Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620110001&lang=es vol. 16 num. 1 lang. es <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Coping under pressure: Strategies for maintaining confidence amongst South African soccer coaches</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100001&lng=es&nrm=iso&tlng=es Sport coaching can be a fulfilling and rewarding occupation, but can also be stressful because of the demands and expectations of various external factors. The complex and extraordinary demands placed on coaches, force them to perform multiple roles (e.g. educator, motivator, counsellor, adviser, trainer, manager and administrator). Soccer coaches face a number of challenges, frustrations, conflicts and tensions, the enormity of which is often underestimated. This notion is supported by the description of coaching as a perilous occupation in which coaches experience pressures like stress, conflict and tension, media pressure and intrusions into family life. This study explored the perceptions of South African soccer coaches in terms of the mechanisms they use to cope with potential stressors experienced in their jobs and employed a non-experimental design, using a quantitative approach, to assess stress and coping strategies of South African coaches. One hundred and twelve soccer coaches, coaching at the provincial level and higher, completed a questionnaire on stress and stress coping mechanisms used in their coaching jobs. Descriptive data analysis was completed using the Statistical Package for Social Sciences (SPSS - version 16). The sources of stress experienced and coping methods used by the coaches were evaluated. Results revealed that the top three sources of stress were a lack of resources, fixture backlog and games where the outcome is critical, whilst the lowest three sources of stress were political interference, physical assaults from players and substituting a player. Moreover, various coping strategies used by the coaches showed that an average of 5.68%, 5.14% and 89.78% of the sample used maladaptive coping, emotion management coping and problem management coping strategies respectively. Academic and practical implications of the study results are discussed.<hr/>Sport afrigting kan 'n baie vervullende en bevredigende beroepskeuse wees, maar as gevolg van die eise en verwagtinge van verskeie omgewings faktore, kan dit ook as 'n spanningsvolle beroep ervaar word. Afrigters moet verskeie rolle vertolk (o.a. opvoeder, motiveerder, sielkundige, adviseerder, afrigter, bestuurder en administrateur) wat deel uitmaak van die komplekse en buitengewone eise wat op hulle geplaas word. Sokker afrigters beleef 'n aantal uitdagings, konflik situasies, frustrasies en spanning waarvan die impak of waarde daarvan selde gemeet kan word. Afrigting as 'n konsep word beskryf of gedefinieer as 'n potensieel onveilige en/of wisselvallige beroep waar die meerderheid afrigters spanning ervaar, konflik beleef, media druk moet verwerk en 'n geweldige inbreuk op hul persoonlike en familielewe ervaar. Hierdie studie ondersoek Suid-Afrikaanse sokker afrigters se persepsies aangaande die meganismes wat hulle gebruik om die potensiële spanning van hul beroep te bestuur. Die studie is gebaseer op 'n nie-eksperimentele ontwerp met 'n kwantitatiewe benadering van Suid-Afrikaanse sokker afrigters om spanning te evalueer en te bestuur. Een honderd en twaalf sokker afrigters wat op provinsiale vlak of hoër afgerig het, het vraelyste ingevul aangaande spanning en spanning hanteringstegnieke wat in hul afrigtingsberoepe gebruik is. Beskrywende data analise is met behulp van 'n statistiese pakket in Sosiale Wetenskap (SPSS-weergawe 16) gedoen. Die oorsake van spanning asook die hanteringstegnieke wat deur die afrigters gebruik is, is geevalueer. Die resultate het bevind dat daar drie duidelike oorsake van spanning was, naamlik 'n tekort aan hulpbronne, die akkumulasie van geskeduleerde wedstryde asook wedstryde waarvan die uitslag krities is. Die drie laagste oorsake van spanning was onder andere politieke inmenging, fisiese aanranding deur spelers en die vervanging van spelers. Die afrigters het 'n verskeidenheid van spannings hanteringstegnieke gebruik, maar die resultate toon dat 5.68%, 5.14% en 89.78% van die eksperimentele groep oneffektiewe spannings-, emosionele- en probleem bestuurstegnieke geïmplementeer het. Akademiese en praktiese implikasies van die navorsingsresultate word bespreek. <![CDATA[<b>Teenagers' experiences of sexual health dialogue in the rural villages of the Vhembe District, Limpopo Province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100002&lng=es&nrm=iso&tlng=es Dialogue with teenagers about sexual health is of global concern, as it is found mostly to be minimal, if not absent. This limitation is influenced by the cultural values, beliefs and norms of teenagers. To a great extent, culture influences which and how sexual health issues can be discussed between teenagers and adults. The purpose of this study was to explore and describe teenagers' experiences of sexual health dialogue in the rural areas of the Vhembe district in Limpopo province, South Africa. A qualitative, explorative, descriptive and contextual research approach was used. Data were collected by means of in-depth, individual interviews and focus-group discussions. A purposive sampling method was used to select the 57 participating teenagers, based on criteria that were set. The findings of the study indicated that there was minimal dialogue between adults and teenagers about sexual health. Most teenagers reported that they learned about issues related to sexual health from friends, the media, initiation schools and relatives who, most often, were aunts. It was also noted with concern that the teenagers always equated sexual health to the act of intercourse and that no attention was paid to other aspects of sexual health. Recommendations to improve the current situation were made.<hr/>Dialoog met tienerjariges rakende seksuele gesondheid is 'n wêreldwye probleem omdat daar gevind is dat dit meestal minimaal is of glad nie plaasvind nie. Hierdie beperking word beïnvloed deur die tienerjariges se kulturele waardes, oortuigings en norme. Kultuur beïnvloed in 'n groot mate watter seksuele gesondheidsake tussen tienerjariges en volwassenes bespreek kan word, en hoe dit gedoen kan word. Die doel van hierdie studie was om tienerjariges se ondervindings van seksuele gesondheidsdialoog in die landelike gebiede van die Vhembe-distrik in die Limpopo-provinsie van Suid-Afrika te ondersoek en te bespreek. 'n Kwalitatiewe, ondersoekende, beskrywende en kontekstuele navorsingsbenadering is gevolg. Data is versamel deur middel van grondige individuele onderhoude en fokusgroep-besprekings. 'n Doelbewuste steekproefmetode is gebruik om die 57 deelnemende tienerjariges op grond van bepaalde kriteria te selekteer. Die bevindings van die studie het aangedui dat daar minimale dialoog oor seksuele gesondheid tussen tienerjariges en volwassenes is. Die meeste tienerjariges het gerapporteer dat hulle by vriende, die media, inisiasieskole en familielede, meestal 'n tante, van seksuele gesondheid geleer het. Daar is met kommer opgemerk dat tienerjariges seksuele gesondheid aan die daad van omgang gelykstel en dat geen aandag aan ander aspekte van seksuele gesondheid geskenk is nie. Aanbevelings ter verbetering van die situasie is gemaak. <![CDATA[<b>Character strengths of adolescent survivors of childhood cancer</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100003&lng=es&nrm=iso&tlng=es There is increased interest in possible positive outcomes for survivors of childhood cancer. This study investigated the manifestation of character strengths in adolescents who have survived cancer compared to that seen in healthy adolescents. The aim was to establish whether specific character strengths may be more prominent in adolescents who have survived cancer than in healthy adolescents. Two groups of participants, consisting of adolescents who have survived childhood cancer (n = 21) and a group of healthy adolescents (n = 21), were obtained through convenience sampling. They completed the Values in Action Inventory for Youth (VIA-Youth) (Park & Peterson 2006) as a measure of character strengths. No significant differences were found between the character strengths of adolescents who have survived cancer and their healthy peers, unlike the findings of a similar earlier study with adults (Peterson, Park & Seligman 2006). It is concluded that the experience of serious illness such as cancer neither hindered nor enhanced the development of character strengths in this group of adolescent survivors. More research is needed to understand positive psychological functioning in the aftermath of childhood cancer.<hr/>Daar is toenemende belangstelling in moontlike positiewe uitkomste vir kinders wat kanker oorleef het. Hierdie studie het ondersoek hoe karaktersterktes na vore kom in adolessente wat as kinders met kanker gediagnoseer is in vergelyking met dié in 'n groep gesonde adolessente. Die studie het ten doel gehad om vas te stel of spesifieke karaktersterktes meer opvallend na vore kom in adolessente wat kanker oorleef het. Die deelnemers is deur middel van gerieflikheidsteekproefneming gekies. Die twee groepe het bestaan uit adolessente wat as kinders met kanker gediagnoseer is (n = 21) en 'n groep gesonde adolessente (n = 21). Deelnemers het die Values in Action Inventory for Youth (VIA-Youth) (Park & Peterson 2006) voltooi ten einde karaktersterktes te bepaal. Daar was geen beduidende verskil tussen die karaktersterktes van die adolessente wat kanker oorleef het en die gesonde groep nie, anders as met 'n soortgelyke vroeëre studie onder volwassenes (Peterson, Park & Seligman 2006). Dit blyk dat die ervaring wat met ernstige siekte soos kanker gepaardgaan, ontwikkeling van karaktersterktes nóg bevorder nóg belemmer het in hierdie groep adolessente kankeroorwinnaars. Verdere navorsing is nodig om aspekte van positiewe sielkundige funksionering in adolessente kankeroorwinnaars te verstaan. <![CDATA[<b>Physical activity levels and energy expenditure of 9-year-old - 12-year-old overweight and obese children</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100004&lng=es&nrm=iso&tlng=es The high occurrence of overweight and obesity amongst children is a disturbing health problem worldwide. Possible causes of increasing childhood obesity are inactivity and energy imbalances. The aim of this study was to analyse the total energy expenditure (TEE) and physical activity levels in 9-year-old - 12-year-old overweight and obese children during a weekday and a weekend day, as well as during a weekday morning and afternoon. Twenty-four 9-year-old - 12-year-old children (seven boys and 17 girls), of whom nine were overweight and 15 were obese, were selected from seven public primary schools for this study. Body mass index (BMI) cut-off points were used to distinguish between overweight and obese. Each participant wore an ACTICAL™ monitor to determine their physical activity levels and TEE. It was found that the TEE of the children did not differ between a week day and a weekend day, although the TEE of the week day afternoon differed significantly from that of the weekday morning. Unlike the overweight children, none of the obese children met the requirements of 60 minutes of moderate-intensity physical activity per day. Strategies should be found to increase the activity levels of overweight and, especially, obese children, specifically during the mornings and over weekends.<hr/>Die hoë voorkoms van oorgewig en obesiteit onder kinders is wêreldwyd 'n kommerwekkende gesondheidsprobleem. Fisieke onaktiwiteit en energiewanbalanse word as moontlike oorsake van die probleem beskou. Die doel van hierdie studie was om die totale energieverbruik (TEV) en fisieke-aktiwiteitsvlakke van 9-jarige - 12-jarige oorgewig- en obese kinders tydens 'n totale weeksdag en naweekdag te ontleed, asook tydens die oggend en middag van 'n weeksdag. Vier-en-twintig 9-jarige - 12-jarige kinders (sewe seuns en 17 dogters), waarvan nege oorgewig en 15 obees was, is uit sewe publieke laerskole vir die studie gekies. Afsnypunte volgens die liggaamsmassa-indeks (LMI) is gebruik om tussen oorgewig en obees te onderskei. Elke deelnemer het 'n ACTICAL™ monitor gedra om hul fisieke-aktiwiteitsvlakke en TEV te bepaal. Die studie het getoon dat die TEV van die kinders op 'n weeksdag en naweekdag nie verskil het nie, alhoewel TEV tydens die middag van die weeksdag betekenisvol verskil het van die oggend s'n. Anders as die oorgewig kinders, het geen van die obese kinders aan die voorgestelde riglyn van 60 minute se matig intensiewe fisieke aktiwiteit per dag voldoen nie. Strategieë moet gevind word om die vlakke van aktiwiteit van oorgewig en veral obese kinders te verhoog, spesifiek gedurende die oggende en oor naweke. <![CDATA[<b>The competencies of the shift leader in the intensive care unit setting, in a private hospital group in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100005&lng=es&nrm=iso&tlng=es Newly qualified intensive care nurses are forced into positions of authority and responsibility as shift leaders at an early stage and are not given a chance to consolidate their new knowledge with practice. They have to be responsible and accountable not only for their own actions, but also for those of their staff. The purpose of this study was to explore and describe the competencies of the shift leader in the intensive care unit setting to determine whether there is a gap between what is expected of the shift leader and what is happening in reality. A quantitative, descriptive design was used and cluster sampling was implemented. Questionnaires were used to gather data from three clusters, comprising 11 hospitals from a single private hospital group. Of the 251 questionnaires that were handed out to intensive care personnel (including trained and non-trained staff), 98 were returned, resulting in a response rate of 39%. An in-depth literature study and submission of questionnaires to experts before being administered to respondents ensured validity and reliability. Results were used to describe a typology of the competencies of the shift leader in the intensive care setting and indicated that respondents classified competencies related to the application of the nursing process in the intensive care unit in all its facets as essential competencies. None were classified as a critical competency and only four were classified as specific competencies. All respondents in the three clusters regarded their shift leaders as competent.<hr/>Pas-gekwalifiseerde, intensiewesorg-verpleegkundiges word op 'n vroeë stadium as skofleiers in posisies van gesag en verantwoordelijkheid geplaas en word nie die kans gegun om hul nuwe kennis met die praktyk te konsolideer nie. Tog moet hulle verantwoordelikheid en aanspreeklikheid aanvaar nie net vir hul eie aksies nie, maar ook vir dié van hul personeel. Die doel van hierdie studie was om die vaardighede van skofleiers in die opset van die intensiewesorg-eenheid te ondersoek en te beskryf om te bepaal of daar 'n gaping bestaan tussen wat van hulle verwag word en wat in werklikheid gebeur. 'n Kwantitatiewe, beskrywende ontwerp is gebruik en 'n trossteekproef is geïmplementeer. Vraelyste is gebruik om data in te samel van drie trosse bestaande uit 11 hospitale van 'n enkele privaathospitaalgroep. Van die 251 vraelyste wat uitgedeel is aan intensiewesorg-personeel (insluitend opgeleide en nie-opgeleide personeel), is 98 terugontvang, wat vertaal na 'n responskoers van 39%. 'n Diepgaande literatuurstudie en voorlegging van vraelyste aan deskundiges voordat dit aan respondente uitgedeel is, het bygedra tot geldigheid en betroubaarheid. Resultate is gebruik om 'n tipologie van die vaardighede van skofleiers in 'n intensiewesorg-eenheid te beskryf en dit het geblyk dat respondente die vaardighede wat verband hou met die verpleegproses in die intensiewesorg-eenheid in al sy fasette as noodsaaklike vaardighede klassifiseer. Geen vaardigheid is as kritiek geklassifiseer nie en slegs vier vaardighede is as spesifieke vaardighede geklassifiseer. Al die respondente in die drie trosse het hul skofleiers as vaardig beskou. <![CDATA[<b>Positive and negative emotional responses to work-related trauma of intensive care nurses in private health care facilities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100006&lng=es&nrm=iso&tlng=es Intensive care nursing is a stressful occupation and nurses are continually subjected to both primary and secondary trauma. Responses may be positive in the form of compassion satisfaction, or negative in the form of compassion fatigue. However, nurses tend to deny the negative impact of secondary trauma which leads to the silencing response and subsequent burnout. This article explores and describes the presence of these emotions and the relationships between them. A quantitative approach with a non-probability sampling method was used. The sample consisted of 30 registered nurses working in private health care intensive care units in East London, Eastern Cape. Data were gathered via the Professional Quality of Life Scale: Compassion Satisfaction and Fatigue Subscales - Revision IV (ProQOL - R-IV) and the Silencing Response Scale and were analysed according to descriptive statistics and correlation coefficients. Findings suggest a high risk for compassion fatigue, a moderate risk for burnout and the silencing response and moderate potential for compassion satisfaction. A marked negative relationship was found between compassion satisfaction and burnout and a substantial positive relationship between compassion fatigue and burnout, as well as compassion fatigue and the silencing response.<hr/>Intensiewesorgverpleging is 'n stresvolle beroep en verpleegsters word gedurig aan beide primêre en sekondêre trauma blootgestel. Reaksie hierop kan óf positief wees, in die vorm van empatie-tevredenheid, óf negatief, in die vorm van empatie-uitputting. Verpleegsters is egter geneig om die negatiewe impak van sekondêre trauma te ontken, wat gevolglik tot stilswye en uitbranding kan lei. Hierdie artikel ondersoek en beskryf die teenwoordigheid en verwantskap tussen hierdie emosies. 'n Kwantitatiewe benadering met 'n nie-waarskynlikheidsteekproefmetode is gebruik. Die steekproef het bestaan uit 30 geregistreerde verpleegsters wat in privaat-intensiewesorgeenhede in Oos-Londen in die Oos-Kaap werk. Data is met behulp van die vierde hersiening van die 'Professional Quality of Life Scale: Compassion Satisfaction and Fatigue Subscales' en die 'Silencing Response Scale' ingevorder en verwerk met verwysing na beskrywende statistieke en korrelasiekoëffisiente. Die resultate dui op 'n hoë risiko vir empatie-uitputting, 'n matige risiko vir uitbranding en die stilswye-reaksie, sowel as 'n matige potensiaal vir empatie-tevredenheid. 'n Beduidende negatiewe verwantskap blyk tussen empatie-tevredenheid en uitbranding te bestaan, terwyl 'n aansienlik positiewe verwantskap tussen empatie-uitputting en uitbranding en empatie-uitputting en die stilswye-reaksie bestaan. <![CDATA[<b>The emotional well-being of the nurse within the multi-skill setting</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100007&lng=es&nrm=iso&tlng=es The emotional well-being of nurses working in a multi-skill setting may be negatively influenced by their challenging work environment. A qualitative, explorative, descriptive and contextual study was conducted to investigate this phenomenon. The purpose of this study was to explore and describe the experience, as well as perceptions of coping mechanisms, of nurses working in the multi-skill setting, and to formulate recommendations to promote their emotional well-being. The population consisted of nurses working in a multi-skill setting (a Level-2 hospital) and included professional nurses, enrolled nurses and nurse assistants. An all-inclusive sample was used. Semi-structured interviews were conducted with three professional nurses, six enrolled nurses and one nurse assistant. These interviews were analysed according to the method described by Creswell (2003:192). The findings indicated that nurses have positive as well as negative experiences of the multi-skill setup. They cope by means of prioritising tasks, faith, self-motivation and mutual support. They also made suggestions for the promotion of their emotional well-being, on personal as well as managerial levels. Recommendations for further research, nurse education and practice were formulated. Recommendations for practice include 'on-the-spot' in-service training, appropriate task allocation, clearly defined scope of practice, time for rest and debriefing, strengthened relationships with management, promotion of strengths and creating a support system.<hr/>Die emosionele welstand van verpleegkundiges werksaam in 'n multivaardigheidsopset kan moontlik negatief beïnvloed word deur die uitdagende werksomgewing. 'n Kwalitatiewe, verkennende, beskrywende en kontekstuele studie is uitgevoer om hierdie verskynsel te ondersoek. Die doel van hierdie studie was om die ervaring van verpleegkundiges, asook hul persepsies van hanteringsmeganismes, in 'n multi-vaardigheidsopset te verken en beskryf, sowel as om aanbevelings vir die bevordering van hulle emosionele welstand te formuleer. Die populasie het bestaan uit verpleegkundiges werksaam in 'n multivaardigheidsopset ('n Vlak-2 hospitaal) en het professionele verpleegkundiges, ingeskrewe verpleegkundiges en verpleegassistente ingesluit. 'n Alles-insluitende steekproef is gebruik. Semi-gestruktureerde onderhoude is met drie professionele verpleegkundiges, ses ingeskrewe verpleegkundiges en een verpleegassistent gevoer. Hierdie onderhoude is volgens die metode deur Creswell (2003:192) beskryf, geanaliseer. Die bevindinge het getoon dat verpleegkundiges positiewe sowel as negatiewe ervaringe van die multivaardigheidsopset het. Hulle gebruik taakprioritisering, geloof, selfmotivering en wedersydse ondersteuning as hanteringsmeganismes. Hulle het ook voorstelle gemaak vir die bevordering van hul emosionele welstand, op persoonlike sowel as bestuursvlak. Aanbevelings vir verdere navorsing, verpleegonderwys en die praktyk is geformuleer. Aanbevelings vir die praktyk sluit in 'in-die-oomblik' indiensopleiding, toepaslike taaktoewysing, duidelikheid oor bestek van praktyk, tyd vir rus en ontlading, verbeterde verhoudings met bestuur, bevordering van sterk karaktereienskappe en die skep van 'n ondersteuningsnetwerk. <![CDATA[<b>Exploring the bio-psychosocial effects of renal replacement therapy amongst patients in a state hospital in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100008&lng=es&nrm=iso&tlng=es This article described a qualitative study that investigated the bio-psychosocial effects of renal replacement therapy on patients in a state hospital in South Africa. The study aimed to investigate the level of debility experienced by patients undergoing haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) and to explore how this debility affects their bio-psychosocial functioning. Respondents comprised a small sample of HD and CAPD patients. Using an interview schedule as the research tool allowed rich data to be uncovered. Content analysis and reducing data into themes facilitated data analysis. Although the study was not quantitative and thus did not allow for comparative analysis, themes regarding the levels of stress emerged amongst participants. The HD group voiced greater concerns regarding the degree of debility and psychosocial distress than the CAPD group. Governmental support for holistic kidney disease treatment and careful teaming of key role players to reduce the severity and far-reaching bio-psychosocial effects of HD and CAPD treatment are recommended.<hr/>Hierdie artikel beskryf 'n kwalitatiewe studie wat die bio-psigososiale effekte van niervervangingsterapie op pasiënte in 'n staatshospitaal in Suid-Afrika ondersoek het. Die studie is gemotiveer deur die mate van debiliteit van pasiënte wat hemodialise (HD) en kontinue ambulatoriese peritoneale dialise (KAPD) ondergaan en wat oënskynlik verder strek as bloot die fisieke aspekte van die siekte en die behandeling daarvan. Respondente het bestaan uit 'n klein groep HD- en KAPD-pasiënte. Deur 'n onderhoudskedule as die navorsingsinstrument te gebruik, is ryk data onthul. Inhoudanalise en die redusering van data tot temas het die data-analise gefasiliteer. Alhoewel die studie nie kwantitatief was nie en vergelykende analise dus nie moontlik was nie, het temas van spanning onder die respondente voorgekom. Dit was duidelik uit die onderhoude met albei pasiëntgroepe en inhoudanalise dat die HD-groep meer bekommernis oor die graad van debiliteit en psigososiale stres getoon het as die KAPD-groep. Regeringsondersteuning vir holistiese nierbehandeling en versigtige samestelling van 'n span sleutelrolspelers vir die vermindering van die erns en verreikende gevolge van HD en KAPD word voorgestel. <![CDATA[<b>The physical activity and health status of two generations of Black South African professional women</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100009&lng=es&nrm=iso&tlng=es Increased health risks associated with physical inactivity in the Black population have been reported in recent years. Black women, suffering the highest levels of inactivity, overweight and obesity, are at greatest risk of developing chronic diseases of lifestyle. This explorative-descriptive study investigated the physical activity patterns and health status of two generations of Black professional women, reflecting pre-democracy and post-democracy age groups. Quantitative measures were used, including the ActiGraph GT1M accelerometer, the Global Physical Activity Questionnaire and the Health-Promoting Lifestyle Profile. Sample groups comprised teachers, nurses, social workers and public sector managers. Participants aged between 35 and 45 years were allocated to the older generation group (n = 111), whilst those aged between 18 and 21 years (students in the mentioned professional fields) were allocated to the younger generation group (n = 69). The results indicated that these women displayed lower levels of health-promoting behavioural practices than expected, significantly lower levels of physical activity and significantly higher levels of overweight and obesity than the South African norms. The observation that the younger group appeared to be replicating the patterns of the older women is a cause of concern. Greater compliance to health-promoting behaviours was expected in this group owing to participants' professional involvement in health, education and social development fields. Wide-ranging initiatives are necessary to promote physical activity and health amongst the Black female population in South Africa.<hr/>Gedurende die afgelope jare het navorsing onder die Swart bevolking 'n toename in gesondheidsrisiko's wat met fisieke onaktiwiteit geassosieer is, getoon. Swart vroue, wat die hoogste vlakke van onaktiwiteit, oorgewig en obesiteit toon, blyk ook die grootste risiko te loop om leefstylverwante chroniese siektes te ontwikkel. Hierdie ondersoekend-beskrywende studie het die fisieke aktiwiteitspatrone en gesondheidstatus van twee generasies van Swart professionele vroue ondersoek. Die tweegenerasiesteekproef verteenwoordig voor- en na-demokrasie-ouderdomsgroepe. Kwantitatiewe meetinstrumente, naamlik die ActiGraph GT1M versnellingsmeter, Globale Fisieke Aktiwiteitsvraelys en die Gesondheidsbevorderende Leefstylprofiel is gebruik. Die steekproef het onderwysers, verpleegkundiges, maatskaplike werkers en bestuurders in die openbare sektor ingesluit. Deelnemers tussen 35 en 45 jaar is aan die ouergenerasie-toetsgroep toegewys (n = 111), terwyl dié tussen 18 en 21 jaar (studente in bogenoemde studierigtings) aan die jongergenerasie-toetsgroep toegewys is (n = 69). Die resultate het gewys dat die Swart professionele vroue laer as verwagte gesondheidsbevorderende gedrag, betekenisvol laer vlakke van fisieke aktiwiteit en betekenisvol hoër vlakke van oorgewig en obesiteit toon as die Suid-Afrikaanse norme. Die waarneming dat die jonger groep dieselfde gedragspatrone as die ouer vroue getoon het, is h bron van kommer. h Groter nakoming van gesondheidsbevorderende gedrag is onder die jonger groep vroue verwag, aangesien hulle hul opleiding in die professionele sektor van gesondheid, onderwys en maatskaplike werk ontvang. h Holistiese benadering is nodig om fisieke aktiwiteit en gesondheid onder Swart Suid-Afrikaanse vrouens te bevorder. <![CDATA[<b>Scoring clinical competencies of learners: A quantitative descriptive study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100010&lng=es&nrm=iso&tlng=es This article reports the correlation between different clinical assessors' scoring of learners' clinical competencies in order to exclude any possible extraneous variables with regard to reasons for poor clinical competencies of learners. A university in Gauteng, South Africa provides a learning programme that equips learners with clinical knowledge, skills and values in the assessment, diagnosis, treatment and care of patients presenting at primary health care (PHC) facilities. The researcher observed that, despite additional clinical teaching and guidance, learners still obtained low scores in clinical assessments at completion of the programme. This study sought to determine possible reason(s) for this observation. The objectives were to explore and describe the demographic profile of learners and the correlation between different clinical assessors' scoring of learners. A purposive convenience sample consisted of learners (n = 34) and clinical assessors (n = 6). Data were collected from learners using a self-administered questionnaire and analysed using a nominal and ordinal scale measurement. Data from clinical assessors were collected using a checklist, which was statistically analysed using a software package. The variables were correlated to determine the nature of the relationship between the different clinical assessors' scores on the checklist to ensure inter-rater reliability. Findings showed that there was no significant difference in the mean of the scoring of marks between clinical assessors after correlation (p < 0.05). Thus, scoring of marks did not contribute to poor clinical competencies exhibited by learners.<hr/>Hierdie artikel beskryf die ondersoek na die korrelasie tussen verskillende kliniese assesseerders se puntetoekenning tydens assessering van leerders se kliniese vaardighede ten einde enige moontlike vreemde veranderlikes met betrekking tot redes vir swak prestasie uit te skakel. 'n Universiteit in Gauteng, Suid-Afrika bied 'n leerprogram aan wat leerders toerus met kliniese kennis, vaardighede en waardes in die beraming, diagnose, behandeling en sorg van pasiënte in primêre gesondheidsorgfasiliteite (PGS). Die navorser het waargeneem dat, ten spyte van addisionele kliniese onderrig en begeleiding, leerders steeds teen die einde van die program lae punte in kliniese evaluasies behaal het. Die studie het die moontlik rede(s) vir hierdie waarneming ondersoek. Die doel van die studie was om die demografiese profiel van leerders, sowel as die korrelasie van die puntetoekenning deur verskillende kliniese assesseerders, te verken en te beskryf. 'n Doelbewuste gerieflikheidsteekproef het uit leerders (n = 34) en kliniese beoordelaars (n = 6) bestaan. Data is versamel deur leerders individueel 'n vraelys te laat voltooi. Hierdie data is met behulp van n nominale en rangorde-skaal geanaliseer. Kliniese assesseerders het 'n kontrolelys voltooi en data is met behulp van 'n statistiese sagtewarepakket geanaliseer. Die veranderlikes is vergelyk om die aard van die verhouding tussen die verskillende kliniese assesseerders se tellings op die kontrolelys te bepaal. Dit is gedoen om interbeoordeelaarbetroubaarheid te verseker. Resultate het getoon dat daar geen statisties beduidende verskille tussen die gemiddelde puntetoekenning van verskillende kliniese assesseerders bestaan het na korrelasie nie (p < 0.05). Die puntetoekenning het dus nie tot die swak kliniese vaardighede van die leerders bygedra nie. <![CDATA[<b>The development of an instrument to measure women's experience of an aerobic dance class</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100011&lng=es&nrm=iso&tlng=es The purpose of the study was to pilot an instrument to measure women's experience in an aerobic dance class with regard to their descriptions of the general atmosphere, the music, the dance moves and routines, and the instructor. In addition, the participants were asked to rate a list of exercise benefits in order of personal importance. A sample of 27 women, ranging in age from 25 to 60 years participated in this pilot study. The women responded with positive endorsements for all aspects of the overall dance experience, but their most affirming descriptions revolved around the instructor. There was an almost unanimous agreement amongst the participants about the importance of the instructor's role in their experience of the class. Their responses to the open-ended questions supported these sentiments. The mental and physical benefits were rated as important for most of the women whilst a much lower percentage rated the social benefit as important. Two items in the semantic differential posed problems but the instrument showed promise in eliciting key aspects of women's experience in an aerobics dance class.<hr/>Die doel van die studie was om 'n instrument daar te stel wat die ervaring van vroue in 'n fiksheidsdans-klas meet: hulle ervaring ten opsigte van die algemene atmosfeer en die musiek, asook hulle opinie oor die dans-roetines en -bewegings en die instrukteur. Die deelnemers is ook gevra om 'n lys te maak van die voordele van oefening met verwysing na hulleself. 'n Steekproef van 27 vroue tussen die ouderdomme van 25 tot 60 jaar is in hierdie loodsstudie gebruik. Die vroue het positief gereageer op alle aspekte van die algehele dansondervinding, maar hul mees positiewe ervaring was gesentreer om die instrukteur. Verder was hulle opinie rakende die belangrikheid van die instrukteur se rol in hul ondervinding van die klas byna dieselfde. Hulle antwoorde op die oop-einde vrae het hierdie sentimente ondersteun. Die psigiese en fisiese voordele is as die belangrikste deur die meeste vroue aangedui, terwyl 'n veel laer persentasie die sosiale voordeel as belangrik beskou het. Afgesien van twee problematiese items in die semantiese differensiasie, het die instrument belofte getoon om sleutelaspekte van vroue se persepsies van 'n fiksheidsdansklas te identifiseer. <![CDATA[<b>A survival analysis of South African children under the age of five years</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100012&lng=es&nrm=iso&tlng=es The South African Demographic Health Survey data set (SADHS) of 2003 contains massive individual-level information on South African children under the age of five years selected from a random sample of 7756 households. The data set contains data on socio-economic, demographic, health-related and sanitary variables gathered by using multistage cluster sampling. The objective of the study was to identify key predictors of mortality amongst children under the age of five years. Logistic regression analysis and Cox regression were used for data analysis. Under-five mortality was significantly influenced by three predictor variables (breastfeeding, marital status, and ownership of a flush toilet). The hazard ratio of the variable 'breastfeeding' was 3.09 with P = 0.000 and 95% confidence interval (CI) of (1.899, 5.033). The hazard ratio of the variable 'toilet' was 2.35 with P = 0.016 and 95% confidence interval of (1.172, 4.707). The hazard ratio of the variable 'marital status' was 1.74 with P = 0.035 and 95% confidence interval of (1.041, 2.912). Adjustment was factored in for the mother's level of education and wealth index. <![CDATA[<b>An exploration of personal, relational and collective well-being in nursing students during their training at a tertiary education institution</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100013&lng=es&nrm=iso&tlng=es The well-being of nursing students has become crucial because of the multidimensional challenges that nursing professionals have to deal with. A community psychology framework was adopted in this study. The aim of the research was to explore the different dimensions of well-being as described by nursing students. A purposive and availability sample was used to gather qualitative data (interviews, focus groups and visual presentations) during 2008 and 2010 from first-year nursing students, which were thematically analysed. The emergent themes were grouped according to personal, relational and collective well-being. The findings indicated that nursing students' personal well-being was undermined by a lack of autonomy, feelings of uncertainty, and feelings of pressure and disillusionment with the nursing profession and their training. Personal well-being was also described in terms of dispositional optimism and the need for a sense of purpose and deeper meaning. Relational well-being was expressed by the nursing students in relation to their friends, family and lecturers. The different relationships were important sources of comfort and encouragement. Their collective well-being was threatened by a challenging work environment, lack of role models in clinical settings as well as incongruence between theoretical training and practical application. Recommendations for improving the different dimensions of well-being are suggested.<hr/>Die welsyn van verpleegkundestudente het deurslaggewend geword as gevolg van die uiteenlopende uitdagings wat verpleegkundiges moet hanteer. 'n Gemeenskapsielkunde raamwerk is in hierdie studie gebruik. Die doel van die navorsing was om die verskillende dimensies van welsyn van verpleegkundestudente te ondersoek. 'n Doelgerigte en beskikbaarheidsteekproef is gebruik om kwalitatiewe data (onderhoude, fokusgroepe en visuele voorstellings) wat gedurende 2008 en 2010 van eerstejaar-verpleegkundestudente bekom is, deur middel van tematiese inhoudsontleding te analiseer. Die temas wat na vore gekom het, is gegroepeer volgens persoonlike, verhoudings- en gemeenskaplike welsyn. Die bevindinge het aangedui dat die verpleegkundestudente se persoonlike welsyn ondermyn word deur 'n gebrek aan outonomie, gevoelens van onsekerheid en om onder druk te verkeer, asook 'n ontnugtering met die verpleegkunde professie en opleiding. Persoonlike welyn is ook beskryf in terme van 'n optimistiese ingesteldheid en die behoefte aan sinvolheid en 'n dieper betekenis. Verhoudingswelsyn is deur die verpleegkundestudente uitgedruk in terme van hulle verhouding met hul vriende, familie en dosente. Die verskillende verhoudings word as belangrike bronne van ondersteuning en aanmoediging geag. Gemeenskaplike welsyn word bedreig deur 'n uitdagende werksomgewing, die afwesigheid van rolmodelle in die kliniese omgewings asook die teenstrydigheid van die teoretiese opleiding met die praktiese toepassing daarvan. Aanbevelings vir die bevordering van welsyn in die verskillende dimensies word voorgestel. <![CDATA[<b>Nigerian health workers' views concerning factors influencing paediatric adherence to anti-retroviral therapy</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100014&lng=es&nrm=iso&tlng=es Few studies have focused on paediatric anti-retroviral therapy (ART) adherence in Nigeria, probably because of the ethical challenges involved in studying children. The study aimed to identify factors that influence paediatric ART adherence as perceived by health care workers providing ART services in two cities in Nigeria. Knowledge about such factors would be used to formulate recommendations for enhancing paediatric ART adherence in Nigeria, for facilitating the tasks of the health care workers and for enhancing the ART programme's effectiveness. An exploratory descriptive qualitative research design was used to identify and to describe health care workers' views in Kano and Lagos, Nigeria. Three focus group discussions were conducted at two clinics that provide free paediatric ARVs (antiretroviral drugs). The transcribed data were analysed by using the framework approach of data analysis. Health care providers perceived poverty, illiteracy, stigma, discrimination, inappropriate care approaches, and parental dynamics as factors that influence paediatric ART adherence. Paediatric ART adherence levels in Nigeria could be enhanced by emphasising paediatric ART adherence counselling and by adopting a comprehensive family centred care approach, by improving free paediatric ART services and by empowering parents and reducing stigma and discrimination.<hr/>Min studies het al op pediatriese anti-retrovirale behandeling (ARB) nakoming in Nigerië gefokus, wat moontlik toegeskryf kan word aan die etiese uitdagings betrokke by die bestudering van kinders. Die studie het gepoog om faktore te identifiseer wat pediatriese ARB nakoming kan beïnvloed, soos waargeneem deur gesondheidsdienswerkers wat ARB dienste verskaf in twee stede in Nigerië. Kennis van sulke faktore sal aangewend word om aanbevelings te maak om die pediatriese ARB nakoming in Nigerië te verbeter, om die taak van die gesondheidsorgwerkers te vergemaklik en om die ARM (anti-retrovirale medisyne) program se doeltreffendheid te verbeter. 'n Verkennende beskrywende kwalitatiewe navorsingsontwerp was benut ten einde gesondheidswerkers in Kano en Lagos, Nigerië, se standpunte te identifiseer en te beskryf. Drie fokusgroepbesprekings is gehou in twee klinieke wat gratis ARMs verskaf. Die getranskribeerde data is ontleed deur die raamwerkbenadering tot data analise te gebruik. Gesondheidsdienswerkers het waargeneem dat armoede en ongeletterdheid, stigma en diskriminasie, ontoepaslike sorgbenaderings en ouerlike dinamika, faktore was wat pediatriese ARB nakoming beïnvloed het. Pediatriese ARB nakomingsvlakke in Nigerië kan verbeter word deur pediatriese ARB nakomingsberading te beklemtoon, deur die aanvaarding van 'n omvattende gesinsgesentreerde sorgbenadering wat gratis ARB dienste bied, deur die verbetering van ARB dienste, die bemagtiging van ouers en die vermindering van stigma en diskriminasie. <![CDATA[<b>Exploring the needs and resources of children in a haematology-oncology unit</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100015&lng=es&nrm=iso&tlng=es Too often a child's body is restored to health in the hospital, but the child is sent home with emotional wounds. This study explored the needs of children in a haematology-oncology unit as well as the resources that could be mobilised in order to address these needs by firstly carrying out a literature review. A field study was then conducted in order to prioritise the resources according to their importance for children in a haematology-oncology unit. A definite trend could be found in the way that the children responded to the request to prioritise the resources. The first three resources, as chosen by the children, all concerned the external social environment of the child. It could therefore be concluded that support from parents and other people of significance are most important to the child and should be taken into account when facilitating support for children in a haematology-oncology unit. It could also be concluded that these children do not experience sufficient control in their situation and it could therefore be suggested that children in a haematology-oncology unit should experience more control and power in their situation.<hr/>So dikwels word 'n kind se liggaam genees in die hospitaal, maar hierdie selfde kind gaan huis toe met emosionele wonde. Die behoeftes van kinders in 'n hematologie-onkologie eenheid is ondersoek asook die hulpbronne wat gemobiliseer kan word om hierdie behoeftes aan te spreek deur gebruik te maak van 'n literatuurstudie. Daarna is 'n veldstudie gedoen om hierdie hulpbronne te prioritiseer volgens die belangrikheid daarvan vir kinders in 'n hematologie-onkologie eenheid. Die manier waarop die kinders die hulpbronne geprioritiseer het, het 'n definitiewe tendens getoon. Die eerste drie hulpbronne wat deur die kinders gekies is, is al drie hulpbronne wat die eksterne sosiale omgewing van die kind behels. Die gevolgtrekking kan dus gemaak word dat die ondersteuning van ouers en ander persone wat belangrik is vir die kind, van uiterste belang is en in aanmerking geneem behoort te word in die fasilitering van ondersteuning van kinders in 'n hematologie-onkologie eenheid. Die gevolgtrekking wat gemaak kan word is dat hierdie kinders nie genoeg beheer ervaar in hulle situasie nie en daarom word voorgestel dat kinders in 'n hematologie-onkologie eenheid meer bemagtig behoort te word gegewe hulle omstandighede. <![CDATA[<b>A closer look at racial differences in the reporting of self-assessed health status and related concepts in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100016&lng=es&nrm=iso&tlng=es South Africa's populace is characterised by large differences in health, with vast inequalities between members of different groups that can be identified by using a number of tested health indicators, with self-assessed health (SAH) status amongst them. Generally, the average White person's health, however measured, is considerably better than that of Black African persons with the health of Indian and Coloured persons somewhere between the two. Typically, this pattern is attributed to the continued association between race and socio-economic status. Recent empirical work conducted, however, seems to cast doubt on the validity of the assumption that SAH can be compared directly across members of different groups. In light of this concern, and the challenge which it poses to the interpretation of the results of much current South African empirical work, this article explores possible systematic differences with respect to the perception and reporting of SAH between members of different race groups in South Africa. Using data drawn from a nationally representative survey of approximately 3000 respondents, this study analysed racial differences in SAH alongside domain-specific SAH and attitudes to a number of health-related areas (e.g. reference groups, perceptions of main influences on health, etc.). The analysis revealed a number of differences when compared to the usual racialised pattern observed. It is held that these differences suggest that there might be a role for race to play in the assessment and reporting of SAH independently of its continued association with socio-economic status.<hr/>Suid-Afrikaners word gekenmerk deur groot verskille in die gesondheidsvlakke van die bevolking, met beduidende ongelykhede tussen die verskillende bevolkingsgroepe wat geïdentifiseer kan word met behulp van vele beproefde gesondheidsaanwysers, onder meer self-geassesseerde gesondheid (SAH)-status. Die gemiddelde Wit persoon se gesondheid is, nieteenstaande die maatstaf, aansienlik beter as dié van 'n Swart-Afrikaanse person, met die gesondheid van die Indiër persoon en Kleurling persoon wat êrens tussen die twee groepe lê. Hierdie tendens word tipies toegeskryf aan die voortgesette assosiasie tussen ras en sosiaal-ekonomiese status Onlangse empiriese werk werp egter twyfel op die geldigheid van die veronderstelling dat SAH van lede van verskillende groepe direk met mekaar vergelyk kan word. In die lig hiervan en die uitdaging wat dit inhou vir die interpretasie van die resultate van 'n baie onlangse Suid-Afrikaanse empiriese studie, ondersoek hierdie artikel moontlike sistematiese verskille met betrekking tot die persepsie en rapportering van SAH tussen mense van verskillende rassegroepe in Suid-Afrika. Data vanuit 'n nasionale verteenwoordigende opname van ongeveer 3000 respondente is in hierdie studie gebruik. Die studie ontleed hierdie rasseverskille in SAH tesame met die domein-spesifieke SAH asook die gesindhede ten opsigte van 'n aantal van die gesondheidsverwante gebiede (bv. verwysingsgroepe, die persepsies van die belangrikste invloede op gesondheid ens.) Die analise het 'n aantal verskille getoon in vergelyking met die gewone patroon wat op ras gebaseer is. Daar is van mening dat hierdie verskille daarop dui dat ras dalk tog 'n rol speel in die evaluering en rapportering van SAH, ongeag die voortgesette assosiasie met sosiaal-ekonomiese status. <![CDATA[<b>A surveillance of needle-stick injuries amongst student nurses at the University of Namibia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100017&lng=es&nrm=iso&tlng=es Needle-stick injuries have the potential to change a student nurse's life; yet they are dealt with covertly and many go unreported. This could create difficulties when evaluating a curriculum, because potential risk issues in nursing education might go undetected. In addition, needle-stick injuries are inherently preventable occupational health hazards. The fact that there has been, until now, no information available on the incidence of, and context in which needle-stick injuries occur amongst student nurses in Namibia, is of particular concern for nurse educators in that country. The purpose of this study was therefore to determine the incidence of needle-stick injuries and to describe the context of their occurrences. A framework known as Haddon's matrix made it possible to approach this survey from both an occupational and a nursing education perspective. The questionnaire was completed by 198 students and it was found that, during 2008 alone, 17% of student nurses sustained needle-stick injuries, but only 55% of these reported it. In addition, in 55% of the occasions on which the student nurses were injured, they were not accompanied by a registered nurse. The recommendations made are based on the three phases of Haddon's matrix, namely pre-injury, injury and post-injury phases. These recommendations focussed on student accompaniment by registered nurses, the completion of reflective exercises, sensitisation sessions before placement in clinical areas, as well as the utilisation of independent student counsellors.<hr/>Enige naaldprik-insident kan 'n groot omwenteling in 'n student-verpleegkundige se lewe te weeg bring. Ten spyte hiervan word sodanige insidente nie openlik hanteer nie, en dikwels word dit nie eers gerapporteer nie. Dit mag egter kurrikulering-evaluerings kompliseer want potensiële risiko-aspekte in verpleegonderwys mag dalk nie geidentifisser word nie. Naaldprik-ongelukke is in wese beroepsgesondheidsaspekte, wat inherent voorkombaar is. Dit was dan ook 'n bron van kommmer onder verpleegopvoeders in Namibië, aangesien geen inligting beskikbaar was oor die voorkoms en konteks van naaldprik-ongelukke onder student-verpleegkundiges in Namibië nie. Die doel van hierdie studie was dus on die voorkoms en konteks waarbinne naaldprik-ongelukke plaasvind te beskryf. Daar was reeds a raamwerk beskikbaar, naamlik die Haddon-matriks. Diè raamwerk het dit moontlik gemaak om die opname te benader vanuit sowel 'n beroepsgesondheids-perspektief as 'n verpleegopvoedkundige perspektief. Die vraelys is voltooi deur 198 studente en van die bevindings was dat gedurende 2008 alleen, 17% van die student-verpleegkundiges naaldprik-insidente gehad het, maar dat slegs 55% van die beseerdes dit aangemeld het. Daar is ook gevind dat in 55% van die gevalle, hulle nie deur 'n geregistreerde verpleegkundige vergesel was nie. Aanbevelings wat gemaak is, is gebaseer op die drie fases van die Haddon-matriks, naamlik die voor-beserings-fase, die beserings-fase en die na-beserings-fase. Die aanbevelings is gefokus op student-begeleiding, reflektiewe oefeninge, sensitiseringsessies voor die plasings in kliniese areas, asook ondersteuning van 'n onafhanklike berader. <![CDATA[<b>Yes, breast cancer related lymphoedema can be managed</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100018&lng=es&nrm=iso&tlng=es The purpose of the study was to demonstrate that breast cancer related lymphoedema can be managed by means of Complete Decompression Therapy and consequently improve quality of life. An instrumental case study design was used. The target population was all women with breast cancer related lymphoedema living in Tshwane, the context of the study. The patient with the most severe breast cancer related lymphoedema treated by the researcher is presented. Mixed methods were used to gather data. The expected 60% limb volume reduction could not be achieved after 4 weeks of induction therapy. After 8.5 weeks of treatment, the limb volume reduced from the initial 3841 mL to 1639 mL, a 57.2% reduction. Patient compliance to compression therapy was a challenge and led to relapse extending the induction phase of treatment. Despite the prolonged treatment, the limb volume reduction improved the patient's quality of life. The study demonstrated and confirmed that despite a degree of non-compliance, breast cancer related lymphoedema can be managed with Complete Decongestive Therapy which, in turn, improves the quality of life of women living with breast cancer.<hr/>Die doelstelling van die studie was om te demonstreer dat borskanker-verwante limfedeem deur middel van Volledige Dekompressie Terapie beheer kan word wat gevolglik die pasiënt se lewenskwaliteit verbeter. 'n Instrumentele gevallestudie-ontwerp is gevolg. Die populasie waaruit die geval gekies is, het uit alle vroue met borskanker-verwante limfedeem in Tshwane, die konteks van die studie, bestaan. Die pasiënt met die ergste limfedeem wat die navorser behandel het, word voorgedra. Gekombineerde metode is ingespan om data in te samel. Die verwagte 60% vermindering in die armedeem binne 4 weke van induksie behandeling is nie bereik nie. Na 8.5 weke van behandeling het die edeem van die oorspronklike 3841 mL tot 1639 mL verminder wat 'n 57.2% reduksie verteenwoordig. Die pasiënt het nie die voorskrifte ten opsigte van dekompressie terapie noukeurig nagekom nie, wat terugvalling en 'n verlengde induksie-fase tot gevolg gehad het. Die vermindering van die armedeem het die pasiënt se lewenskwaliteit nogtans positief beïnvloed. Die studie het aangetoon dat, ten spyte van pasiënt afvalligheid, dit moontlik was om borskanker-verwante limfedeem deur middel van Volledige Dekompressie Terapie te verminder en lewenskwaliteit te verbeter. <![CDATA[<b>The prevalence of resilience in a group of professional nurses</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100019&lng=es&nrm=iso&tlng=es The literature and practice show that many professional nurses feel emotionally overloaded and are experiencing job dissatisfaction, which often results in them leaving the profession. Paradoxically, some nurses choose to remain in nursing and survive, cope and even thrive despite their unique workplace adversities. It is, however, not known what the prevalence of resilience amongst nurses is, and what influence working in private versus public contexts has on this resilience. The aims of this study were to determine the prevalence of resilience in a group of professional nurses, to determine whether private versus public contexts played a role in nurses' resilience, and to obtain an indication of participants' views of their profession and resilience therein. A cross-sectional survey design was used where professional nurses (N = 312) working in public and private hospitals in South Africa voluntarily completed measures of psycho-social well-being as indicators of their degree of resilience. They also answered three open-ended questions on their profession. Results showed moderate-to-high correlations amongst scales, indicating conceptual coherence as indicators of resilience. Prevalence of resilience was determined by normalising the mean scores of the measuring instruments. The total value of the normalised mean scores was given as a fraction (0-1), representing a level of resilience manifested by the participants across all scales. This indicated three levels of resilience: 10% of participants manifested low resilience, 47% moderate resilience and 43% high resilience. Nurses in private health care had significantly (small practical effect) higher levels of resilience than nurses in public health care.<hr/>Die literatuur en praktyk dui daarop dat baie professionele verpleegkundiges emosioneel uitgeput is, werksontevredenheid ervaar en dikwels die beroep verlaat. Paradoksaal kies sommige verpleegkundiges om in die beroep te bly, en floreer selfs ten spyte van hul unieke en moeilike werksomstandighede. Dit is egter nie bekend wat die voorkoms van veerkragtigheid in verpleegkundiges is nie, of wat die invloed van werk in privaat versus die openbare omgewing op veerkragtigheid is nie. Die doelwitte van die studie was om die voorkoms van veerkragtigheid in 'n groep professionele verpleegkundiges te bepaal, om die rol van privaat versus openbare omgewings in veerkragtigheid te bepaal, en om 'n aanduiding van deelnemers se siening oor hul professie en veerkragtigheid daarin, te bekom. 'n Dwarsdeursnit ontwerp was gebruik waarin professionele verpleegkundiges (N = 312) werksaam in openbare of privaat hospitale in Suid-Afrika vrywillig vraelyste oor psigososiale welstand as aanduiders van die vlak van veerkragtigheid, voltooi het. Hulle het ook drie oop-einde vrae oor hul beroep beantwoord. Bevindinge het op matige tot hoë korrelasies tussen skale gewys wat dui op konseptuele koherensie tussen die indikatore van veerkragtigheid. Veerkragtigheid is bereken deur normalisering van die gemiddelde tellings vir die meetinstrumente van al die skale. Die totale waarde van genormaliseerde gemiddeldes was as 'n fraksie (0-1) uitgedruk. Drie vlakke van veerkragtigheid het gemanifesteer, 10% van die deelnemers het met lae veerkragtigheid gemanifesteer, 47% met matige veerkragtigheid en 43% met hoë veerkragtigheid. Verpleegkundiges in privaat gesondheidsorg het beduidende (klein praktiese waarde) hoër vlakke van veerkragtigheid getoon as verpleegkundiges in openbare gesondheidsorg. <![CDATA[<b>Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100020&lng=es&nrm=iso&tlng=es Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir-ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years &gt; age < 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.<hr/>Huidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot 'n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in 'n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van 'n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir-ritonavir met 'n VDD van 1066.4/264 mg en efavirens met 'n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is 'n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom. <![CDATA[<b>Experiences of being a therapy radiographer</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100021&lng=es&nrm=iso&tlng=es The purpose of this research was to explore and describe how therapy radiographers experience their profession. A qualitative, exploratory, descriptive and contextual design was utilised. The purposive sample consisted of 14 therapy radiographers employed at an academic hospital in Gauteng, South Africa. Data were collected using focus group interviews until data saturation was achieved. An appreciative inquiry interview technique was utilised, and data analysis was conducted by open coding to identify themes. Themes that were identified were life-giving forces that promote personal and professional engagement resulting in a sense of purpose; professional stagnation; and facilitating change through harnessing positive energy and commitment for change.<hr/>Die hoofdoel van hierdie navorsing is om te verken en beskryf hoe radioterapeute hulle beroep beleef. 'n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp is gebruik. Die doelgerigte steekproef het bestaan uit 14 radioterapeute werksaam by 'n akademiese hospitaal in Gauteng, Suid Afrika. Data is met behulp van fokusgroep onderhoude ingesamel totdat dataversadiging bereik is. 'n 'Appreciative inquiry' onderhoudstegniek is gebruik met die stel van vrae, en data analise is met behulp van oop kodering gedoen om temas te identifiseer. Die temas wat geidentifiseer was is lewensgewende magte wat persoonlike en professionele betrokkenheid bevorder wat 'n singewing tot gevolg het; professionele stagnering; en fasilitering van verandering deur die gebruikmaking van positiewe energie en toewyding vir verandering. <![CDATA[<b>A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African community</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362011000100022&lng=es&nrm=iso&tlng=es The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (http://www.ebsco.co), which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.<hr/>Die status van ouer volwassenes in Afrika beklee'n klein, maar vinnig groeiende deel van die globale verouderings literatuur. Die menslike immuniteitsgebreksvirus (MTV) en verworwe immuniteitsgebreksindroom (VIGS) pandemie het 'n nuwe fokus op die veranderende rol van bejaardes in die gemeenskap wat deur VIGS beïnvloed word, gegenereer. In sub-Sahara Afrika waar na beraming miljoene geïnfekteer word met MIV, met sowat twee miljoen sterftes jaarliks gerekordeer onder die tradisoneel produktiewe volwassenes, word daar van die kinders en bejaardes verwag om ongewone verantwoordelikhede op hulle te neem as gevolg van die verlies aan ouers of broodwinners. 'n Literatuuroorsig wat handel oor bejaardes en MIV en VIGS het die geanaliseerde data voorsien vir hierdie artikel. Toegang tot die databasis was meestal deur EBSCO (http://www.ebsco.co) wat soektog toegelaat het tot groot databasisse en soekenjins wat bruikbaar in die akademiese opset is en die vind van artikels aangaande gesondheid, gesondheidverwante akademiese joernale en argief verslae. Bevindings toon dat die VIGS pandemie direkte en indirekte effekte het. Hierdie effekte manifisteer in 'n stel sosiaal verwante, ekonomiese en psigologiese dimensies wat ten einde 'n impak op die gesondheid en welstand van bejaardes het. Daar is tot die gevolgtrekking gekom dat meer gedoen moet word om die kennis basis van MIV en VIGS te artikuleer om die sosiale, ekonomiese en politiese beleid in kennis te stel, om sodoende die resulterende probleme van MIV en VIGS op die bejaarde Afrika populasie te verlig.