Browsing Faculty of Community & Health Sciences by Title
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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) -
Wegner, Liezel; Struthers, Patricia (Africa Association for Health, Physical Education, Recreation,Sport and Dance/LAM Publications Limited, 2011)[more][less]
Abstract: In the Western Cape, learners with physical disabilities are accepted into ordinary schools (a school that is not a special school) as a part of the inclusive education initiative. This article reports on a survey designed to determine the types of sports that are available for learners with physical disabilities in ordinary public primary schools and the factors influencing their participation in sport. The study sample included 31 learners with physical disabilities (learners with movement or mobility difficulties or who used an assistive device) attending seven ordinary public primary schools, one teacher from each school and one teacher from each of eight conveniently selected special schools. Three questionnaires were used, one for the learners, another for the teachers at the ordinary schools and the third for the teachers at the special schools. Analysis was done using SPSS Version 15. The main findings of the study were that 32% (n=10) of learners participated in sports. They were expected to participate in the type of sports that were already offered at the school. No adapted sport was offered specifically for these learners. Most learners wanted to participate in swimming. Fewer types of sports were offered in ordinary schools than in special schools. Barriers to participation included poor teacher preparation and inadequate financial support. The shortage of support from school staff, occupational therapists and physiotherapists in addition to inadequate financial support needs to be addressed by the Department of Basic Education and Department of Sport and Recreation to enable the learners to participate in sports at ordinary schools. URI: http://hdl.handle.net/10566/470 Files in this item: 1
WegnerSportsDisability2011.pdf (126.4Kb) -
Frantz, Jose M.; Smith, Mario (Faculty of Community and Health Sciences, University of the Western Cape, 2010)[more][less]
Abstract: INTRODUCTION: Strategies for improving the publication output of academics are an essential component of research directives at tertiary institutions. The aim of this report was to highlight the effects of a writing retreat as an intervention strategy used by a university faculty to improve academic publication output. The strategy used included a structured programme over a period of three days guided by a facilitator. METHODS: The report uses a qualitative design to report the effects of the writing retreat on the participants. RESULTS: The major themes that emerged were reviewing and critical reading, writing for publication, personal growth and confidence, dedicated time, peer mentoring, programme structure and facilitation, and future directives. CONCLUSION: From the feedback obtained, it is evident that strategies such as a writing retreat provide academics with an opportunity to produce articles that are a benefit to the authors’ career trajectories as well as the institutional publication profile of their university. URI: http://hdl.handle.net/10566/188 Files in this item: 1
FrantzSmithStaff2010.pdf (106.5Kb) -
Lehmann, Uta (Health Systems Trust, 2008)[more][less]
Abstract: This chapter reviews the progress made in recent years to strengthen human resources to deliver health care within a Primary Health Care approach. It focuses specifically on the availability and preparedness of old and new cadres of health workers, their distribution within the South African health system, as well as their training and development. Findings suggest that overall the health workforce is substantially weaker today than it was in the mid-1990s. There are fewer doctors and nurses available for the vast majority of public sector dependent population, as production has not kept up with population growth, increasing care needs and attrition. Disparities between provinces remain, and disparities between the private and public sectors have grown. The nursing sector faces a serious crisis brought on by an aging professional population. Progress with the development of mid-level cadres has been slow, with pharmacy being the exception. Furthermore, the implementation of community health worker programmes remains fragmented and uneven. Importantly, while there has been curriculum reform in many medical schools, there has been no fundamental shift in the orientation and resourcing of health professions. Health workers entering primary or community care services, thus, often remain illprepared and find themselves poorly supported and resourced. It is suggested that the following areas must be a priority in the human resource agenda in coming years: an accelerated production of professionals and mid-level cadres; comprehensive curriculum audits; the regulation and integration of community health workers; and an integrated and comprehensive reconfiguration of Primary Health Care teams. URI: http://hdl.handle.net/10566/437 Files in this item: 1
LehmannPrimaryHealthCare2009.pdf (692.3Kb) -
Shamu, Simukai; Abrahams, Naeemah; Temmerman, Marleen; Musekiwa, Alfred; Zarowsky, Christina (Public Library of Science, 2011)[more][less]
Abstract: Background: Intimate partner violence (IPV) is very high in Africa. However, information obtained from the increasing number of African studies on IPV among pregnant women has not been scientifically analyzed. This paper presents a systematic review summing up the evidence from African studies on IPV prevalence and risk factors among pregnant women. Methods: A key-word defined search of various electronic databases, specific journals and reference lists on IPV prevalence and risk factors during pregnancy resulted in 19 peer-reviewed journal articles which matched our inclusion criteria. Quantitative articles about pregnant women from Africa published in English between 2000 and 2010 were reviewed. At least two reviewers assessed each paper for quality and content. We conducted meta-analysis of prevalence data and reported odds ratios of risk factors. Results: The prevalence of IPV during pregnancy ranges from 2% to 57% (n = 13 studies) with meta-analysis yielding an overall prevalence of 15.23% (95% CI: 14.38 to 16.08%). After adjustment for known confounders, five studies retained significant associations between HIV and IPV during pregnancy (OR1.48–3.10). Five studies demonstrated strong evidence that a history of violence is significantly associated with IPV in pregnancy and alcohol abuse by a partner also increases a woman’s chances of being abused during pregnancy (OR 2.89–11.60). Other risk factors include risky sexual behaviours, low socioeconomic status and young age. Conclusion: The prevalence of IPV among pregnant women in Africa is one of the highest reported globally. The major risk factors included HIV infection, history of violence and alcohol and drug use. This evidence points to the importance of further research to both better understand IPV during pregnancy and feed into interventions in reproductive health services to prevent and minimize the impact of such violence. URI: http://hdl.handle.net/10566/461 Files in this item: 1
ShamuPartnerViolenceReview2011.pdf (319.5Kb) -
Assuman, Nuhu; Frantz, Jose M. (Faculty of Community and Health Sciences, University of the Western Cape, 2008)[more][less]
Abstract: Introduction Although stretching increases soft tissue flexibility and joint range of motion, numerous studies demonstrated contradictory findings as to its effect in injury prevention. Aim The purpose of this systematic review is to assess the effectiveness of stretching on the prevention of injuries. Methods An electronic search using MEDLINE, SCIENCE DIRECT, COCHRANE, EBSCOHOST, SPORTDiscus and CINAHL databases, checking the references. Randomised control trials (RCTs) and cohort studies investigating stretching as an injury prevention measure published in the last decade were selected in this review. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Results Two RCTs and two prospective cohort studies all of high quality were included in this analysis. One cohort study found that stretching reduced the incidence of exercise related injuries. Two RCTs and one cohort study found that stretching did not produce practical reduction on the occurrence of injuries. Conclusion Stretching exercises does not give a practical useful reduction in the risk of injuries. Not enough recent research has been done to draw definitive conclusion on the effect of stretching in injury prevention. Well designed studies are needed to shed light as to the effect of stretching in exercise-related injury risk reduction. URI: http://hdl.handle.net/10566/117 Files in this item: 1
NuhuStretching2008.pdf (374.7Kb) -
Lehmann, Uta; Van Damme, Wim; Barten, Francoise; Sanders, David (BioMed Central, 2009)[more][less]
Abstract: Ever since the 2006 World Health Report advocated increased community participation and the systematic delegation of tasks to less-specialized cadres, there has been a great deal of debate about the expediency, efficacy and modalities of task shifting. The delegation of tasks from one cadre to another, previously often called substitution, is not a new concept. It has been used in many countries and for many decades, either as a response to emergency needs or as a method to provide adequate care at primary and secondary levels, especially in understaffed rural facilities, to enhance quality and reduce costs. However, rapidly increasing care needs generated by the HIV/AIDS epidemic and accelerating human resource crises in many African countries have given the concept and practice of task shifting new prominence and urgency. Furthermore, the question arises as to whether task shifting and increased community participation can be more than a short-term solution to address the HIV/AIDS crisis and can contribute to a revival of the primary health care approach as an answer to health systems crises. In this commentary we argue that, while task shifting holds great promise, any long-term success of task shifting hinges on serious political and financial commitments. We reason that it requires a comprehensive and integrated reconfiguration of health teams, changed scopes of practice and regulatory frameworks and enhanced training infrastructure, as well as availability of reliable medium- to long-term funding, with time frames of 20 to 30 years instead of three to five years. The concept and practice of community participation needs to be revisited. Most importantly, task shifting strategies require leadership from national governments to ensure an enabling regulatory framework; drive the implementation of relevant policies; guide and support training institutions and ensure adequate resources; and harness the support of the multiple stakeholders. With such leadership and a willingness to learn from those with relevant experience (for example, Brazil, Ethiopia, Malawi, Mozambique and Zambia), task shifting can indeed make a vital contribution to building sustainable, cost-effective and equitable health care systems. Without it, task shifting runs the risk of being yet another unsuccessful health sector reform initiative. URI: http://hdl.handle.net/10566/316 Files in this item: 1
LehmannTaskShifting2009.pdf (219.6Kb) -
Puoane, Thandi; Sanders, David; Ashworth, Ann; Ngumbela, Modesta (Democratic Nursing Organisation of South Africa, 2006)[more][less]
Abstract: A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/caregivers. Nurses’ attitudes were compared before and after attending a 5-day training course to improve the management of malnutrition along with implementing World Health Organization (WHO) guidelines. Severe malnutrition is a major cause of death among paediatric patients in many hospitals in South Africa. A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/caregivers. Nurses’ attitudes were compared before and after attending a 5-day training course to improve the management of malnutrition along with implementing World Health Organization (WHO) guidelines. Focus group discussions were conducted in isiXhosa following a semi-structured discussion guide. Three themes emerged from these discussions, i.e. blame was placed on the mothers for not giving adequate care, malnourished children were valued less than those with other conditions, and resentment that nurses felt towards caregivers. underlying reasons for negative attitudes towards severely malnourished children and their caregivers were misunderstandings of the causes of severe malnutrition, misinterpretation of clinical signs,especially poor appetite and and high mortality during treatment.However, successful application of the treatment guidelines altered these perceptions and helped nurses to have a better understanding of the causes of the presenting clinical signs. These nurses have begun advocating for raised awareness and the need to include the WHO Ten Steps of treatment in the nursing curricula and in-service training. A cadre of volunteer nurse-trainers has been formed in Eastern Cape. Experience in this province has shown that in-service training changes attitudes to malnutrition and treatment practices, as well as saving lives. URI: http://hdl.handle.net/10566/297 Files in this item: 1
PuoaneTrainingNurses2006.pdf (666.8Kb) -
Goggin, Kathy; Puoane, Thandi (University of KwaZulu-Natal, 2010)[more][less]
Abstract: This study reports on the cultural and language translation of measures for use with Zulu speakers in South Africa. The translation process was purposefully used to integrate our diverse 14 person study team by employing Community Based Participatory Research (CBPR) strategies. Measures included: the Medical Outcomes Study HIV Health Survey (MOS-HIV), Center for Epidemiologic Studies Depression Scale (CES-D), and Perceived Stress Scale (PSS). The translation was made complex by the variation in Zulu dialects across regions and even between two cities only forty-five minutes apart. Carefully conceived translations can simultaneously produce good translations and deepen team members’ understanding of each other. URI: http://hdl.handle.net/10566/270 Files in this item: 1
13 Goggin FIN.pdf (125.1Kb) -
Willemse, Juliana; Kortenbout, Elma (AOSIS OpenJournals, 2012)[more][less]
Abstract: The practice of community health nursing (CHN) may enhance the life experiences of families and communities, particularly amongst the poor and socially marginalised. CHN provides for a deeper understanding of the health status of families living within communities, for example, where and how they live, their cultural context and their ability to identify resources available to assist with their health care (Allender, Rector & Warner 2010:17). This qualitative phenomenological study reflects on the self-reported lived experiences of undergraduate CHN students at the University of the Western Cape in the City of Cape Town, South Africa. These students conducted a family health assessment (FHA) learning task at the homes of families within communities. Purposive and convenience sampling was used by students who had conducted an FHA. Fourteen students agreed to participate in the study, of whom nine were interviewed, two withdrew and the remaining three were not interviewed since no new data were emerging during interviews, indicating that saturation had been reached. During in-depth interviews with seven female and two male students, data for the exploration of the lived experiences was gathered through the following question: ‘How did you experience the FHA?’ Field notes were taken and used to capture non-verbal communication of participants. The focus of the study was to explore the lived experiences of students and not those of the family on whom the FHA was completed. Data collected were categorised into themes, guided by the systematic data analysis process of Tesch (1990) cited in Cresswell (2003:192). Four themes emerged: challenges of family selection, challenges of safety, socio-cultural challenges and academic challenges experienced by the participants. This study will inform future research and curriculum planning for CHN education in a multifaceted context. URI: http://hdl.handle.net/10566/588 Files in this item: 1
WillemseNursesAssessment2012.pdf (427.8Kb)