt, Willy (South African Society of Physiotherapy, 2009)[more][less]
Abstract: The structure and process of rehabilitation of stroke patients affects the outcomes of the patients. The aim of this study was to determine the structure and process of rehabilitation of stroke patients at Community Health Centres (CHCs) in the Western Cape, South Africa. A quantitative descriptive study was conducted. Questions and archived records were used to collect the data. The study sample used to collect information related to the structure consisted of therapists (16) employed at the centres; while the study sample used to collect information related to the process consisted of 100 first time stroke patients. Descriptive statistics were conducted using Excel and SPSS . The results of the study revealed that there is a lack of occupational and speech therapy services at the centres forming part of the study sample. At centres where these services are provided the frequency and intensity with which the services are received by the patients is extremely low. Further research is needed to determine if the decreased intensity is only as a result of decreased availability of services or if inability of stroke clients to access the services also plays a role URI: http://hdl.handle.net/10566/522 Files in this item: 1
RhodaStructureRehabilitation2009.pdf (188.2Kb) -
Scott, Vera; Stern, Ruth; Sanders, David; Reagon, Gavin; Mathews, Verona (BioMed Central, 2008)[more][less]
Abstract: BACKGROUND: While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets. METHODS: A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision. RESULTS: The studies both demonstrate the value of adopting the GEGA approach of research to action, adopting three pillars of assessment and monitoring; advocacy; and community empowerment. In the Equity Tools for Managers Project study, the participation of managers meant that their support for implementation was increased, although the failure to include nurses and communities in the study was noted as a limitation. The development of a community Water and Sanitation Forum to support the Project had some notable successes, but also experienced some difficulties due to lack of capacity in both the community and the municipality. CONCLUSION: The two very different, but connected projects, demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice. URI: http://hdl.handle.net/10566/171 Files in this item: 1
ScottResearchToAction2008.pdf (299.6Kb) -
Rowe, Michael; Frantz, Jose M.; Bozalek, Vivienne (Association for Medical Education in Europe, 2012)[more][less]
Abstract: BACKGROUND: Developing practice knowledge in healthcare is a complex process that is difficult to teach. Clinical education exposes students to authentic learning situations, but students also need epistemological access to tacit knowledge and clinical reasoning skills in order to interpret clinical problems. Blended learning offers opportunities for the complexity of learning by integrating face-to-face and online interaction. However, little is known about its use in clinical education. AIM: To determine the impact of blended learning in the clinical education of healthcare students. METHODS: Articles published between 2000 and 2010 were retrieved from online and print sources, and included multiple search methodologies. Search terms were derived following a preliminary review of relevant literature. RESULTS: A total of 71 articles were retrieved and 57 were removed after two rounds of analysis. Further methodological appraisals excluded another seven, leaving seven for the review. All studies reviewed evaluated the use of a blended learning intervention in a clinical context, although each intervention was different. Three studies included a control group, and two were qualitative in nature. Blended learning was shown to help bridge the gap between theory and practice and to improve a range of selected clinical competencies among students. CCONCLUSION: Few high-quality studies were found to evaluate the role of blended learning in clinical education, and those that were found provide only rudimentary evidence that integrating technology-enhanced teaching with traditional approaches have potential to improve clinical competencies among health students. Further well-designed research into the use of blended learning in clinical education is therefore needed before we rush to adopt it. URI: http://hdl.handle.net/10566/308 Files in this item: 1
RoweBlendedLearning2012.pdf (1.048Mb) -
Scott, Vera; Chopra, Mickey; Azevedo, Virginia; Caldwell, Judy; Naidoo, Pren; Smuts, Brenda (BioMed Central Ltd, 2010)[more][less]
Abstract: BACKGROUND: In South Africa the need to integrate HIV, TB and STI programmes has been recognised at a policy and organisation level; the challenge is now one of translating policies into relevant actions and monitoring implementation to ensure that the anticipated benefits of integration are achieved. In this research, set in public primary care services in Cape Town, South Africa, we set out to determine how middle level managers could be empowered to monitor the implementation of an effective, integrated HIV/TB/STI service. METHODS: A team of managers and researchers designed an evaluation tool to measure implementation of key components of an integrated HIV/TB/STI package with a focus on integration. They used a comprehensive health systems framework based on conditions for programme effectiveness and then identified and collected tracer indicators. The tool was extensively piloted in two rounds involving 49 clinics in 2003 and 2004 to identify data necessary for effective facility-level management. A subsequent evaluation of 16 clinics (2 per health sub district, 12% of all public primary care facilities) was done in February 2006. RESULTS: 16 clinics were reviewed and 635 records sampled. Client access to HIV/TB/STI programmes was limited in that 50% of facilities routinely deferred clients. Whilst the physical infrastructure and staff were available, there was problem with capacity in that there was insufficient staff training (for example, only 40% of clinical staff trained in HIV care). Weaknesses were identified in quality of care (for example, only 57% of HIV clients were staged in accordance with protocols) and continuity of care (for example, only 24% of VCT clients diagnosed with HIV were followed up for medical assessment). Facility and programme managers felt that the evaluation tool generated information that was useful to manage the programmes at facility and district level. On the basis of the results facility managers drew up action plans to address three areas of weakness within their own facility. CONCLUSIONS: This use of the tool which is designed to empower programme and facility managers demonstrates how engaging middle managers is crucial in translating policies into relevant actions. URI: http://hdl.handle.net/10566/173 Files in this item: 1
ScottScalingUpIntegration2010.pdf (627.0Kb) -
Julie, Hester; Daniels, Felicity; Khanyile, Thembisile (Faculty of Community and Health Sciences, University of the Western Cape, 2007)[more][less]
Abstract: This article is informed by a retrospective study conducted by the first author, and a limited literature review on service-learning in South Africa. It attempts to give the reader a clearer understanding of service-learning by contextualizing service-learning within current debates about community engagement in higher education institutions in South Africa. A few dominant definitions of SL are described to espouse the underlying pedagogy of SL. Service –learning is then differentiated from other forms of clinical practice currently in use in nursing, based on the conceptual framework of Furco (1996). The latter discussion thus provides a backdrop for the brief description on how SL has been incorporated into the nursing curriculum at the University of the Western Cape (UWC). Lastly the challenges related to the implementation of SL are discussed. URI: http://hdl.handle.net/10566/93 Files in this item: 1
Julie_Service2007.pdf (52.26Kb) -
Julie, Hester; Daniels, Priscilla; Adonis, Tracey-Ann (University of Johannesburg, 2005)[more][less]
Abstract: Domestic violence is a pervasive problem in South Africa. The School of Nursing at the University of the Western Cape has responded to the challenge of training sensitive, knowledgeable and skilled health personnel by developing a Management of Gender-Based Violence (GBV) module. The purpose of this paper is to describe the professional and personal development of nursing students in this programme through their service-learning experience in the GBV module based on the analysis of the description of the students’ reflective journals, group project reports and a focus-group discussion as the primary data sources. Analysis showed that students gained critical thinking skills and developed an understanding of the supportive role health professionals can play through developing skills of caring, advocacy and a commitment to civic engagement, which promotes collaborative relationships. Some of the lessons learnt from this experience include realistic planning in terms of outcomes, time frames, and available resources as well ensuring support from colleagues for the effective implementation of the programme. URI: http://hdl.handle.net/10566/82 Files in this item: 1
Julie_Service2005.pdf (65.50Kb) -
Puoane, Thandi; Matwa, Princess; Hughes, Gail; Bradley, Hazel A. (Kamla-Raj Enterprises, 2006)[more][less]
Abstract: The present study was undertaken to examine socio-cultural factors that influence food intake in different groups of people residing in a black township in Cape Town. Focus group discussions and in-depth interviews were used to explore these factors in men, and women of different age groups. Discussions were recorded, transcribed and analysed according to emerging themes. The main findings of the study indicated that in addition to nourishing the body, food is a sign of warmth, acceptance and friendship. Meat consumption on a daily basis is associated with a high socioeconomic status, while consumption of vegetables only is associated with a low socioeconomic status. Eating large portions of food is associated with affordability. Food is used for celebrations, rituals, and for welcoming guests. Food is also used during social occasions when people get together and meet socially. Sweets, ice cream and cakes are consumed on happy occasions. Fatty meat is a sign of generosity; lean meat and black tea is often used during mourning periods. Eating behaviours are learned during socialization, and carried over from generation to generation. There are socially accepted norms and values surrounding people’s understanding of what food is. This information needs to be used in a more constructive way to help people choose food wisely to prevent over nutrition and associated risks. In conclusion, this paper illustrates the impact of socio-cultural factors on eating patterns in this population and emphasizes the need to take these factors into consideration in development of interventions to promote healthy eating. URI: http://hdl.handle.net/10566/253 Files in this item: 1
JHE-SI-14-12-089-093-Puoane-T-Text.pdf (145.3Kb)