Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620100001&lang=en vol. 15 num. 1 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Nursing in Saudi Arabia: Reflections on the experiences of South African nurses</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100001&lng=en&nrm=iso&tlng=en The purpose of the study was to describe and reflect on the lived experiences of the South African nurses residing and working in the Kingdom of Saudi Arabia. A qualitative, exploratory, descriptive and contextual design with a phenomenological approach was adopted. Data were collected by means of individual interviews and the personal journals of the nurses who met the sampling criteria. The data analysis was done according to Tesch's descriptive method (in Creswell 1994). The main theme that emerged was one of 'cultural diversity'. Sub-themes related to the nurses' religious/spiritual, environmental, emotional/psychological and professional experiences were also identified. A literature control was undertaken to verify the results. Limitations were highlighted, conclusions were drawn and recommendations relating to nursing research, education and practice were made.<hr/>Die doel van die studie was om die lewenservarings van Suid-Afrikaanse verpleegkundiges wat in die Koningkryk van Saoedi-Arabië werksaam en woonagtig is, te beskryf en daaroor te besin. 'n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp of strategie van ondersoek, vanuit 'n fenomenologiese benadering, is vir die doel ingespan. Data is ingesamel aan die hand van individuele onderhoude met deelnemers wat aan die kriteria vir insluiting by die steekproef voldoen het en persoonlike joernale wat deur hierdie deelnemers bygehou is. Data-ontleding is volgens die beskrywende metode van Tesch (in Creswell 1994) gedoen. Die hooftema voortspruitend uit die navorsing was dieé van 'kulturele diversiteit'. Verdere temas ten opsigte van verpleegkundiges se godsdienstige/geestelike, omgewings-, emosionele/psigiese en professionele ervarings is ook geïdentifiseer. 'n Literatuurkontrole is onderneem om die navorsingsbevindinge te verifieer. Beperkings is uitgelig, en gevolgtrekkings en aanbevelings gerig op verpleegkundige navorsing, onderrig en praktyk is gemaak. <![CDATA[<b>A model for incorporating specialist nurse education into a university context. Part 1: Methodological perspectives</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100002&lng=en&nrm=iso&tlng=en The education of nurses for specialist practice takes place mainly in nursing colleges. In view of ongoing debates about the future positioning of nursing education, an investigation regarding the incorporation of college-based specialist nurse education into universities was needed. The purpose of the study was to develop and describe a model for specialist nurse education in a university. The objectives were set in two phases: Phase 1 objectives were designed to enable the identification of concepts in relation to university education and Phase 2 objectives, to enable the development of a model for specialist nurse education in a university context. This paper gives an account of only the methodology used to meet the research purpose and objectives. It outlines the objectives of Phases 1 and 2, including a detailed description of the research design. In discussing the research design, particular attention was given to theory development. The research methods were described with reference to data collection methods and procedures, study samples and sampling methods, data analysis methods and processes, to ensure the trustworthiness of the study. The model is described in Part 2 of the article.<hr/>Die onderrig van verpleegkundiges in gespesialiseerde verpleegpraktyk vind hoofsaaklik in verpleegkolleges plaas. In die lig van die voortslepende debat rondom die toekomstige posisionering van verpleegonderrig is ondersoek na die inkorporering van spesialis vepleegopleiding aan universitieite as noodsaaklik geag. Die doel van hierdie studie was om die model vir gespesialiseerde vepleegopleiding aan universitiete te ontwikkel en te beskryf. Die navorsingsdoelwitte is geformuleer aan die hand van twee fases. Die doelwitte in Fase 1 was ontwerp om die konsepte betreffende universiteitsopleiding te identifiseer. Die doelwitte in Fase 2 was op die ontwikkeling van 'n model vir die onderrig in gespesialiseerde verpleegkunde aan 'n universiteit gerig. Hierdie artikel gee 'n oorsig oor slegs die metodiek wat gebruik is om die doel en navorsingsdoelwitte te bereik. Dit verskaf 'n oorsig oor Fase 1 en 2 en sluit 'n omvattende beskrywing van die navorsingsontwerp in. In die bespreking van die navorsingsontwerp word spesifieke aandag aan teoriegenerering gewy. Die navorsingsmetodes word beskryf met verwysing na data insamelingsmetodes-en-prosedures, die steekproef, en steekproefmetodes, data analiseringsmetodes-en-prosedures wat die betroubaarheid van die studie verseker het. Die model word in Deel 2 van die artikel beskryf. <![CDATA[<b>Prevalence of zinc deficiency among primary school children in a poor peri-urban informal settlement in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100003&lng=en&nrm=iso&tlng=en This cross-sectional study assessed the risk of zinc deficiency in randomly selected children, aged between 7 and 11 years, living in a poor, peri-urban informal settlement in South Africa. Dietary intake of 149 respondents was evaluated by 24-hour recall and quantitative food frequency questionnaires. Anthropometric and biochemical indices of a subset of 113 were determined. Descriptive statistics, analysis of variance and Pearson correlations were computed using the Statistical Package for Social Sciences, version 14.0. Anthropometric data were analysed using the World Health Organization Anthro plus version 1.0.2 statistical software. Dietary data were analysed with FoodFinder® version 3. The mean age of the children was 9.0±1.1 years. Few zinc-rich sources appeared in the diet that was predominantly plant-based. Mean dietary zinc intake was 4.6±2.2 mg/day. The mean value of serum zinc was 66.4±21.5 µg/dL, with 46% of the children having values less than the 70 µg/dL cutoff. The findings indicate a high risk of zinc deficiency and suboptimal zinc status for the majority of this study population of children, possibly as a result of low consumption of food sources with high bioavailability of zinc, which invariably is a direct consequence of poverty and food insecurity.<hr/>Die doel van hierdie dwarsdeursnitstudie was die bepaling van die risiko van 'n sinktekort in 'n ewekansige steekproef van 7 tot 11 jaar-oue kinders, woonagtig in 'n arm, voorstedelike informele woonbuurt in Suid Afrika. Dieetinnames van 149 respondente is geëvalueer deur 24-uur herroep en kwantitatiewe voedselfrekwensie vraelyste. Antropometriese en biochemiese indikatore van 'n kleiner steekproef van 113 is ook bepaal. Beskrywende statistiek, analise van variansie en Pearsonkorrelasies is bepaal deur die Statistical Package for Social Sciences, uitgawe 14.0. Antropometriese data is geanaliseer deur die statistiese program, Anthro plus, uitgawe 1.0.2, van die Wêreld Gesondheid Organisasie. Dieetdata is met behulp van FoodFinder® uitgawe 3 geanaliseer. Die gemiddelde ouderdom van die kinders was 9.0±1.1 jaar. Min sinkryke voedselbronne is in die hoofsaaklik plantryke dieet waargeneem. Die gemiddelde sinkinname was 4.6±2.2 mg/dag en die gemiddelde serumsinkwaarde was 66.4±21.5 µg/dL, met 46% van die kinders se waardes onder die 70 µg/dL afsnypunt. Die bevindings dui op 'n hoë risiko vir sinktekort en suboptimale sinkstatus vir die meerderheid van hierdie kinders, moontlik as gevolg van die swak inname van voedselbronne met hoë biobeskikbare sink, wat gewoonlik 'n direkte gevolg van armoede en huishoudelike voedsel insekuriteit is. <![CDATA[<b>Depth of poverty in an informal settlement in the Vaal region, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100004&lng=en&nrm=iso&tlng=en Despite the large number of people currently living in poverty in sub-Saharan Africa, the debate about the definition and meaning of poverty continues. Two distinct problems exist regarding the measurement of poverty, namely the difficulty of identifying the poor in a population and the difficulty in developing an index for the measurement of poverty. The main objective of the survey was to apply a poverty model for determining the depth of poverty in an informal settlement in the Vaal Region, as well as the impact of possible income-generating activities on the community. A questionnaire, which had been devised for measuring poverty indicators, was administered to 429 randomly selected households in the informal settlement, with the poverty model being applied to measure the degree of poverty. The results of the survey showed that 286 households lived in poverty at the time. The impact of extra income on the poverty levels of these 286 households was then determined. The results of the survey also showed that the unemployment level was 91% and that the mean monthly income was R612.50. The average poverty gap was R1017.21, with the poverty gap ratio being 56%. The poverty model showed that an increase of R500 in monthly household income resulted in a poverty gap ratio of 35%. The results indicated that the community was a poverty-stricken community, suffering from chronic food insecurity. The results of the study will be used to facilitate the planning and implementation of sustainable, income-generating, community-based interventions aimed at promoting urban food security and alleviating poverty in the community in question.<hr/>Ten spyte van die groot hoeveelheid mense wat steeds wêrelwyd in armoede leef, duur die debat oor die definisie en betekenis van armoede nog altyd voort. Daar word twee definitiewe probleme met die meting van armoede ervaar, naamlik die identifisering van die armes in 'n gemeenskap, en die ontwikkeling van 'n indeks vir die meet van armoede. Die hoofdoel van hierdie studie was om 'n armoedemodel vir die dieptemeting van armoede in 'n informele nedersetting in die Vaal-area toe te pas, en om die impak van moontlike aktiwiteite wat inkomste genereer in dieselfde gemeenskap te bepaal. 'n Vraelys wat ontwerp is om armoede aan te dui en te meet is ewekansig aan 429 huishoudings in die informele nedersetting uitgedeel om te voltooi en die armoedemodel is toegepas om die diepte van armoede te meet. Die resultate het getoon dat 286 huishoudings in armoede leef. Die impak van ekstra inkomste op armoedevlakke is in die 286 huishoudings bepaal. Die resultate het verder getoon dat die werkloosheidsvlak 91% was en dat die gemiddelde maandelikse huishoudelike inkomste R612.50 was. Die gemiddelde armoedegaping was R1017.21, met 'n armoedegapingverhouding van 56%. Die armoedemodel het getoon dat 'n verhoging van R500 in maandelikse huishoudelike inkomste die armoedegapingverhouding na 35% verlaag het. Die resultate het bewys dat hierdie 'n armoedige gemeenskap met kroniese voedselonsekerheid was. Die uitkoms van die studie sal gebruik word vir die beplanning en implementering van gemeenskapgebaseerde ingrypings om volhoubare inkomste te genereer om stedelike voedselsekerheid te bevorder en die armoede in hierdie gemeenskap te verlig. <![CDATA[<b>A woman-centred childbirth model</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100005&lng=en&nrm=iso&tlng=en A model for woman-centred childbirth was developed through four phases in accordance with the objectives of the study, namely, a description of mothers' experiences of childbirth and that of attending midwives of managing mothers during childbirth concept analysis of woman-centred care, model development, and an evaluation phase. The identified concepts and sub-concepts were classified and developed into in a conceptual model within the six elements of the practice theory, as outlined by Dickoff, James and Wiedenbach's (1968:423) survey list cited by Madela-Mntla (1999:69) in Tlakula (1999:119). These elements are recipient, agent, context, procedure, purpose and dynamic. The relational statements derived after conceptualisation of each of the six concepts were inferred through the process of deductive analysis and synthesis. The development of the woman-centred childbirth model contained six components, namely, goals, concepts, definitions, relationships, structures and assumptions, as outlined in Chinn and Jacobs (1987:116). The model was evaluated in accordance with Chinn and Kramer's (1995:134-135) method and refined by experts in midwifery practice and model generation. Limitations were recognised and recommendations made.<hr/>Die model vir vrouegesentreerde sorg is ontwikkel deur vier fases in ooreenstemming met die doelwitte van die studie, naamlik, beskrywing van die moeders se ondervinding van kindergeboorte en dié van die diensdoende vroedvroue wat die moeders tydens kindergeboorte bestuur het, ontleding van die begrip 'vrouegesentreerde sorg', modelontwikkeling en die evalueringsfase. Die geïdentifiseerde konsepte en subkonsepte is geklassifiseer en gekonseptualiseer in 'n konseptuele model binne die ses elemente van die praktykteorie soos omlyn deur Dickoff, James en Wiedenbach (1968:423) in hulle oorsiglyne wat in Madela-Mntla (1999:69) aangehaal word in Tlakula (1999:119). Hierdie elemente is ontvanger, agent, konteks, prosedure, doel en dinamika. Die relasionele verklarings afgelei na die konseptualisering van elkeen van die ses konsepte, is afgelei deur die proses van deduktiewe ontleding en sintese. Die ontwikkeling van die 'vrouegesentreerde-sorg kindergeboortemodel' het ses komponente bevat, naamlik, doelwitte, konsepte, definisies, verwantskappe, strukture en assumpsies soos omlyn in Chinn en Jacobs (1987:116). Die model is geëvalueer volgens Chinn en Kramer (1995:134-135) se metode en verfyn deur deskundiges in verloskundige praktyk en die generering van modelle. Beperkings is erken en aanbevelings is gemaak. <![CDATA[<b>The lived experiences of late-adolescent female suicide survivors: 'A part of me died'</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100006&lng=en&nrm=iso&tlng=en People's thoughts often focus on the suicide victim immediately after a completed suicide. Yet, the real victims of such an event are those individuals who are left behind to cope with the aftermath of the suicide. This phenomenological psychological study explored the lived experiences of late-adolescent suicide survivors, particularly those negative experiences that seemed to worsen in the weeks and months after a significant other's completed suicide. The research participants were five female late-adolescents (aged 17-22 years) who were recruited by means of purposive sampling at a South African tertiary institution and at youth camps. Data collection consisted of collage-facilitated, face-to-face phenomenological interviews. In addition, some participants provided documentary material in the form of personal diaries, letters and poems. The data analysis was conducted according to Giorgi's phenomenological method. The following salient experiences emerged during the data analysis: guilt, self-blame, blaming others or God, anger, loss or restriction of 'self', depression, suboptimal behavioural coping patterns, changes in relationship dynamics, and suicidality. The results of this study can be used by mental health professionals and caregivers to support adolescent suicide survivors effectively, in the midst of their mourning.<hr/>Mense se gedagtes fokus meestal op die selfmoordslagoffer onmiddellik na 'n voltooide selfmoord. Tog is die werklike slagoffers die persone wat agterbly om die lewe na die selfmoord te hanteer. Hierdie fenomenologies-sielkundige studie het die geleefde belewenisse van laat-adolessente oorlewendes ondersoek, spesifiek daardie negatiewe belewenisse wat skynbaar erger word in die weke en maande na 'n betekenisvolle ander se voltooide selfmoord. Die navorsingsdeelnemers was vyf vroulike laat-adolessente (17-22 jaar oud) wat gewerf is deur middel van doelgerigte selektering by 'n Suid-Afrikaanse tersiêre instelling en jeugkampe. Data-insameling het geskied aan die hand van collage-gefasiliteerde, aangesig-tot-aangesig fenomenologiese onderhoude. Sommige deelnemers het addisionele dokumente in die vorm van persoonlike dagboeke, briewe en gedigte beskikbaar gestel vir data-analise. Die data is geanaliseer volgens Giorgi se fenomenologiese metode. Die volgende belewenisse het na vore getree tydens die data-analise: skuldgevoelens, self-blaam/spyt, blameer ander/God, woede, verlies/inperking van 'self', depressie, sub-optimale gedragshanteringspatrone, veranderinge in verhoudingsdinamika, en selfmoordneigings. Die resultate van hierdie studie kan deur geestesgesondheidwerkers en versorgers aangewend word om adolessente selfmoordagtergeblewenes effektief te ondersteun in die rouproses. <![CDATA[<b>Foreign nursing students: Their profile and perceptions of nursing care in Namibia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100007&lng=en&nrm=iso&tlng=en A survey was conducted using open and close-ended questions to determine how visiting nursing students in Namibia could be assisted during their visits (cultural encounters). Many students decide to complete their clinical exposure in a foreign country, either for personal reasons or in order to meet the course requirements for transcultural nursing. Since 1998, Namibia has received a number of these students. In discussion and from passing remarks from the students themselves, the question has arisen as to how an optimum placement for each student might be achieved. Aspects of the Campina-Bacote model and The Process of Cultural Competence in the Delivery of Health Care Services were used to answer this question. It was decided to gather both biographical (profile) information and information on perceptions of nursing care in Namibia from such foreign nursing students. The biographical (profile) information collected indicates a prevalence of certain shared biographical characteristics among international students. Such students tend to be adventurous, caring and sensitive to human rights issues. This finding correlates with the constructs of cultural desire and cultural awareness as described in the model of Campina-Bacote. Based on this finding, specific recommendations were made for clinical allocations. From the data gathered from the open-ended questions, three themes emerged: firstly, nursing in Namibia has identifiable characteristics; secondly, there is a paternalistic and one-sided communication style among nursing caregivers in Namibia; and finally, nursing care delivery in this country is often characterised by a detached attitude. It was concluded that these themes correlated with a cultural awareness and cultural knowledge among the nursing students. The discovery of these themes was useful for making recommendations for clinical guidelines to help these students adapt, as well as for providing a foundation and substantiation for clinical placement.<hr/>'n Opname bestaande uit oop en geslote vrae is uitgevoer om te bepaal hoe besoekende verpleegstudente aan Namibië ondersteun kan word (kulturele ervarings). Baie studente besluit om hulle kliniese praktika in die buiteland te voltooi, óf om persoonlike redes óf om aan kursusvereistes in transkulturele verpleging te voldoen. Sedert 1998 het Namibië 'n aantal van hierdie studente ontvang. Uit gesprekke met sowel as spontane kommentaar deur hierdie studente het die vraag ontstaan hoe hulle optimum plasing verseker kan word. Aspekte van die model van Campina-Bacote, naamlik The process of cultural competence in the delivery of health care services, is benut om hierdie vraag te beantwoord. Daarom is besluit om biografiese inligting sowel as inligting oor die studente se persepsies van verpleging in Namibië in te samel. Die biografiese inligting (profiel) het die voorkoms van sekere biografiese kenmerke onder die internasionale studente getoon: Hulle neig daartoe om avontuurlik, deernisvol en sensitief vir menseregte te wees. Dié bevinding korreleer met die konstrukte van kulturele begeertes en kulturele bewustheid soos beskryf in die model van Campina-Bacote. Op grond van hierdie bevindinge is bepaalde aanbevelings aangaande hulle kliniese plasings gemaak. Die data deur die oop vrae verkry het drie temas gegenereer, naamlik dat verpleging in Namibië bepaalde identifiseerbare kenmerke openbaar, dat 'n paternalistiese en eensydige kommunikasiestyl onder verpleegkundiges in Namibië voorkom en dat verpleegsorg deur 'n onbetrokke houding gekenmerk word. Die gevolgtrekking was dat hierdie temas met 'n kulturele bewustheid en kulturele kennis onder die verpleegstudente korreleer. Die identifisering van hierdie temas was bruikbaar as basis vir die motivering van kliniese plasings en in die maak van aanbevelings ten opsigte van kliniese riglyne om die studente te help om aan te pas. <![CDATA[<b>The systems psychodynamic leadership coaching experiences of nursing managers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100008&lng=en&nrm=iso&tlng=en The mostly linear and mechanistic nature of the nursing manager role is rapidly becoming more dynamic and systemic. The change involves task and people management within a constantly changing organisational identity, taking up multiple leadership roles, having to authorise oneself and others in a complex matrix system, and managing conscious and unconscious psychological boundaries within and between conflicting systems. The aim of this study was to describe the systems psychodynamic learning experiences of nursing managers during leadership coaching. The coaching task was to provide learning opportunities to the individual leader, towards gaining insight into conscious and unconscious leadership dynamics in terms of anxiety, task, role, authorisation, boundaries and identity. A qualitative research design was used. Six nursing managers attended ten leadership coaching sessions over ten weeks. Field notes and reflective essays were analysed using systems psychodynamic discourse analysis. The findings indicated clarity and authorisation in the participants' primary task and normative roles; anxiety and de-authorisation in their experiential and phenomenal roles; anxiety in boundary management related to the misuse of power by others; and the continuous exploration of their leadership role identity towards achieving integration. Participants' learning experiences were evaluated in terms of criteria for organisational learning, after which a general hypothesis was formulated.<hr/>Die meestal liniêre en meganistiese aard van die verpleegbestuursrol is vinnig besig om na 'n meer dinamiese en sistemiese rol te verander. Die verandering behels taak- en mensbestuur binne 'n steeds veranderende organisasie-identiteit, waar 'n verskeidenheid rolle opgeneem word, die self en ander in 'n komplekse matrikssisteem bemagtig word, en waartydens bewuste en onbewuste sielkundige grense in en tussen botsende sisteme bestuur word. Die doel van hierdie studie was om die sisteem-psigodinamiese leerervaringe van verpleegbestuurders tydens leierskapafrigting te beskryf. Die afrigtingstaak was om leergeleenthede aan die individuele leier beskikbaar te stel vir die ontwikkeling van insig in bewuste en onbewuste leierskapsdinamika in terme van angs, taak, rol, outoriteit, grense en identiteit. 'n Kwalitatiewe navorsingsontwerp is gebruik. Ses verpleegbestuurders het tien leierskapafrigtingsessies oor tien weke bygewoon. Veldnotas en besinnende opstelle is deur middel van sisteem-psigodinamiese gespreksanalise ontleed. Die bevindinge dui op duidelikheid oor en bemagtiging in hulle primêre taak en normatiewe rol; angs en ontmagtiging in hulle ervarings- en fenomenale rolle; angs in grenshandhawing wat verband hou met magsmisbruik deur andere; en die voortdurende ondersoek en integrasie van leierskapsrol-identiteit. Deelnemers se leerervarings is na aanleiding van kriteria vir organisasieleer geëvalueer, waarna die algemene hipotese geformuleer is. <![CDATA[<b>A complicated grief intervention model</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100009&lng=en&nrm=iso&tlng=en Complicated grief refers to a prolonged state of grief and indicates the inability of the client to incorporate the death into his or her life. Few social workers in South Africa assess the possibility of complicated grief as a contributing factor to impaired social functioning. This can be as a result of limited knowledge, ignorance and/or insufficient skills on the part of the social worker to assess and identify complicated grief. In this article, the researchers tabulate some of the models and approaches to bereavement and discusses its applicability to complicated grief. Specific attention is given to the Dual Process Model (Stroebe & Schut 1999) and the Task-Centred approach (a social work approach to therapy) in an attempt to develop a model for complicated grief intervention. This article furthermore proposes the Complicated Grief Intervention Model through the integration of the Dual Process Model and the Task-Centred approach while drawing on intervention techniques from other therapeutic approaches.<hr/>Gekompliseerde rou verwys na 'n verlengde staat van rou en impliseer 'n onvermoë by die klient om die dood van 'n geliefde in sy/haar lewe te integreer. Gekompliseerde rou word deur min maatskaplike werkers as bydraende faktor tot verlaagde maatskaplike funksionering geassesseer. Dit kan toegeskryf word aan beperkte kennis, ignorering van/of ontoereikende vaardighede by die maatskaplike werker in die identifisering en assessering van gekompliseerde rou. Die outeurs tabuleer sommige van die rouberadingsmodelle en -benaderings in hierdie artikel en bespreek die toepaslikheid daarvan op gekompliseerde rou. Spesifieke aandag word aan die Tweeledige Prosesmodel (Dual Process Model) (Stroebe & Schut 1999) verleen, asook aan die taakgesentreerde benadering ('n maatskaplike werkbenadering) in 'n poging om 'n model te ontwikkel vir gekompliseerde rou intervensie. Die artikel beveel aan dat die Gekompliseerde Rou Intervensie Model (GRIM) deur middel van die integrasie van die Tweeledige Prosesmodel en die taakgesentreerde maatskaplike werkbenadering aangebied word, terwyl intervensietegnieke van verskeie terapeutiese benaderings benut word. <![CDATA[<b>Concept-mapping as a teaching method to facilitate critical thinking in nursing education: A review of the literature</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100010&lng=en&nrm=iso&tlng=en Nursing students are exposed to a vast amount of information and reading material that is very specific, technical, and new to the students. Unless nurse educators provide a learning environment that promotes understanding through interaction, students might only commit unassimilated information to their short-term memory through rote learning, and no meaningful learning will occur. Nursing students must be able to link learned facts, concepts and principles with new knowledge in order to make sound rational decisions in practice (All & Havens 1997:1210, 1213). The aim of this paper is to describe the utilisation of concept-mapping as a teaching method to facilitate critical thinking by students in nursing education. The description of the utilisation of concept-mapping is done from the theoretical framework of concept-mapping and critical thinking to provide the epistemological basis for concept-mapping (Facione 1990:6, 13). Based on the exploration and description of the theoretical frameworks, four steps to facilitate critical thinking were formulated through concept-mapping on the basis of the educational process: the identification, interactive constructing process, formulation and evaluation steps. It is concluded that the utilisation of these steps will assist nurse educators to implement concept-mapping as a teaching method to facilitate critical thinking by student nurses in nursing education. Recommendations are made.<hr/>Verpleegkundestudente word blootgestel aan 'n geweldige hoeveelheid inligting en leesmateriaal wat baie spesifiek, tegnies en nuut is vir die studente. Tensy verpleegkundeopvoeders 'n leeromgewing kan voorsien wat deur interaksie die bevordering van begrip bewerkstellig, kan studente inligting deur papegaaiwerk in hul korttermyngeheue stoor, eerder as om dit te assimileer - geen betekenisvolle leer sal dus plaasvind nie. Verpleegkundestudente moet die vermoë hê om die verband tussen aangeleerde feite, konsepte en beginsels en nuwe kennis te lê sodat hulle in die praktyk rasionale besluite kan maak (All & Havens 1997:1210, 1213). Hierdie artikel het ten doel om die aanwending van konsepkartering as 'n onderrigstrategie te beskryf, ten einde die kritiese denke van leerders in die verpleegkunde te fasiliteer. Die beskrywing van die aanwending van konsepkartering word vanuit die teoretiese raamwerke van konsepkartering en kritiese denke gedoen om die epistemologiese grondslag vir konsepkartering te voorsien (Facione 1990:6, 13). Gegrond op die verkenning en beskrywing van die teoretiese raamwerke, word vier fases vir die fasilitering van kritiese denke geformuleer deur middel van konsepkartering. Hierdie verkenning en beskrywing is gebaseer op die onderwysproses: die identifiseringsfase, die interaktiewe konstrueringsproses, die formuleringsfase en evalueringsfase. Die gevolgtrekking word gemaak dat die aanwending van hierdie fases verpleegopvoeders behulpsaam sal wees in die implementering van konsepkartering as 'n onderrigmetode om kritiese denke by leerling verpleërs te fasiliteer in verpleegkunde-onderwys. Aanbevelings word gemaak. <![CDATA[<b>Adaptation of the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African context: Part 1</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100011&lng=en&nrm=iso&tlng=en Literacy levels are increasingly important in health care because professional nurses and other health care professionals often use written health education materials as a major component in patient education. In South Africa, no current instrument is available to assess the literacy levels of patients in the primary health care setting, though several instruments have been developed and validated internationally. The purpose of this paper was to adapt and validate the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African context. The REALM-R is a short instrument that is designed to rapidly screen clients in the primary health care setting for low health literacy. A modified Delphi-technique was used to measure the judgement of a group of experts for the purpose of making a decision. Eight experts in the field of Nursing Science were selected purposively to obtain the most reliable consensus. Data was collected by means of a self-report whereby participants responded to a series of questions posed by the researcher. Descriptive statistics was used for analysing data. The REALM-R was adapted to the South African context to ensure that the literacy level of South African clients is measured with an appropriate instrument.<hr/>Geletterdheidsvlakke word toenemend belangrik in gesondheidsorg aangesien geregistreerde verpleegkundiges en ander gesondheidswerkers dikwels geskrewe gesondheidopvoedkundige materiaal gebruik. Op die oomblik in Suid-Afrika is daar geen geletterdheidsvlaksinstrument beskikbaar om pasiënte in primêre gesondheidsorg se geletterdheid te toets nie. Daar bestaan wel gevalideerde internasionale instrumente. Die doel van die studie was om die REALM-R, 'n internasionaal gevalideerde mediese geletterdheidsinstrument, aan te pas en te valideer om in die Suid-Afrikaanse konteks gebruik te kan word. Die REALM-R is 'n kort geletterdheidsinstrument wat ontwikkel was om primêre sorg pasiênte wat moontlik lae geletterdheidsvaardigheid het, te kan sif. 'n Aangepasde Delphi-tegniek is gebruik om die oordeel van 'n groep kundiges in te win. Agt kundiges in verpleegwetenskappe is doelgerig gekies ten einde 'n betroubare ooreenkoms te verkry. Data is deur middel van self-raportering ingewin deurdat die deelnemers op vrae, gestel deur die navorser, geantwoord het. Beskrywende statistiek is gebruik om die data te ontleed. Die REALM-R is aangepas vir die Suid-Afrikaanse konteks ten einde 'n geskikte instrument beskikbaar te stel om die geletterdheidsvaardigheid van primêre sorg pasiente vinnig en akkuraat te kan meet. <![CDATA[<b>Young South Africans' views on, and perceptions of, abstinence and faithfulness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100012&lng=en&nrm=iso&tlng=en The goals of the Abstinence and Be Faithful Among Youth (ABY) project were to enhance local responses among the youth in South Africa to prevent HIV infection through encouraging abstinence, faithfulness and avoidance of unhealthy sexual behaviour among youths over a five-year period. A quantitative baseline evaluation of the ABY project was conducted in five cities in South Africa. Data were collected from learners and youths just before the ABY intervention started at nine randomly selected sites in Johannesburg, Cape Town, Durban, Port Elizabeth and Mthatha using a three-stage cluster sampling design. In total, nine sites were randomly selected from a possible eighteen. At each of the data-collection points, data were collected from 60 participants. In total there were 27 data-collection points and 1620 respondents. Young people have strong views on abstaining from sexual intercourse, as 83% said that it was possible not to have sex for as long as you can. There was also strong support for abstinence, as 78.5% said that not having sex was the best way of preventing infection with HIV. In total, 68.1% of the youths said that the media had a positive influence on encouraging abstinence and 72.1% said role models could help them not to have sex, while 84.3% said that leadership and life skills workshops were helpful in encouraging them to abstain from sex. In total, 68.7% of young people said that the media encouraged faithfulness in relationships and 84.6% said that life skills workshops were helpful in encouraging them to remain faithful to one partner. Young people have strong views on and support for abstinence. They also have strong views on and perceptions of remaining faithful to one partner. These findings are a valuable guide to the views and perceptions of young people with respect to abstinence and faithfulness before interventions are implemented.<hr/>Die doel van die Abstinence and Be Faithful for Youth (ABY) projek was om die plaaslike reaksie onder jong mense te versterk ten einde MIV-infeksies te voorkom deur onthouding, getrouheid en vermyding van ongesonde seksuele gedrag onder die jeug oor 'n vyfjaar-tydperk aan te moedig. 'n Kwantitatiewe basislyn-evaluering van die ABY-projek is in vyf stede in Suid Afrika uitgevoer. Data is van leerders en jongmense by nege lukraak gekose plekke in Johannesburg, Kaapstad, Durban, Port Elizabeth en Mthatha met behulp van 'n klustermonsternemingsontwerp in drie fases ingesamel kort voor die ABY-intervensie begin het. In totaal is nege plekke lukraak gekies uit 'n moontlike agtien. By elke data-insamelingspunt is data van 60 deelnemers verkry. In totaal was daar 27 data-insamelingspunte en 1620 respondente. Jongmense het sterk menings oor seksuele onthouding, aangesien 83% gesê het dat dit moontlik is om seksuele omgang vir so lank moontlik te vermy. Daar was ook sterk ondersteuning vir onthouding, aangesien 78% gesê het dat onthouding die beste voorkomingsmaatreël vir MIV-infeksie is. Wat die media betref, het 68.1% van die jongmense aangedui dat dit 'n positiewe invloed het om onthouding aan te moedig en 71.1% het aangedui dat rolmodelle hulle kan help om nie seks te beoefen nie, terwyl 84.1% aangedui het dat leierskaps- en lewensvaardigheidswerkswinkels hulle gehelp het om hulle van seks te onthou. In totaal het 68.7% van die jongmense aangedui dat dit getrouheid in vaste verhoudings aanmoedig en 84.6% het aangedui dat lewensvaardigheidswerkswinkels hulle aangemoedig het om getrou aan een persoon te wees. Jongmense het sterk menings oor onthouding en ondersteun dit ten sterkste. Hulle het ook sterk menings oor en persepsies van getrouheid aan een metgesel. Hierdie bevindinge is 'n waardevolle riglyn oor jongmense se menings en persepsies rakende onthouding en getrouheid voordat intervensies geïmplementeer word. <![CDATA[<b>Assessment of the English literacy level of patients in primary health care services in Tshwane, Gauteng province: Part 2</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100013&lng=en&nrm=iso&tlng=en Low literacy can be described as the inability to read, write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the English literacy levels of primary health care patients using the Learning Ability Battery (LAB) and the adapted Rapid Estimate of Adult Literacy, Revised (REALM-R) and to determine how the results of the adapted REALM-R correlate with those of the LAB. Data were collected by means of a self-report whereby the participants had to answer the questions that were posed in the LAB and read the words out loud for the adapted REALM-R. The data analysis was performed by means of descriptive and inferential statistics, including the chi-square test and Spearman's rho. The result of the study indicated that in South Africa, school grades achieved and the reading levels of primary health care patients differ with four grades. In terms of the correlation between the results of the adapted REALM-R and those of the LAB, a correlation of r = 0.43 (p < 0.001) could be established. Depending on the cut-off point used for the adapted REALM-R, 67% of the participants had low literacy levels. The study provides evidence of the importance of a validated, quick and easy-to-administer literacy screening tool. The effective assessment of patients' literacy levels will assist registered professional nurses to provide health education on an appropriate level to improve patients' health literacy.<hr/>Lae geletterdheidsvlakke kan beskryf word as 'n persoon se onvermoë om doeltreffend te lees, te skryf of syfers te gebruik. Die beperkte vermoë om te lees en gesondheidsorgvoorskrifte te verstaan, gee direk tot swak gesondheidsuitkomste aanleiding. Die doel van hierdie studie was om die Engelse geletterdheidsvlakke van primêregesondheidsorg-pasiënte deur middel van twee instrumente, naamlik die Learning Ability Battery (LAB) en die aangepasde Rapid Estimate of Adult Literacy, Revised (REALM-R) te assesseer. Daar is voorts ook bepaal hoe die resultate van die aangepaste REALM-R met die LAB korreleer. Data is deur self-rapportering ingesamel, waar die deelnemers vrae uit die LAB-instrument moes beantwoord en spesifieke woorde vir die aangepaste REALM-R hardop te lees. Die data is ontleed deur gebruik te maak van beskrywende en inferensiële statistiek, met inbegrip van 'n chikwadraat-toets en Spearman se rho. Die resultate dui daarop dat die skoolgraad bereik en die leesgeletterdheid van die deelnemers in Suid-Afrika met vier grade verskil. Die korrelasie tussen die resultate van die LAB en die aangepaste REALM-R was r = 0.43 (p < 0.001). Na gelang van die afsnypunt wat vir die aangepaste REALM-R gebruik word, dui die resultate daarop dat 67% van die deelnemers lae geletterdheidsvlakke het. Die studie toon die belang van 'n geldige, vinnige instrument vir geletterdheidsifting. Die doeltreffende assessering van pasiënte se geletterdheidsvlakke kan geregistreerde verpleegkundiges help om gesondheidsonderrig op 'n toepaslike vlak aan te bied ten einde pasiënte se gesondheidsgeletterdheid te verbeter. <![CDATA[<b>'No condom, no sex': Easy to say, but not possible for all South African women</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100014&lng=en&nrm=iso&tlng=en Cervical cancer is the most common cancer in South African women. The human papillomavirus (HPV) is the biggest risk factor for developing this cancer. However, condom use protects against HPV transmission. The purpose of the study was to investigate whether Black women living in Tshwane, South Africa, were able to protect themselves against cervical cancer by insisting on condom use. The study was exploratory, qualitative and contextual, and a convenience snowball sampling method was used. The sample size was determined through data saturation (n = 20). Self-reported data were gathered by means of interviews, and analysed using Tesch's approach. Four themes emerged, (1) knowledge of cervical cancer, (2) sexual behaviour, (3) social problems and (4) emotions. The study provided evidence that women were not able to protect themselves from cervical cancer by insisting on condom use. Women lacked knowledge of cervical cancer and did not associate condom use with self-protection against this disease. Most of their sex partners refused to use condoms. Poverty, physical abuse, helplessness and fear prevented women from insisting on the use of condoms. Primary prevention strategies should focus on empowering women to protect themselves from cervical cancer and not leave this important issue to someone who might refuse it.<hr/>Servikskarsinoom is die mees algemene kanker in Suid-Afrikaanse vroue. Die menslike papiloom virus (MPV) is die grootse oorsaak van hierdie kanker. Oordraging van die virus kan egter met kondoomgebruik voorkom word. Die doel van die studie was om te bepaal of Swart vroue woonagtig in Tshwane, Suid-Afrika, hulself teen die virus kan beskerm deur op kondoomgebruik aan te dring. Die studie was eksploratief, kwalitatief en kontekstueel en 'n gerieflikheids sneeubal metode het die steekproef gerig. Die steekproefgrootte is deur dataversadiging bepaal (n = 20). Data is ingesamel deur middel van onderhoude en die data is met behulp van Tesch se metode geanaliseer. Vier temas is geïdentifiseer, (1) kennis van servikskarsinoom, (2) seksuele gedrag, (3) sosiale probleme en (4) emosies. Die studie het bevind dat vroue hulle nie self teen servikskarsinoom kan beskerm deur op kondome aan te dring nie. Kennis van die siekte was so gebrekkig dat vroue nie kondoomgebruik met servikskarsinoom vereenselwig het nie. Die meeste van hul seksmaats het geweier om kondome te gebruik. Armmoede, fisiese geweld, hulpeloosheid en vrees het vroue weerhou om op die gebruik van kondome aan te dring. Primêre voorkomingstrategië behoort op selfbemagtiging van vroue te konsentreer. Dit sal voorkom dat vroue van mans, wat hulle die reg kan weier, afhanklik is vir beskerming teen servikskarsinoom. <![CDATA[<b>Retaining professional nurses in South Africa: Nurse managers' perspectives</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100015&lng=en&nrm=iso&tlng=en South Africa is experiencing a serious shortage of nurses, which has to be addressed to prevent crises in health care services. Previous studies (Fletcher 2001:324; Oosthuizen 2005:117) found that nurses change their work environment due to dissatisfaction with their job situations. This implies that creating a favourable environment in the workplace situation could help retain professional nurses in their posts, implying that retention strategies should be effective. An exploratory, descriptive, contextual and qualitative design was used to describe nurse managers' views on factors which could influence professional nurse retention, as well as their views regarding attributes that were required to enable them to contribute towards enhancing professional nurse retention. A purposive sample of nurse managers employed in public and private hospitals in the Gauteng province was selected. Semi-structured interviews were conducted with 21 nurse managers. The results were analysed qualitatively and contextualised within Vogt, Cox, Velthouse and Thames's Cork-Top (Bottleneck) Theory of Nurse Retention (1983) and Lewin's Force-Field Analysis Theory (1952). Factors pertaining to individual nurses, the organisation and nurse managers could influence the retention of professional nurses. Poor working conditions, long and inconvenient working hours, uncompetitive salaries and professional development of nurses have to be addressed to enhance professional nurses' retention. Unsafe working environments and a lack of resources threaten the safety and well-being of nurses and patients and contribute to high turnover rates. Nurse managers have to address shortcomings in their managerial and leadership skills and implement changes within a multigenerational nursing workforce and challenging working environments.<hr/>Suid-Afrika ervaar 'n ernstige tekort aan verpleegkundiges wat aangespreek moet word ten einde krisisse in gesondheidsorgdienste te voorkom. Vorige studies (Fletcher 2001:324; Oosthuizen 2005:117) het bevind dat verpleegkundiges hulle werksomgewing verander as gevolg van ontevredenheid met hulle werksituasies. Dit impliseer dat die daarstelling van 'n gunstige omgewing in die werkpleksituasie, kan help om professionele verpleegkundiges in hulle poste te behou, wat beteken dat retensiestrategieë doeltreffend moet wees. 'n Verkennende, beskrywende, kontekstuele, kwalitatiewe ontwerp was gebruik om verpleegbestuurders se sienings te bekom, oor faktore wat professionele verpleegkundiges se retensie kan beïnvloed, asook hulle sienings omtrent vereiste hoedanighede wat hulle in staat sou stel om professionele verpleegkundiges se retensie te bevorder. 'n Doelgerigte steekproef van verpleegbestuurders in openbare en private hospitale in die Gauteng provinsie is gekies. Semi-gestruktureerde onderhoude is met 21 verpleegbestuurders gevoer. Die resultate is kwalitatief ontleed en gekontekstualiseer volgens Vogt, Cox, Velthouse en Thames se Kurkprop Bottelnek (Cork-Top Bottleneck) Teorie van Verpleegretensie (1983) en Lewin se Kragveld Analise Teorie (1952). Faktore met betrekking tot individuele verpleegkundiges, die organisasie en verpleegbestuurders kan die retensie van professionele verpleegkundiges beïnvloed. Swak werksomstandighede, lang en ongerieflike werksure, nie-mededingende salarisse en professionele ontwikkeling van verpleegkundiges moet aangespreek word om professionele verpleegkundiges se retensie te bevorder. Onveilige werksomgewings en 'n gebrek aan hulpbronne bedreig die veiligheid en die welsyn van verpleegkundiges en pasiënte en dra by tot hoë omsetsyfers. Verpleegbestuurders moet die tekortkominge in hulle bestuurs- en leierskapsvaardighede aanspreek en veranderinge implementeer binne 'n multigenerasie verpleegwerkkrag en uitdagende werksomgewings. <![CDATA[<b>A model for higher education campus health services</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100016&lng=en&nrm=iso&tlng=en This study was undertaken in order to develop a holistic healthcare model that would assist registered nurses who are employed at a higher education campus' health service to render a healthcare service relevant to the healthcare needs of the campus healthcare consumers. A theory-generative, qualitative, explorative, descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare service on campus. The main concepts of holistic healthcare were identified from the information obtained from the in-depth, focus group interviews that were conducted with the participants. The process of theoretical model generation was conducted according to the steps of theory generation as proposed by Walker and Avant (1995:39), namely that of concept analysis, the placing of concepts in relationships, a description of the model and guidelines to operationalise the model. This model provides a structured holistic healthcare frame of reference for registered nurses employed in a campus health service at a Higher Education Institution (HEI) and could be used to assist all campus healthcare consumers to become balanced whole persons who are able to realise their dreams and maintain consistency with regard to optimal health and capacity.<hr/>Hierdie studie is onderneem om teneinde 'n holistiese gesondheidsorgmodel te ontwikkel wat geregistreerde verpleegkundiges, werksaam by 'n hoër onderwys kampusgesondheidsorgdiens, kan help om 'n gesondheidsorgdiens te kan lewer wat relevant is tot die gesondheidsbehoeftes van die kampusgesondheidsorg verbruikers. 'n Teorie-generende, kwalitatiewe, eksplorerende, beskrywende en kontekstuele navorsingsontwerp vir teorie genering is gebruik om 'n holistiese gesondheidsorgmodel vir hoër onderwys kampusgesondheidsorgdienste te ontwikkel. Tydens die studie het dit duidelik geword dat die deelnemers 'n behoefte het daaraan om 'n meer omvattende gesondheidsorgdiens op kampus te ervaar. Die hoof konsepte van holistiese gesondheidsorg was geïdentifiseer vanuit die data wat verkry was deur die in-diepte fokusgroep onderhoude wat met die deelnemers gevoer is. Die proses van model-generering is uitgevoer volgens die stappe soos voorgestel deur Walker en Avant (1995:30) naamlik dit van konsep-analise, die plasing van konsepte in verhoudings, die beskrywing van die model en die riglyne om die model operatief te maak. Die model maak voorsiening vir 'n gestruktureerde holistiese gesondheidsorgraamwerk wat as verwysing kan dien vir geregistreerde verpleegkundiges werksaam by 'n kampus gesondheidsorgdiens by 'n Hoër Onderwys Instansie (HOI) en kan gebruik word om alle kampus gesondheidsorgverbruikers te help om gebalanseerde, heel persone te word wat in staat is om hul drome te vervul en konsekwentheid met betrekking tot optimale gesondheid en kapasiteit te handhaaf. <![CDATA[<b>Factors affecting mothers' choice of breastfeeding vs. formula feeding in the lower Umfolozi district war memorial hospital, KwaZulu-Natal</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100017&lng=en&nrm=iso&tlng=en The aim of this study was to determine which factors influence choice of breast- versus the formula-feeding of infants. This may help to understand where the focus should lie in the promotion of breastfeeding. A structured questionnaire was completed by a 100 women and focus-group discussions were held with 22 women who delivered babies at the Lower Umfolozi District War Memorial Hospital (LUDWM) in Kwazulu-Natal. Most of the mothers (72%) chose breastfeeding and 58% intended to breastfeed for only 6 months. One-third (33%) were influenced by health care professionals and 44% of the mothers made their own decisions in their feeding method. Only one participant stated that she chose formula-feeding due to her HIV-positive status, but in the focus-group discussions, the fear of transmission of HIV through breast-milk was stated as an important reason why mothers chose replacement-feeding. Significantly more HIV-infected than uninfected mothers chose replacement-feeding as the feeding method and mothers who chose breastfeeding were significantly older than mothers who selected replacement-feeding. They made their infant-feeding decision earlier than those who chose replacement-feeding. Findings showed that the majority of women in this study did not have access to running water and flush toilets in their houses. In these areas where replacement-feeding will not be acceptable, feasible, affordable, sustainable and safe, due to lack of sanitation and poor socio-economic status, health professionals should promote exclusive breastfeeding for 6 months, even though there is a high prevalence of HIV infection.<hr/>Die doel van die studie was om te bepaal watter faktore vroue in hulle keuse van bors- of bottelvoeding beïnvloed. Dit sal help om te verstaan op watter faktore gesondheidswerkers moet fokus wanneer borsvoeding bevorder word. 'n Gestruktureerde vraelys is voltooi deur 100 vroue en fokusgroepbesprekings is met 22 vroue wat by die Laer-Umfolozi Distrik Gedenk-hospitaal (LUDWM) geboorte geskenk het gehou. Die meerderheid vroue (72%) het borsvoeding gekies, 58% het voorgeneem om vir 6 maande te borsvoed. 'n Groot aantal vroue (97%) het inligting oor babavoedingskeuses by gesondheidswerkers ontvang. Een derde van die vroue (33%) is deur die gesondheiswerkers beïnvloed en 44% van die deelnemers het aangedui dat niemand hulle beïnvloed het nie. Beduidend meer MIV-geïnfekteerde as ongeïnfekteerde moeders het kunsvoeding bo borsvoeding verkies. Net een moeder het gerapporteer dat sy kunsvoeding gekies het as gevolg van haar MIV-positiewe status, maar in die fokusgroepbespreking is die mening gelug dat die vrees van MIV oordrag deur borsmelk grootliks bygedra het dat MIV geïnfekteerde moeders kunsvoeding gekies het. Die moeders wat borsvoeding gekies het was beduidend ouer en het die voedingsmetode beduidend vroeër gekies as die wat kunsvoeding gekies het. Die resultate dui aan dat kunsvoeding nie aanvaarbaar, uitvoerbaar, bekostigbaar, volhoubaar en veilig is in die studie-area nie, as gevolg van swak sanitasie en die swak sosio-ekonomiese toestande. Gesondheidswerkers behoort dus eksklusiewe borsvoeding vir die eerste ses maande te bevorder, al is die prevalensie van MIV-infeksie hoog. <![CDATA[<b>Coping responses as predictors of satisfaction with life amongst a group of patients diagnosed with diabetes mellitus</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100018&lng=en&nrm=iso&tlng=en The purpose of this study was to investigate the extent to which coping responses could predict the level of life satisfaction experienced by patients suffering from diabetes mellitus. A non-experimental, cross-sectional design was adopted. The sample consisted of 154 individuals (62 Type I diabetics, 80 Type II diabetics, and 12 individuals for whom diagnostic information was not available) recruited from the outpatient diabetes clinic at a large state hospital. All participants completed the Coping Responses Inventory - Adult Version, as well as the Satisfaction with Life Scale. Initially, Pearson product-moment correlation coefficients were calculated to examine the relationship between the predictor variables (coping responses) and the criterion variable (satisfaction with life). Hierarchical regression analyses were conducted to determine the amount of variance in the satisfaction with life scores that was explained by coping responses. The combination of approach and avoidance coping subscales accounted for 33% of the variance in the participants' satisfaction with life scores. However, upon further analysis, the avoidance coping subscales were found to account for 28% of the variance in the sample's satisfaction with life. The cognitive avoidance subscale and the acceptance or resignation subscale were found to correlate negatively with satisfaction with life at the 1% level of significance. It appears that approach coping responses do not predict the satisfaction with life experienced by individuals suffering from diabetes. However, avoidant coping responses, particularly cognitive avoidance and acceptance or resignation, are predictive of lower levels of satisfaction with life.<hr/>Die doel van hierdie navorsing was om vas te stel tot watter mate hanteringsgedrag (coping responses) die vlak van lewenstevredenheid by pasiënte wat aan diabetes ly kan voorspel. 'n Nie-eksperimentele, dwarssnit ontwerp is gebruik. Die steekproef het uit 154 individue (62 Tipe I-diabetes, 80 Tipe II-diabetes en 12 individue waarvan die diagnostiese inligting nie beskikbaar was nie) bestaan, wat van die buitepasiënte kliniek by 'n groot staatshospitaal verkry is. Alle deelnemers het die Coping Responses Inventory - Adult Version, sowel as die Satisfaction with Life Scale voltooi. Aanvanklik is die Pearson produkmoment korrelasie koëffisiënte bereken om die verhouding tussen die voorspeller-veranderlikes (coping responses/hanteringsgedrag) en die kriterium-veranderlike (satisfaction with life/lewenstevredenheid) te ondersoek. Hiërargiese regressie-analise is uitgevoer om die hoeveelheid variansie in die lewenstevredenheid-telling wat deur hanteringsgedrag verklaar is, te bepaal. Die kombinasie van approach en avoidance coping subscales het 33% van die variansie in die deelnemers se Lewenstevredenheid-telling verklaar. Na verdere ontleding is egter gevind dat die avoidance coping subscales 28% van die variansie in die lewenstevredenheid van die steekproef verklaar het. Daar is gevind dat die cognitive avoidance subscale en die acceptance or resignation subscale negatief op die 1 % peil van betekenisvolheid met lewenstevredenheid korreleer. Dit blyk dat toenaderings (approach coping responses) nie die lewenstevredenheid by individue wat aan diabetes ly, voorspel nie. Vermydingsgedrag (avoidant coping responses), in besonder kognitiewe vermyding en aanvaarding of berusting, is egter voorspellend van laer vlakke van lewenstevredenheid. <![CDATA[<b>Value-sensitive clinical accompaniment in community nursing science</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100019&lng=en&nrm=iso&tlng=en Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field, community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population, with each group espousing different value systems. Both parties - students and community nurses - report that, due to these differences, value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science. The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory, descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings, participant observation and focus group interviews. Data were collected by means of video recordings, participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder, using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed, analysed and coded by the researcher and the external coder, using Tesch's steps of analysis (Creswell 1994:155-156). Lincoln and Guba's criteria (1985:290) for trustworthiness were applied to the study. The general findings indicate that clinical accompaniment in community nursing is not value sensitive and, as a result, guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed) were identified: respect during clinical accompaniment, value-sensitive communication and sensitivity to the quality of clinical accompaniment.<hr/>Kliniese gemeenskapsgesondheidsfasiliteite waar voorgraadse studente geplaas word vir gemeenskapsverpleegkundepraktika is dinamies en het groot veranderinge oor die laaste paar jare ondergaan. In die kliniese veld verteenwoordig gemeenskapsverpleegkundiges en voorgraadse studente verskillende rasse en taal- en etniese groepe in die Suid-Afrikaanse bevolking, elkeen met verskillende waardes. Albei partye - studente en gemeenskapsverpleegkundiges - het gerapporteer dat waardekonflik weens verskillende kulture en waardes tydens kliniese begeleiding ervaar word, wat kliniese leer op sy beurt in gemeenskapsverpleegkunde negatief beïnvloed. Die doel van diestudie was om die belewenis van studente met betrekking tot waardesensitiewe kliniese begeleiding in gemeenskapsverpleegkunde te verken en te beskryf. 'n Verkennende, beskrywende en kontekstuele ontwerp is gebruik. Die interaksie wat tussen die gemeenskapsverpleegkundiges en studente tydens kliniese begeleiding plaasgevind het, is vir waardesensitiwiteit deur middel van video-opnames, deelnemerobservasie en fokusgroeponderhoude verken. Die data wat deur middel van video-opnames en deelnemerobservasie ingesamel is, is deur die navorser en 'n eksterne kodeerder ontleed en gekodeer.'n Induktiewe beskrywende metode is gebruik om belangrike segmente van die gereeldheid van gedrag te identifiseer en beskryf. Fokusgroeponderhoude is deur die navorsers en 'n eksterne kodeerder getranskribeer, ontleed en gekodeer deur gebruik te maak van Tesch se stappe van analise (Creswell 1994:155-156). Lincoln en Guba (1985:290) se kriteria vir geloofwaardigheid is in die studie gebruik. Die algemene bevindinge dui daarop dat kliniese begeleiding in gemeenskapsverpleegkunde nie waarde-sensitief is nie. Gevolglik moet riglyne vir waarde-sensitiewe kliniese begeleiding vir voorgraadse studente in gemeenskapsverpleegkunde ontwikkel word. Die volgende waardes (waardes waarvoor riglyne ontwikkel moet word) is geïdentifiseer, naamlik respek tydens kliniese begeleiding, waarde-sensitiewe kommunikasie en sensitiwiteit vir gehalte van kliniese begeleiding. <![CDATA[<b>Sexual risk behaviour amongst young people in the Vhembe district of the Limpopo province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100020&lng=en&nrm=iso&tlng=en This study entailed a quantitative, cross-sectional survey amongst young people in four villages of the Vhembe district of the Limpopo province. The purpose of the research was to determine the sexual health risk behaviour indicators prevalent amongst young people that could contribute to the spread of HIV and AIDS in this district. The objectives of this study were (1) to identify sexual risk behaviour, (2) to establish the prevalence of substance use before sexual intercourse, (3) to determine the prevalence of coerced sexual intercourse and (4) to determine the prevalence of forced sexual intercourse amongst young people in the Vhembe district. Purposive sampling was used to select the four villages that participated in the study and simple, random sampling was used to select the respondents. A total of 400 respondents participated in the study, 227 of which were female and 173 were male. The following sexual risk behaviour indicators were identified (1) early sexual debut, (2) teenage pregnancy and (3) early marriage. It was found that young people expose themselves to sexual intercourse without condoms, and that they are likely to have sexual intercourse without a condom in return for reward, and to have sexual intercourse with a famous person. Approximately 20% of the sexually active respondents had used substances before sexual intercourse. Alcohol and marijuana ('dagga') were most commonly used amongst those respondents taking substances before sexual intercourse, and these were used predominantly in coerced and forced sexual intercourse.<hr/>Die studie was 'n kwantitatiewe, deursnee-opname wat onder jongmense in vier dorpies in die Vhembe-distrik van die Limpopo-provinsie uitgevoer is. Die doel van die navorsing was om vas te stel watter aanwysers van risikogedrag ten opsigte van seksuele gesondheid onder die jongmense voorkom wat moontlik tot die verspreiding van MIV en vigs in hierdie distrik bydra. Die doelstellings van hierdie studie was om (1) seksuele risikogedrag te identifiseer, (2) die voorkoms van middelgebruik voor seksuele omgang te bepaal, (3) die voorkoms van gedwonge seksuele omgang en (4) die voorkoms van geforseerde seksuele omgang onder jongmense in die Vhembe-distrik te bepaal. Doelgerigte steekproefneming is gebruik om die vier dorpies wat aan die studie deelgeneem het, te selekteer en eenvoudige ewekansige steekproefneming is gebruik om die respondente te selekteer. 'n Totaal van 400 respondente het aan die studie deelgeneem, waarvan 227 vroulik en 173 manlik was. Die volgende aanwysers van seksuele risikogedrag is geïdentifiseer (1) vroeë seksuele debuut, (2) tienerswangerskap en (3) vroeë huwelik. Daar is gevind dat jongmense hulself aan seksuele omgang sonder kondome blootstel, en dat hulle waarskynlik seksuele omgang sonder 'n kondoom sal hê in ruil vir vergoeding en seksuele omgang met 'n bekende persoon sal hê. Ongeveer 20% van die seksueel aktiewe respondente het middels voor seksuele omgang gebruik. Alkohol en marijuana ('dagga') was die algemeenste middels onder diegene wat middels voor seksuele omgang gebruik het, en dit is meestal in gedwonge en geforseerde seksuele omgang gebruik. <![CDATA[<b>The effects of fatigue and the post-concussion syndrome on executive functioning in traumatic brain injury and healthy comparisons</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100021&lng=en&nrm=iso&tlng=en In this study, behavioural manifestations of compromised executive control, including perseveration and reduced inductive reasoning, on the Wisconsin Card Sorting Test (WCST) were investigated. Performance was affected by fatigue in both a head-injured and matched population, which has implications for health care professionals involved in rehabilitation and assessment. A fatigue condition was manipulated for 15 moderate to severe traumatic brain injury (TBI) individuals through the course of a three-hour neuropsychological testing session. A comparison sample of 15 participants in a group of 'no history of TBI' was fatigued through the same approach. All fatigued participants (with and without TBI) displayed trends towards increased levels of perseveration and reduced inductive reasoning on the WCST. Thus, the effects of fatigue on high-level functioning are pervasive even when not head-injured. This finding supports the sub-optimal performance in cognitive skills, specifically in executive control, that is often found in fatigued people. These findings are relevant for the manner in which rehabilitation interventions and medico-legal assessments are structured. Importantly, the order of tests, their interpretation and rest sessions should be clearly indicated and interpreted in assessment reports and rehabilitation sessions.<hr/>In hierdie studie is gedragsmanifestering in individue met gekompromitteerde uitvoerende funksionering, met inbegrip van perseverasie en verminderde induktiewe redenering, op die Wisconsin-kaartsorteringstoets (WCST), bestudeer. Die waarneming dat prestasie deur uitputting beïnvloed word in sowel normale populasies as dié met kopbeserings het implikasies vir gesondheidsorgpersoneel wat by rehabilitasie en assessering betrokke is. 'n Uitputtingstoestand is gemanipuleer vir 15 matig ernstige individue met traumatiese kopbeserings (TKB) vir die duur van 'n drie uur lange toetssessie. 'n Vergelykingsmonster van 15 deelnemers met geen geskiedenis van kopbeserings is deur dieselfde metodologie uitgeput. Alle uitgeputte deelnemers (met en sonder TKB) het 'n neiging na verhoogde vlakke van perseverasie en verminderde induktiewe redenering op die WCST getoon. Die impak van uitputting op hoëvlak-funksionering is dus verreikend, selfs in gevalle waar geen kopbesering opgedoen is nie. Die bevinding ondersteun suboptimale prestasie in kognitiewe vaardighede, en spesifiek in uitvoerende beheer, wat dikwels onder uitgeputte mense gevind word. Hierdie bevindinge is van belang vir die manier waarop rehabilitasie-intervensies en regsgeneeskundige assesserings gestruktureer word. Die volgorde van toetse, die interpretasie daarvan en die rusperiodes moet duidelik in assesseringsverslae en rehabilitasiesessies aangetoon en geïnterpreteer word. <![CDATA[<b>The health care needs of the physically disabled patient in a home-based care environment: Implications for the training of ancillary health care workers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100022&lng=en&nrm=iso&tlng=en According to existing literature, ancillary health care workers (AHCWs) often do not meet the health care needs of patients with physical disabilities (physically disabled patients) in a home-based environment, because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term, home-based care in the northern suburbs of Johannesburg and, based on results, to offer recommendations for the training of AHCWs. Qualitative, exploratory, descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted, where participants had to answer the questions (1)'What are your health care needs?' and (2) 'How should these be met?' Data saturation was ensured, after which Tesch's method of data analysis was followed. Three categories of health care needs were identified (1) physical health care needs, (2) interpersonal relationship needs and (3) social needs, and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs. From the themes, recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient's individual needs, and should use knowledge and critical thinking skills to ensure a patient-centred care setting.<hr/>Volgens die literatuur kan assistentgesondheidsorgwerkers (AGWs), as gevolg van ontoereikende opleiding, nie altyd aan die behoeftes van fisies gestremde pasiënte in 'n tuisopset voldoen nie. Die doel van hierdie navorsingstudie was om die gesondheidsorgbehoeftes van langtermyn, tuisgebaseerde fisies gestremde pasiënte in die noordelike voorstede van Johannesburg te verken en te beskryf, en om hieruit aanbevelings vir die opleiding van AGWs voor te stel. Kwalitatiewe, verkennende, beskrywende en kontekstuele metodes is gebruik om die data in te samel en die analise te doen. Die studiepopulasie het uit agt fisies gestremde deelnemers bestaan wat 'n AGW aangestel het om hulle met hul langtermyntuisversorging by te staan. Doelbewuste steekproefneming met die daaropvolgendesneeubalmetode is gebruik om verdere deelnemers vir die studie te identifiseer. Individuele onderhoude is gevoer waartydens deelnemers die volgende vrae moes beantwoord (1) 'Wat is jou gesondheidsorgbehoeftes?' en (2) 'Hoe behoort hieraan voldoen te word?' Datasaturasie is verseker, waarna Tesch se data-analisemetode gevolg is. Drie kategorieë van gesondheidsorgbehoeftes is geïdentifiseer (1) fisiese gesondheidsorgbehoeftes, (2) interpersoordike verhoudingsbehoeftes en (3) sosiale behoeftes, en 12 temas is van hierdie kategorieë afgelei. Hierdie gesondheidsorgkategorieë behoort aandag tydens die opleiding van AGWs te kry. Aan die hand van die temas is aanbevelings gemaak vir die opleiding van AGWs in tuisgebaseerde sorg van fisies gestremde pasiënte. AGWs behoort ondersteuning te bied om die omgewing by die individuele behoeftes van die pasiënt aan te pas, en moet hul kennis en kritiese denkvaardighede kan toepas om n pasiëntgesentreerde omgewing te verseker. <![CDATA[<b>Self-care symptom-management strategies amongst women living with HIV/AIDS in an urban area in KwaZulu-Natal</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100023&lng=en&nrm=iso&tlng=en People living with HIV and AIDS experience a number of symptoms such as fatigue, nausea and vomiting, fever and anxiety during the various stages of the illness. This has a negative effect on their quality of life. Women are the most commonly infected group and are at greater risk of acquiring HIV than men. In addition to their vulnerability, women have other responsibilities in society and expectations from society to fulfil. Women's health-seeking and health practice behaviours are often hindered by a number of factors, including family responsibilities, poverty and fear. This paper presents the findings of a qualitative study aimed at exploring the self-care symptommanagement strategies used by women living with HIV and AIDS in an urban area in KwaZulu-Natal in 2006. Eleven participants were selected through a purposive sampling method until saturation was reached. Individuals were assessed in depth, using the symptom-management strategy interview. Qualitative content analysis was used to examine the transcribed interviews, using a deductive approach based on the categories of self-care symptom-management strategies. Various physical and psychological symptoms and a number of self-care symptom-management strategies were reported by the participants and these included taking medication and seeking help. The study makes recommendations on how to improve women's ability to employ a self-care strategy in managing their HIV- and AIDS-related symptoms.<hr/>Mense wat met MIV en Vigs leef, ervaar verskeie simptome in die verskillende stadiums van die siekte, soos moegheid, naarheid en braking, koors en angstigheid. Dit het 'n negatiewe effek op hul lewensgehalte. Vroue is die groep wat die meeste besmet word, en staan 'n groter risiko om MIV op te doen as mans. Benewens hul vatbaarheid, het vroue ook ander verantwoordelikhede en verwagtinge om in die samelewing te vervul. Vroue se gesondheidsbevorderende en gesondheidspraktykgedrag word dikwels gekniehalter deur 'n aantal faktore, wat familieverantwoordelikhede, armoede en vrees insluit. Hierdie artikel bied die bevindinge aan van 'n kwalitatiewe studie gemik op die verkenning van selfsorg-simptoombeheerstrategieë wat deur vroue met MIV en Vigs in 2006 in 'n stedelike gebied in KwaZulu-Natal gebruik is. 'n Steekproef van 11 respondente is geselekteer deur middel van 'n doelbewuste steekproefmetode totdat versadiging bereik is. Individuele diepte-onderhoude is gevoer deur gebruik te maak van die simptoombeheerstrategie-onderhoud. Kwalitatiewe inhoudelike analise is gebruik om die getranskribeerde onderhoude te analiseer deur middel van 'n deduktiewe metode gegrond op die kategorieë van selfsorg-simptoombeheerstrategieë. Verskeie fisiese en psigologiese simptome asook 'n aantal selfsorg-simptoombeheerstrategieë is deur die respondente gerapporteer. Die selfsorg-simptoombeheerstrategieë wat in die studie identifiseer is, het die neem van medikasie en die soek na hulp ingesluit. Die studie maak aanbevelings oor hoe om vroue se vermoë om 'n selfsorg-strategie om MIV- en Vigs-verwante simptome te beheer, te verbeter. <![CDATA[<b>Stakeholders' perceptions of the delivery and quality of sexually transmitted infection treatment by private practitioners in Windhoek, Namibia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100024&lng=en&nrm=iso&tlng=en The primary objective of this study was to explore the perceptions of the community and other stakeholders regarding the delivery and quality of sexually transmitted infection (STI) treatment and care provided by private general practitioners (PGPs) in Windhoek, Namibia. The study provided a situational and contextual analysis employing qualitative methodologies using different methods of data collection. The methodology used included (1) a review of available country policy documents on STI management and surveillance, as well as the policy with regard to private primary care providers, (2) eight in-depth interviews conducted with key informants and (3) three focus-group discussions held with community members attending PGP practices in Windhoek. The perceptions of the care received from PGPs differed from one person to the next. It emerged that some participants had good experiences and some had negative experiences of the care given. The participants believed that going to a PGP for treatment is a matter of affordability that goes hand in hand with the expectations of receiving care, whilst maintaining confidentiality. The study established that there is no real difference between the care provided to patients with medical aid or those without medical aid. It is recommended that interactions between the public and private sector at various levels be initiated to ensure that curable STIs are appropriately managed and that national guidelines for STI management are adhered to. Health workers should also be sensitised about their approach towards patients. It is further recommended that awareness creation amongst PGPs with regard to the public health importance of STIs needs to be raised to encourage them to participate in the STI-control programme.<hr/>Die hoofdoel van die studie was om ondersoek in te stel na die persepsies van die gemeenskap en ander belanghebbendes oor die lewering en kwaliteit van die behandeling en sorg ten opsigte van seksueel oordraagbare infeksies (SOIs) deur privaat algemene praktisyns in Windhoek. Die studie het 'n situasionele en kontekstuele analise behels, waarin gebruik gemaak is van kwalitatiewe metodologieë en verskillende metodes van data-insameling. Die metodologie het ingesluit (1) die bestudering van beskikbare nasionale beleidsdokumente oor die behandeling en monitering van SOIs sowel as die beleid op privaat primêresorgvoorsieners, (2) agt diepte-onderhoude met sleutelinformante en (3) drie fokusgroepgesprekke met lede van die gemeenskap wat die praktyke van privaat algemene praktisyns in Windhoek besoek. Die persepsies van die sorg wat van algemene praktisyns ontvang is, verskil van deelnemer tot deelnemer. Dit het aan die lig gekom dat sommige deelnemers die gelewerde sorg positief ervaar het terwyl ander dit negatief ervaar het. Die deelnemers het geglo dat om 'n algemene praktisyn vir behandeling te besoek 'n kwessie van bekostigbaarheid is wat gepaard gaan met 'n verwagting van sorglewering terwyl vertroulikheid behou word. Die studie het bevind dat daar geen verskil is in die sorg wat gelewer word aan pasiënte met 'n mediese fonds teenoor dié daarsonder nie. Daar word aanbeveel dat interaksie op verskillende vlakke tussen die openbare en privaat sektor aangemoedig moet word om te verseker dat behandelbare SOIs voldoende bestuur word en dat die nasionale riglyne ten opsigte daarvan nagekom word. Gesondheidswerkers behoort gesensitiseer te word ten opsigte van hul benadering tot hul kliënte. Daar word verder aanbeveel dat die bewusmaking van die openbaregesondheidsbelang van SOIs onder privaat praktisyns opgeskerp moet word sodat hulle aan die SOI-beheerprogram sal deelneem. <![CDATA[<b>Further potential savings attributable to maximum generic substitution of antidepressants in South Africa: A retrospective analysis of medical claims</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100025&lng=en&nrm=iso&tlng=en The main objective of the study was to calculate potential cost savings that could have been generated by maximum generic substitution of antidepressants within the private health care sector of South Africa from 2004 to 2006. Data on computerised medicine claims of patients receiving one or more antidepressants during three consecutive years (i.e. 2004, 2005 and 2006) were elicited from a South African pharmaceutical benefit management company. The total study population consisted of 292 071 items (N = 5 982 869) on 273 673 prescriptions (N = 5 213 765) at a total cost of R56 183 697.91 (N = R1 346 210 929.00). A quantitative, retrospective drug utilisation review was conducted, and data were analysed using the Statistical Analysis System® programme. Potential cost savings were computed for criteria-eligible substances in the study population. Generic medicine constituted 58.7% (N = 292 071) of all antidepressants claimed, at a total cost of 28.2% (N = R1 346 210 929.00) of all incurred costs. With total substitution of the average price of all criteria-eligible innovators, a potential saving of 9.3% (N = R56 183 697.91) of the actual antidepressant cost over the study period was calculated. In developing countries with limited health care resources, generic medicines can be cost-saving treatment alternatives.<hr/>Die hoofmikpunt van hierdie studie was om die potensiële kostebesparing te bereken wat deur maksimale generiese vervanging van antidepressante in die Suid-Afrikaanse private gesondheidsorgsektor tussen 2004 en 2006 teweeggebring sou kon word. Data oor gerekenariseerde eise vir medisyne van pasiënte wat een of meer antidepressante gedurende die studietydperk ontvang het (d.i. 2004, 2005 en 2006) is van 'n Suid-Afrikaanse maatskappy wat farmaseutiese voordele bestuur, verkry. Die totale studiepopulasie het bestaan uit 292 071 items (N = 5 982 869) van 273 673 voorskrifte (N = 5 213 765) teen 'n totale koste van R56 183 697.91 (N = R1 346 210 929.00). 'n Kwantitatiewe, retrospektiewe medisyneverbruiksontleding is gedoen en data is geanaliseer deur van die Statistical Analysis System®-pakket gebruik te maak. Potensiële kostebesparings is vir middels in die studiepopulasie wat aan die kriteria voldoen het, bereken. Generiese produkte het 58.7% (N = 292 071) van alle produkte wat voorgeskryf is, uitgemaak, teen 'n totale koste van 28.2% (N = R1 346 210 929.00). Indien die gemiddelde prys van alle middels wat aan die kriteria vir vervanging voldoen het, met die prys vir generiese middels vervang word, is 'n potensiële besparing van 9.3% (N = R56 183 697.91) van die werklike koste vir antidepressante gedurende die studietydperk moontlik. Generiese middels kan in ontwikkelende lande met beperkte gesondheidsorg-hulpbronne kostebesparende alternatiewe wees. <![CDATA[<b>Reasons for students' poor clinical competencies in the Primary Health Care: Clinical nursing, diagnosis treatment and care programme</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100026&lng=en&nrm=iso&tlng=en Die primêre kliniese verpleegkundiges, tradisioneel bekend as primêre gesondheidsorg verpleegkundiges, funksioneer in Suid-Afrika as eerste-linie verskaffers van kliniese primêre gesondheidsorg (PGS) dienste binne die publieke PGS fasiliteite. Dit is hulle uitgebreide rol. Hierdie uitgebreide rol van die verpleegkundige (soos deur Wet op Verpleging, No 50 van 1978, artikel 38A voorgeskryf), vereis opleiding in kliniese vaardighede van hoë gehalte deur verpleegskole en universiteite. Die doelwitte van die navorsing was om die persepsies van beide kliniese dosente en leerders, met betrekking tot die redes vir swak kliniese vaardighede, repektiewelik te verken en te beskryf. Twee temas is deur die resultate as uitdagings (hoof redes) vir die swak vaardighede van leerders aangetoon, naamlik uitdagings in die PGS kliniese praktyk en die uitdagings in die leerprogram (universiteit). <![CDATA[<b>Quality-of-life experiences from the perspective of patients receiving haemodialysis for chronic renal failure</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100027&lng=en&nrm=iso&tlng=en This study describes the experiences of patients receiving haemodialysis for chronic renal failure at the only dialysis centre in Windhoek, Namibia. A qualitative, explorative and descriptive design was used. Data were collected by means of in-depth interviews and analysed using Tesch's process. Four themes emerged from the data, relating to (1) financial constraints, (2) loss of independence and spontaneous activities, (3) strain on relationships and (4) feelings of significant physiological changes and weakness. Based on the results, recommendations were submitted for psychosocial support and the establishment of support groups.<hr/>Hierdie studie beskryf die ervarings van pasiënte wat gehemodialiseer word vir chroniese nierversaking in die enigste dialise-eenheid in Windhoek. 'n Kwalitatiewe, verkennende en beskrywende studie is gedoen. Die data is deur middel van diepte-onderhoude ingesamel, waarna die data aan die hand van Tesch se metode geanaliseer is. Daar het vier temas uit die studie na vore gekom (1) finansiële beperkings, (2) verlies van onafhanklikheid en spontane aktiwiteite, (3) druk in verhoudings en (4) gewaarwordings van beduidende fisiologiese veranderinge en swakheid. Na aanleiding van hierdie bevindings is die daarstel van psigososiale ondersteuning asook ondersteuningsgroepe aanbeveel. <![CDATA[<b>The link between poverty and malnutrition: A South African perspective</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362010000100028&lng=en&nrm=iso&tlng=en In this article, a brief review of the nutritional problems in South Africa, as well as the intergenerational, vicious cycle of poverty and malnutrition, are used to argue for the necessity of including a nutrition intervention component in poverty-alleviation programmes. It is concluded that this cycle can be broken by improving the nutritional status of women in their productive years, whereby foetal malnutrition, arrested mental development and physical stunting in children, adolescents and adults can be prevented. The result will be an improvement in human capital, health and productivity with the ultimate aim of escaping poverty as suggested by the seven principles of Solomons (2005).<hr/>In hierdie artikel word 'n kort oorsig van die voedingsprobleme in Suid-Afrika sowel as die noodlottige siklus van wanvoeding en armoede wat oor generasies strek, gebruik om aan te voer dat dit noodsaaklik is om 'n voedingsintervensie-komponent in programme gemik op die verligting van armoede in te sluit. Daar word tot die gevolgtrekking gekom dat die siklus gebreek kan word as die voedingstatus van vroue in hulle voortplantingsjare verbeter word. Hierdie verbetering sal fetale wanvoeding, sowel as belemmerde groei en kognitiewe ontwikkeling van kinders, adolessente en volwassenes voorkom. Die gevolg sal 'n verbetering van menskapitaal, verbeterde gesondheid en verhoogde produktiwiteit wees, met die uiteindelike doel om armoede te ontsnap soos voorgestel deur die sewe beginsels van Solomons (2005).