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Volume 21, Issue 2.2, 2015
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp i –iv (2015)More Less
This special edition of AJPHERD for the School of Health Sciences, University of Fort Hare focuses on mentoring and public health issues affecting the health care professionals and the rural people of South Africa, and more specifically, the Eastern Cape. The special edition is published in two parts. Issue 2:1 features articles on mentoring and capacity building, nursing training, education and professional issues, while issue 2:2 covers articles in the areas of clinical health, lifestyle behaviour and health promotion, communicable (HIV/TB) and non-communicable diseases, traditional and indigenous health practice, physical activity and tourism.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 241 –256 (2015)More Less
This retrospective study determines the rates and indications for caesarean sections in a freestanding private midwife obstetric unit caring for low-risk, normal uncomplicated pregnant women who attempted vaginal births over a period of five years (2009-2013). Medical records of caesarean sections were examined. Primigravidas between the ages 25-35 primarily made used of the private maternity obstetric unit, with lower rates of multigravida. None of the Grande multigravida clients experienced adverse outcomes or caesarean births. Induction of labour was done primarily for post-dates or fetal macrosomia in the absence of diabetes. Prandin ® was the medication of choice. Caesarean sections were only done on clinically-based decisions, and the clients were given sufficient time to progress through the birth process before surgery became a necessity. The caesarean section average rate was 17% and only two elective caesareans were performed by special requests. Haemorrhage during a caesarean section was almost double the volume of blood loss during a vaginal birth, and post-operative complications necessitated the transfer of clients. The need for blood transfusions was low. Hysterectomies and maternal deaths did not occur during the 5-year period, and the maternal morbidity rates were low for both vaginal births and caesarean sections. Mothers experiencing adverse complications were transferred to a higher level of care, in accordance with the Maternity Guidelines. None of the transferred mothers experienced long-term detrimental outcomes. During the 5-year study period, five known clients who had caesarean sections had wound sepsis. Three were re-admitted in a higher level of care for intra-venous antibiotic treatment. It is not known if the other two were readmitted, or received oral antibiotics only. Women who experienced intra-operative surgical complications or complications following the surgical interventions (perforated bowel, intraabdominal bleeding, deep venous thrombosis) were transferred to higher levels of care. The odds of adverse neonatal outcomes when the mother is low risk, was minimal. Neonatal mortality and morbidity rates were low. One intra partum death was the result of a ruptured uterus during a TOLAC.
Attitude and practice of nurses towards aseptic technique in the prevention of surgical site infectionsAuthor E.O. OwolabiSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 257 –270 (2015)More Less
Despite improvements in operating room practices, instrument sterilization methods, better surgical technique and the best efforts of infection prevention practitioners, surgical site infections (SSIs) remains increasingly major cause of nosocomial (hospital-acquired) infections, globally. The study assesses the attitude and practice of aseptic technique by nurses in the prevention of SSIs at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital (LTH), Osogbo, Nigeria. A structured questionnaire consisting of 27 questions was administered to 102 nurses in the surgical wards of the hospital. About 88(87%) had knowledge on the procedure for surgical site infection and aseptic technique while 14(13%) did not. Attitude and practice of aseptic techniques by nurses showed that 72(71%), 19 (18%), 8(8%) and 3(3%) respondents always, sometimes, rarely and never practiced aseptic technique, respectively. There was a significant (X2=18.290, df=3, p<0.000) relationship between educational qualification of nurses and the attitude and practice of aseptic technique in the prevention of SSIs. However, no significant (X2=4.836, df=3, p<0.184) relationship exist between clinical experience of nurses and the attitude and practice of aseptic technique in the prevention of surgical site infection. Nurses at LTH Osogbo, had good attitude and practice aseptic technique for the prevention of surgical site infections, which is encouraging and should be sustained. The use of aseptic technique should be embraced by nurses and all other healthcare providers as a preventive strategy for surgical site infections.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 271 –281 (2015)More Less
Perinatal period is a time of uncertainty for most women and it is worse with unplanned pregnancy. This study explores the perinatal experiences of undergraduate nursing students pregnant whilst studying. A qualitative, phenomenological and exploratory design within interpretive realism was used. A snowball sampling of nine participants and semi-structured interviews were used to collect data. Thematic data analysis was used. Four themes that emerged were: dynamics on awareness about existence of pregnancy; support system for female students pertaining to reproductive health; encountered psychosocial experiences and coping strategies used by pregnant students. Hiding or late disclosure of pregnancies by undergraduate students resulted in lack of support from the family and the institution. Furthermore, without support undergraduate students were unable to have birth plans as required and that led to unsupervised births in residences.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 282 –291 (2015)More Less
The aim of this record review was to investigate the variables that impact upon the annual escalating cost of treating accident victims with similar injuries.The claims invoices of 1.3 million accident victims in a fee-for-service medical insurance scheme were analysed. The currency exchange rate at the time was used to convert all costs to American dollars. The variety in the nature and number of clinical interventions were largely responsible for the 30% to 3,560% variation in costs between the first and fourth quartiles. A review of patient profiles suggested that discontinuity of care and non-compliance with evidenced based care were the two main reasons for this finding.This is in contrast with many published reports that give patients’ age and sex, co-morbidities, newer technologies and increased administration costs as the main reasons for increasing general medical costs. Funding policies and the structure of health care delivery are needed to make patients and providers of care more accountable for medical intervention. Monitoring patient help seeking behaviour and deviations from evidenced based medical interventions would promote more cost efficient care. Further studies are required to establish whether these accident victim findings are generalizable to the provision of general health care.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 292 –300 (2015)More Less
Hypertension is a global health burden affecting developed and developing countries. Of course, there is a high morbidity and mortality rate of hypertensive patients in spite of hypertensive patients being taught about lifestyle modification. This study examines the effectiveness of lifestyle modification intervention on hypertensive patients in one of the health facility Alice, Eastern Cape, South Africa. A descriptive quantitative research design was applied on a convenience sample 196 respondents. Data were collected by means of self-administered questionnaires. The results revealed that 77% (n=125) knew nothing about hypertension and 23% (n=37) had knowledge and knew what hypertension was. About 76% (n=123) used both drug and lifestyle modification. Concerning barriers/obstacles in practising behaviour modification, 58% (n=94) had no barriers/obstacles in practicing lifestyle modification, while 18% (n=29) had barriers/obstacles. Overwhelming majority (96%; n=156) of the participants indicated they were told on their first and subsequent visits. About 44% (n=71) of the participants were supported by their spouses. Most participants indicated having vegetable gardens in their homes (64%; n=104), while 36% had no vegetable gardens at their homes. Additionally, majority (98%; n=159) of the participants had gardens in the community. However, all the respondents indicated that there were no support groups in their communities. Majority (98%; n=159) of the participants indicated having no support groups at the clinic. All respondents indicated that they did not receive food parcels from the social welfare organisation. The hypertensive patients in this present study lack knowledge on hypertension and importance of lifestyle modification; and have no support structures in the clinics. There is need for intense health education campaigns aimed at increasing knowledge and awareness of the hypertension and its complications in order to promote the quality life of hypertensive people.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 301 –310 (2015)More Less
This study explored the perception of risk of HIV infection among undergraduate nursing students at the University of Fort Hare, East London Campus. An explorative and descriptive qualitative design was used. The convenience and purposeful sampling of 35 students formed part of the study. In-depth interviews and focus group discussions were conducted. Data were analysed using thematic analysis. The findings revealed that risk perceptions for HIV infection were socially constructed and influenced by the ‘student life’ discourse among undergraduate nursing students. The university environment contributed significantly towards the social construction of risk of being infected by HIV. Values that students have internalised from home were seriously challenged by the university life. Students adopted new set of values when they arrive at the university and there was an overwhelming urge to learn and experience new things. Such a conduct was triggered by the new sense of freedom. University life seems to have exposed students to a risk of being infected by HIV as they were unable to maintain the values that they have learned from home.
Feeding methods and diarrhoeal infection rate between exclusively breastfed and exclusively formula-fed infants born to HIV-positive mothersSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 311 –327 (2015)More Less
The purpose of this study was to compare the rates of diarrhoeal infections between exclusively breastfed and exclusively formula-fed infants born to HIV-positive mothers in Nkonkobe District, Eastern Cape Province. A quantitative design was used to determine the differences. The research population was made up of HIV-positive mothers who are practising exclusive breastfeeding and exclusive formula feeding. A convenience sample was utilised, comprised of two hundred and thirty-eight participants in the Nkonkobe District in the Eastern Cape Province. A semi-structured questionnaire was used to collect the necessary data. The findings in this research study reflected that the occurrence of diarrhoeal infection differs between formula fed and breastfed children. Infants born to HIV-positive mothers exclusively practising the breastfeeding method had fewer cases of diarrhoeal infections whilst those exclusively practising the formula feeding method had more cases. There was a significant relationship between feeding method and educational level (X2=18.377; p=0.003) and dependents (X2=57.315; p= 0.050). There is a relationship between the feeding method and the educational level as well as the number of dependants. The importance of disclosure during counselling and post counselling should be emphasised by the health workers to women, so as to avoid complications. Breastfeeding support groups should be established within the community. Pregnant women need to be equipped with knowledge so that they will be able to make informed decisions.
Experiences of HIV positive clients defaulting isoniazid preventive therapy in King Williams town, Buffalo City municipality, Eastern Cape Province, South AfricaSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 328 –347 (2015)More Less
This qualitative study aimed at exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. An in- depth unstructured face-to-face interviews were conducted with 14 participants from four health facilities under Bhisho Primary Health Care Services. Work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment. The respondents suggested the use of text message reminders, non-discrimination of HIV patients because of their status, use of consulting rooms for privacy and the need for nurses and caregivers to control their attitudes when dealing with patients. In order to minimize non-adherence due to migration at the time of enrolment, adequate contact information about the programme be provided to the participants, as well as arrangement be made so that those who migrate can collect their supply of drugs in advance. Also, health care providers should recognize and understand HIV positive clients on IPT differences, and treatment should be offered based on the individual’s needs and in context with their concerns. There is need to organize periodic workshops and in- service trainings for health workers on IPT, its benefits and existing guidelines.
What patients want : a qualitative study of palliative care experiences of HIV and AIDS patients and their familiesSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 348 –359 (2015)More Less
The Patients’ Rights Charter (Health Professions Council of South Africa (HPCSA), (2008) stipulates the provision for “special needs in the case of persons living with HIV or AIDS” and palliative care that is both “affordable and effective”. But exactly what palliative support and care is wanted by HIV positive patients is not clear. This study explored the palliative care experiences of Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficient Syndrome (AIDS) patients and their families. Interviews were performed, on patients and family members of other patients who had received palliative care in a small urban palliative care centre. The research question was, “What was your experience of being cared for in the care centre?” Sampling was purposive and continued until saturation was reached (which was after ten interviews). The interviews were recorded and data transcribed verbatim. The data were analysed, identifying themes and sub-themes using a computer programme (Atlas.ti 6.1) and in collaboration with a co-coder. The study concluded that patients want good holistic care. The most important aspects of care named by the patients and their families were compassion, respect, dignity and spiritual support. The care that patients want is holistic, unsophisticated and relational. This kind of care is what is promoted as palliative care by the World Health Organisation.
Challenges experienced by health care workers in implementing the National Multi-Drug Resistant Tuberculosis guidelinesSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 360 –367 (2015)More Less
This study explored the challenges faced by professional nurses in implementing the National Treatment Guidelines to prevent, detect and manage multi-drug resistant tuberculosis. A qualitative, explorative and descriptive design was used. Purposive sample of clinics and professional nurse was selected and voluntary participation was ensured. Data were collected through individual interviews which were audio-taped and then transcribed verbatim. The findings revealed that multi-drug resistant tuberculosis guidelines were available at the clinics and were implemented by professional nurses. The constraints regarding the management of MDR-TB patients and the overall TB programme includes MDR-TB specific training, staff shortages, dysfunctional community DOT programme and the shortage of beds at MDR treatment centres and patient factors: defaulting, migration for various reasons and alcoholism. These constraints call for intensive strategic management at both policy and facility level. It is also necessary that all policies related to patient management need extensive scientific study to monitor and evaluate their effectiveness. More research studies are required on policy analysis and utilization.
Factors contributing to tuberculosis default rate in Buffalo City Metropolitan municipality, Eastern Cape Province, South AfricaSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 368 –383 (2015)More Less
Tuberculosis (TB) kills approximately three million people per year worldwide. Defaulting from treatment has been one of the major obstacles to treatment management and an important challenge for tuberculosis control. The main purpose of this study was to explore factors contributing to the high default rate of tuberculosis in Buffalo City Metropolitan, Eastern province. This was a qualitative study consisted of all TB clients who were defaulting treatment from January to December 2012 in Zanempilo, Gonubie and Chris Hani clinics in the East London Primary Health care facilities under the Buffalo City Metropolitan Municipality (BCMM). Using a non-probability purposive sampling method, TB registers from January to December 2012 served as a source of information to get the names and addresses of TB defaulters. In-depth unstructured face-to-face interviews were used to collect data from 14 participants. The study revealed that patient behaviour, sickness, feeling better, nurses’ attitudes, work issues and temporary change of residence are the reasons for TB default among the patients. It is imperative to understand predictive factors for treatment default so that programmes can implement specific measures that target the population at risk, since other strategies such as simpler treatment regimens and directly observed treatment seems to be presenting unsatisfactory results.
Efficacy of traditional plant medicine for the treatment of soil transmitted intestinal worms in humans : a systematic reviewSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 384 –396 (2015)More Less
Soil transmitted helminths (STHs) remain a common public health disease infecting more than two billion people, especially children in impoverished developing countries. To date, most traditional systems of medicine heavily depend on medicinal herbs and plants as a source of remedy against intestinal worm infections, however there is a dearth of published data on the efficacy of anthelminthic plants. We conducted a systematic review of clinical trials evaluating the anthelmintic plants in order to determine what is known about the efficacy of anthelmintic plants and also to identify gaps in our knowledge. From 127 possible studies, our meta-analysis included four quasi-randomised studies comparing any traditional medicinal plants against a standard drug, placebo or no treatment. Both authors independently appraised and extracted the main outcome measures: egg reduction rate; reduction of parasitic burden and adverse effects. Nausea was the most common side effect reported in almost every study. The plants Chenopodium ambroisodes, Carica papaya and pumpkin seeds combined with areca nut showed high efficacy rates in reducing the intestinal parasites. There is urgent need for further high quality randomised controlled trials in order to inform and guide clinical decisions regarding integrating indigenous plants into primary healthcare.
Perceptions of indigenous people regarding mental illness at Cacadu District in the Eastern Cape Province, South AfricaSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 397 –406 (2015)More Less
The aim of the study was to explore the perceptions of indigenous people and the role of Traditional Healers in the management of mental ill persons in Cacadu District, Eastern Cape Province, South Africa. This qualitative, exploratory and descriptive study consisted of nine relatives of mental health care users and six traditional healers. Data were collected from two categories namely, relatives of the Mental Health Care Users (MHCUs) and the Traditional healers. An interview guide was used to conduct in-depth face to face interviews. Data were analysed using two techniques, namely coding and reflective remarks. Participants indicated negative impact of mental illness as a result they portrayed great desperation regarding means of accessing cure for mental illness. Some participants showed insufficient knowledge regarding mental illness and had vast perceptions and beliefs regarding the origin of mental illness. Some key findings was that mental illness resulted in tension amongst family members with sick individuals over demanding and exhibiting abusive type of communication which led to serious disharmony within the family structure. Most participants expressed the burden that the family experience during the period when its member is affected by mental illness with regard amount of resources and support that is needed for the mentally ill individual. Families not only provide material resources such as food, clothing, shelter, and money; they are also instrumental in assisting the mentally ill individual to access medical care and community resources. Some family members go to an extent of hiring health caregiver. The relatives do not open up to the health care team about visiting traditional healers. Some family members confirmed that it is not easy to accept mental illness like other common physical illnesses. Some of the causes mentioned by the indigenous people are witchcraft, jealousy, amafufunyana, ukuthwasa and ancestral anger. Indigenous people of Cacadu District view mental illness as spiritual origin but they include western medication for the benefit of the mentally ill. However, the relatives of the MHCUs emphasised economic burden as the major problem brought about as a result of mental illness. The families are not certain about how the admission procedure is conducted. They only phone the police to arrest the person who is mentally ill not knowing that the person might end up in a mental hospital. There is a need for collaboration between Mental Health Care Practitioners/Providers and Traditional Healers in order for them to be more supportive than judgmental. This will prevent relatives of the MHCUs from being secretive in that way the chain of treatment will not be broken resulting to lesser treatment default.
Source: African Journal for Physical Health Education, Recreation and Dance 21, pp 407 –415 (2015)More Less
The aim of the study was to find out whether Physical Education was meeting the expected learning outcomes in the Namibian Lower Primary Phase as outlined in the syllabus. The study adopted qualitative approach and used face to face interviews and document analysis to collect data. The circuit Inspector, Advisory teacher, four Principals, and ten class teachers were interviewed. Results demonstrated that teachers were frustrated and had given up teaching PE in schools due to a lack of equipment and facilities. In some cases, learners were left on their own without a teacher during PE periods and important activities in the syllabus were not being taught. There was no clear evidence that PE was meeting the expected learning outcomes in the Namibian Lower Primary Phase.
Author S.G. TaukeniSource: African Journal for Physical Health Education, Recreation and Dance 21, pp 416 –425 (2015)More Less
The aim of study was to identify the support mechanisms provided to teachers by the circuit and school principals to implement the Physical Education syllabus in the Lower Primary Phase in the Oshana region, Namibia. The study adopted a descriptive design and used interviews to collect data. Twelve primary schools both urban and rural in the Oshakati circuit were purposively selected to form the sample of the study. Participants were the circuit Inspector, Advisory teacher, school Principals and teachers. Results indicated a lack of support in terms of specific workshops and training opportunities, teacher guide, textbooks and facilities and equipment. Participants suggested the government and local communities to support PE subject in Lower Primary Phase so that learners would enjoy physical activities and gain healthy benefits outlined in the syllabus.
In search of potential eco-tourism and eco-femini-tourism artifacts from rural Eastern Cape Province of South Africa : a case of Binfield, Hopefield and Mazotsho village communities of Nkonkobe MunicipalitySource: African Journal for Physical Health Education, Recreation and Dance 21, pp 426 –440 (2015)More Less
Research was done at Binfield, Hopefield and Mazotsho, which are three village communities of the Binfiel Park Dam in Nkonkobe Municipality, Eastern Cape Province, South Africa. These are poverty stricken rural communities with a lot of potential opportunities through which the livelihoods of people can be improved through interventions such as, indigenous knowledge and increase usage of the dam area. Interviews were conducted to establish the existence of ecotourism and ecofeminitourism activities and products thereof which benefit the local people and the environment. This brought in mind the thought of both economical and ecological sustainability. Ornamental ecotourism items included sets of earrings and necklaces (made from beads), wristlets (bones) and bracelets (wood). Agricultural ecofeminitourism items included skei and yoke (made from soft wood Acacia karoo), and hoe and axe (made from steel and soft wood handle). The villagers underused the Binfield Park Dam and vicinity areas located nearby – no fishing, aquaculture, irrigation or recreation. It is concluded that with the help from Government and institutions, the appropriate use of indigenous knowledge and the dam can benefit the communities and the environment regarding ecotourism or ecofeminitourism. Hence in the long term villagers can have better livelihoods other than only the current dependence on grants and aid. The research assumed that with better marketing of locally made artifacts and the dam, livelihoods can be changed for the better while the environment itself benefits from sustainable usage.