Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620120001&lang=pt vol. 17 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>The experiences of AIDS orphans living in a township</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100001&lng=pt&nrm=iso&tlng=pt An overwhelming challenge to health-care professionals today, is the rendering of care services to AIDS orphans. This article is based on a study that explored and described the lived experiences of AIDS orphans in a township in order to understand their 'life world' as AIDS orphans. A further purpose was to provide information to primary health-care nurses (PHCNs), related professionals and partners involved in the care of these children, so that they could plan a care response to meet the orphans' unique needs. A qualitative research design that used an explorative, descriptive, contextual and phenomenological strategy of inquiry was employed. Data were collected by means of in-depth interviews from a purposively selected sample, and were analysed according to the steps of qualitative data analysis proposed by Tesch (Creswell 1994). Guba's model was used to ensure the trustworthiness of the qualitative data. Two main themes and their sub-themes were identified. The first theme was that children experience devastating changes in their life circumstances when they become AIDS orphans. The second theme highlighted how the participants rediscovered hope to persevere. Recommendations directed at nursing practice, education and research, were made based upon the findings.<hr/>'n Uitdaging wat professionele gesondheidswerkers huidiglik oorweldig, is dienslewering aan VIGS weeskinders. Die doel van die studie was om die geleefde ervaring van kinders wat in dorpsgebiede woon en VIGS weeskinders geword het, te verken en te beskryf ten einde hul leefwereld te verstaan. Hierdie inligting kan deur Primêre Gesondheidsorg Verpleegkundiges (PVGs), verwante beroepslui en vennote betrokke by die versorging van hierdie kinders, gebruik word as basis om versorging te beplan wat in die kinders se unieke behoeftes sal voorsien. 'n Kwalitatiewe navorsingsontwerp met verkennende, beskrywende, kontekstuele en fenomologiese strategieë van ondersoek, is gebruik. Data is versamel deur middel van in-diepte onderhoude met 'n doelbewus geselekteerde steekproef. Data is geanaliseer ooreenkomstig die stappe van kwalitatiewe data analise volgens Tesch (in Creswell 1994). Guba se model was gebruik om die betroubaarheid van data te bepaal. Twee hooftemas en hul subtemas is geïdentifiseer. Die eerste tema was dat kinders dramatiese veranderinge in hulle lewensomstandighede ervaar wanneer hulle VIGS weeskinders word. Die tweede tema wat na vore gekom het, was hoe die deelnemers die hoop om voort te gaan met die lewe, herontdek het. Aanbevelings, gebaseer op die bevindinge, is gemaak wat verpleegpraktyk, onderrig en navorsing sal rig. <![CDATA[<b>Exploring the perceptions of psychiatric patients regarding marijuana use</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100002&lng=pt&nrm=iso&tlng=pt There is limited understanding on marijuana use by psychiatric patients, specifically with regard as to why they continue to smoke marijuana despite the negative consequences, such as readmittance to psychiatric hospitals following marijuana-induced psychosis. It is, therefore, important to understand why psychiatric patients continue to use marijuana, despite experiencing its negative effects. The purpose of this study was to explore and describe the perceptions of psychiatric patients with regard to marijuana use in Potchefstroom, North West Province, as well as to formulate recommendations for nursing education, nursing research and nursing practice, with the aim of reducing the readmission of psychiatric patients following marijuana-induced psychosis. A qualitative, exploratory, descriptive and contextual research design was followed in order to give 'voice' to the perceptions of psychiatric patients about marijuana use. Purposive sampling was utilised to identify participants who complied with selection criteria. The sample size was determined by data saturation, which was reached after 10 individual interviews with psychiatric patients. Unstructured individual interviews were utilised to gather data after written approval from the Ethics committee of the North-West University (Potchefstroom Campus), North West Provincial Department of Health, the clinical manager of the psychiatric hospital where data were collected, as well as from the psychiatric patients. The co-coder and the researcher analysed the data independently. The findings of this study include perceptions of psychiatric patients on the use of marijuana, the negative effects of marijuana use, marijuana use and mental illness, and quitting marijuana. Recommendations were formulated for nursing education, nursing research as well as for nursing practice.<hr/>Insig in die gebruik van marijuana deur psigiatriese pasiënte is beperk, spesifiek met betrekking tot hulle redes vir voortgesette marijuana verbruik ten spyte van die negatiewe gevolge daarvan, byvoorbeeld hertoelating tot psigiatriese hospitale na marijuana-geïnduseerde psigotiese episodes. Dit is dus belangrik om te verstaan waarom psigiatriese pasiënte voortgaan om marijuana te gebruik ten spyte van die negatiewe uitwerking daarvan. Hierdie navorsing was ten doel om die persepsies van psigiatriese pasiënte in verband met die gebruik van marijuana in Potchefstroom in die Noordwesprovinsie te verken en te beskryf. So kan aanbevelings gemaak word vir verpleegonderrig, verpleegnavorsing en verpleegpraktyk om meer toepaslike versorging en behandeling te verseker en uiteindelik die heropname van psigiatriese pasiënte as gevolg van marijuana-geïnduseerde psigose te verminder. 'n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp is gevolg om 'n 'stem' te gee aan die persepsies van psigiatriese pasiënte aangaande die gebruik van marijuana. Doelgerigte steekproefneming is gebruik om deelnemers te identifiseer wat sou voldoen aan seleksiekriteria. Die steekproefgrootte is bepaal deur dataversadiging, wat bereik is na 10 individuele onderhoude met psigiatriese pasiënte. Ongestruktureerde individuele onderhoude is gebruik om data te versamel ná geskrewe toestemming van die Etiekkomitee van die Noordwes-Universiteit (Potchefstroom Kampus), van die Noordwes Provinsiale Departement van Gesondheid, die Kliniese bestuurder van die psigiatriese hospitaal waar die data versamel is, sowel as van die psigiatriese pasiënte. Die medekodeerder en die navorser het die data onafhanklik van mekaar geanaliseer. Die bevindings van hierdie studie het die persepsies wat psigiatriese pasiënte het oor die gebruik van marijuana, die negatiewe effekte van die gebruik van marijuana, die gebruik van marijuana en psigiatriese toestande, en die staking van die gebruik van marijuana, uitgelig. Aanbevelings is geformuleer vir verpleegonderrig en verpleegnavorsing, sowel as vir die praktyk van verpleegkunde. <![CDATA[<b>The expectations of fathers concerning care provided by midwives to the mothers during labour</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100003&lng=pt&nrm=iso&tlng=pt Midwives have been criticised for neglecting the expectations and needs of fathers. They either ignore the fathers or pressure them into becoming more involved than they would choose, if allowed to provide support to the mothers during labour. Whilst midwives are providing woman-centred care, it is important that they remember to involve the fathers in decision-making and to acknowledge their role, expectations and needs, because the birth of a child is one of the most important events in a person's lifetime. This study focused on fathers' expectations of the care provided to mothers by the midwives during labour. A qualitative, explorative, descriptive and contextual study design was utilised. In-depth qualitative interviews were conducted with fathers about the care provided to their partners or wives by midwives. Data were then analysed with an open descriptive method of coding that is appropriate for qualitative research. The results of the interviews were subsequently positioned within a holistic health-promotive nursing theory that encompassed body, mind and spirit. The results revealed that fathers saw the provision of comfort and support as the two main aspects for mothers in labour that they expected from midwives. The findings were that midwives should improve their communication skills with the mothers, as well as with the fathers if they are available. Fathers expected midwives to encourage them to accompany the mother during labour and to facilitate bonding between father, mother and baby. The results of this study should assist midwives to provide holistic quality care to mothers and fathers during labour.<hr/>Vroedvroue word daarvan beskuldig dat hulle nie voldoen aan die verwagtinge en behoeftes van die vaders nie. Vaders word, óf deur hulle geïgnoreer, óf druk word op hulle uitgeoefen om meer betrokke te raak as waarmee hulle gemaklik is, indien hulle wel toegelaat word om moeders te ondersteun tydens die kraamproses. Vroedvroue verskaf moeder-gesentreerde sorg, maar dit is nogtans belangrik dat hulle onthou om die vaders te betrek in die besluitneming en hulle rol, verwagtinge en behoeftes te erken omdat die geboorte van 'n kind een van die belangrikste gebeurtenisse in hulle lewens is. Die studie het gefokus op vaders se verwagtinge van die sorg wat verskaf word aan moeders tydens kraam. 'n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele navorsingsontwerp is gebruik. Data is ingesamel deur in-diepte onderhoude met vaders te voer oor die sorg wat aan hul vroue of metgeselle tydens die kraamproses verskaf word deur vroedvroue. Data is daarna geanaliseer deur 'n oop beskrywende metode te gebruik wat toepaslik is vir kwalitatiewe navorsing. Die resultate van die onderhoude is vervolgens geposisioneer binne 'n holistiese, gesondheids-bevorderende teorie wat verwys na liggaam, psige en gees. Die resultate toon dat gemak en ondersteuning die twee hoofkategorieë is wat verskaf moet word deur vroedvroue aan moeders tydens die kraamproses. Die ander kategorieë wat aangedui word in die resultate, is dat vroedvroue hulle onderlinge kommunikasievaardighede moet verbeter, asook hul kommunikasie met die moeders en vaders indien laasgenoemde beskikbaar is. Die vaders het van vroedvroue verwag om hulle aan te moedig om moeders by te staan tydens die kraamproses en om binding tussen vader, moeder en baba aan te moedig. <![CDATA[<b>Guided reflection as a tool to deal with the theory-practice gap in critical care nursing students</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100004&lng=pt&nrm=iso&tlng=pt Critical care nursing students experience inconsistencies between the theoretical content they have learnt and what is expected from them in practice, which retards the learning process. This has been described as the theory-practice gap. There seems to be no single solution to address the integration of theory and practice. In an attempt to bridge this gap, a study was done to establish the influence of guided reflection on critical care nursing students in dealing with their theoretical and practical experiences. A qualitative, explorative, descriptive and contextual design was followed. An instrument for guided reflection was designed which was used during semi-structured interviews during the data collection process. Field notes and narrative descriptions were also used as means to collect data. Themes that emerged from the data included a description of incidents experienced, critical analysis of knowledge, critical analysis of feelings and changed perspective experienced. Theory-practice integration occurred to an extent in some of the categories; conversely, the inability to apply theory to practice evoked responses such as feelings of guilt and incompetence. Guided reflection appeared to have assisted the participants in clarifying theoretical and practical experiences, and in reaching a changed perspective by understanding the link between theory and practice. Guided reflection ought to be incorporated in the education of nurses from their basic training in theory and practice so that student nurses will be aware of their own competencies in order to provide optimal patient care.<hr/>Kritiekesorgverpleegstudente ervaar teenstrydighede ten opsigte van dit wat hul geleer word en wat van hul in die praktyk verwag word wat weer die leerproses vertraag. Dit word as die teorie-praktykgaping beskryf. Daar blyk geen enkelvoudige oplossing te wees vir die integrasie van teorie en praktyk nie. In 'n poging om die gaping te oorbrug, is 'n studie oor die invloed van begeleide refleksie op kritiekesorgverpleegkundige studente se teoretiese en praktiese ervaringe gedoen. 'n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp is gevolg. 'n Instrument vir begeleide refleksie is ontwerp wat gebruik is tydens semi-gestruktureerde onderhoude in die data-insamelingsproses. Veldnotas en narratiewe beskrywings was ook middele ten einde data in te samel. Tema's wat uit die data na vore gekom het was 'n beskrywing van ervaringe, kritiese analise van data, kritiese analise van gevoelens en 'n veranderde perspektief met betrekking tot ervaringe. Teorie-praktyk integrasie het tot 'n mate in sommige kategorieë plaasgevind het. Daarinteen het die onvermoë om die teorie in die praktyk toe te pas response tot gevolg gehad, soos skuldgevoelens en gevoelens van onbevoegdheid. Dit wil voorkom asof begeleide refleksie die deelnemers gehelp het om duidelikheid en 'n veranderde perspektief ten opsigte van hul teoretiese en praktiese ervaringe te verkry. Begeleide refleksie behoort reeds vanaf basiese opleiding in verpleegkundiges se teoretiese en praktiese opleiding geïnkorporeer te word sodat verpleegkundiges bewus sal wees van hulle eie vaardighede om sodoende optimale pasiëntsorg te kan lewer. <![CDATA[<b>The experience of people with oculocutaneous albinism</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100005&lng=pt&nrm=iso&tlng=pt This article reports the experiences of people with oculocutaneous albinism in South Africa. Oculocutaneous albinism is an inherited disorder characterised by the defective production of melanin, with little or no pigmentation in the skin, hair and eyes. This condition is found globally, with a high prevalence in sub-Saharan Africa and in clusters in South America. People with this condition are often stigmatised and discriminated against owing to myths and superstitions held by the public about the condition. To date no studies have explored the psychosocial aspects of oculocutaneous albinism. A qualitative study was conducted in Johannesburg, South Africa during 2007 where a purposive sample of 15 members of the black population with oculocutaneous albinism participated in in-depth individual phenomenological interviews. One central question was posed to facilitate the interviews: Could you please share your experience as a person with albinism? Data from the interviews were analysed using Collaizi's qualitative data analysis method and three main themes emerged: (1) perceptions of the internal environment, for example the self; (2) experiences in the external environment, for example family and community; and (3) the need for self-development and growth based on their experiences. Recommendations are made to enhance the self-concept of and promote a sense of belonging, self-development and growth in people with oculocutaneous albinism.<hr/>Hierdie aanbieding is 'n verslag oor bevindings van die ervaring van persone met okulokutaneuse albinisme in Suid-Afrika. Okulokutaneuse albinisme is 'n oorerflike afwyking, gekenmerk deur 'n gebrekkige melanien produksie. Daar is min of geen pigmentasie in die vel, hare en oë nie. Hierdie toestand word wêreldwyd aangetref met 'n hoër voorkoms in sub-Sahara Afrika en groepe in Suid Amerika. Mense met hierdie toestand het dikwels 'n stigma en daar word teen hulle gediskrimineer as gevolg van mites en bygelowe van die publiek oor die toestand. Tot datum het geen studies die psigososiale aspek van hierdie toestand ondersoek nie. 'n Kwalitatiewe studie is in Johannesburg, Suid-Afrika uitgevoer in 2007. 'n Doelgerigte steekproef van 15 swart mense met okulokutaneuse albinisme het deel geneem aan in diepte individuele fenomenologiese onderhoude. 'n Sentrale vraag was gestel om die onderhoude te fasiliteer: Kan u asseblief u ervaring as 'n persoon met albinisme deel?"' Data van die onderhoude was geanaliseer deur van Collaizi's se kwalitatiewe data analise metode gebruik te maak. Drie hooftemas het te voorskyn gekom, naamlik: (1) persepsies van die interne omgewing byvoorbeeld die self; (2) ervarings van die eksterne omgewing, byvoorbeeld die familie en die gemeenskap; en (3) die behoefte vir self ontwikkeling en groei gebaseer op hulle ervarings. Aanbevelings is gemaak deur die navorsers om self konsep uit te lig , en om 'n gevoel van 'behoort aan', self ontwikkeling en groei in mense met okulokutaneuse albinisme te bevorder. <![CDATA[<b>HIV and AIDS knowledge and sexual behaviours amongst secondary school learners in Harare, Zimbabwe</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100006&lng=pt&nrm=iso&tlng=pt Efforts to stem the tide of the Human immunodeficiency virus (HIV) and Acquired immune deficiency syndrome (AIDS) pandemic in Africa emphasise the necessity that learners should be able to make informed decisions. Although learners in Zimbabwe's schools are taught about HIV and AIDS, the extent of their knowledge needed to be determined. The major objective was to assess the knowledge of secondary school learners in Harare, Zimbabwe, about HIV and AIDS. Structured interviews were conducted with 75 Grade 8 (Form 1) secondary school learners from four schools in Harare. Most learners had obtained their HIV and AIDS knowledge from schools, but some did so from their parents, community activities, the radio or television. No learner had commenced with sexual activities and all had heard about HIV, but not all knew what HIV was, and even fewer could define AIDS. Less than one-third of the learners could mention the three most important HIV preventive measures. Most learners were willing to undergo voluntary counselling and testing (VCT), but few had done so. As no learner had commenced sexual activities, opportunities existed to empower Grade 8 (Form 1) learners with adequate HIV and AIDS knowledge. Generally the learners' HIV and AIDS knowledge levels were high but some misconceptions existed. Schools should engage with radio and television programmes to address misconceptions about HIV and AIDS. Learners should be enabled to access VCT services. More effective HIV prevention education in Zimbabwe's schools, could enable more youth to remain HIV negative.<hr/>Pogings om die Menslike Immuniteitsgebrekvirus (MIV) en Verworwe immuniteits-gebreksindroom (VIGS) pandemiese golf in Afrika te stuit, beklemtoon die noodsaaklikheid dat leerders ingeligte besluite moet kan neem. Alhoewel leerders in Zimbabwe se skole onderrig word oor MIV en VIGS, behoort die omvang van die kennis vasgestel te word. Die hoofdoelwit was om sekondêre skool leerders van Harare, Zimbabwe, se MIV en VIGS kennis te bepaal. Gestruktureerde onderhoude is gevoer met 75 Graad 8 (Vorm 1) sekondêre skool leerders van vier skole in Harare. Die meeste leerders het hulle MIV and VIGS kennis by skole opgedoen terwyl 'n paar dit van hulle ouers, gemeenskapsaktiwiteite, die radio en televisie gekry het. Geen leerders het met seksuele aktiwiteite begin nie, almal het van MIV gehoor, maar nie almal het geweet wat MIV is nie, en nog minder kon VIGS definieer. Minder as een-derde kon die drie belangrikste MIV voorkomende maatreëls noem. Die meeste leerders was gewillig om vrywillige berading en toetsing (VBT) te ondergaan, maar min het dit reeds gedoen. Aangesien geen leerder seksueel aktief was nie, bestaan geleenthede om Graad 8 (Vorm 1) leerders te bemagtig om ingeligte besluite te neem. Oor die algemeen was die leerders se MIV en VIGS kennisvlakke hoog, maar wanopvattings het bestaan Skole behoort saam te werk met radio en televisie programme ten einde wanopvattings aan te spreek. Leerders moet in staat gestel word om VBT dienste te benut. Doeltreffender MIV en VIGS voorligting in Zimbabwe se skole, kan meer jong mense in staat stel of HIV negatief te bly. <![CDATA[<b>A comparative study of the effects of methamphetamine on memory in existing and recovering addicts from a South African population</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100007&lng=pt&nrm=iso&tlng=pt Memory is a complex of systems by which an organism registers, stores and retrieves exposure to an event or experience. Literature purports that methamphetamine users and dependents have been found to exhibits signs of memory impairment. The aim of the research was to establish the possible existence of significant differences in memory in current methamphetamine users, recovering methamphetamine users, and a matched drug naïve control group. Cognitive functioning was assessed via a neurocognitive test battery that examined the memory of 14 current methamphetamine users, 17 recovering methamphetamine addicts, and 18 drug naïve control participants who were matched according to the demographic variables of age, gender and educational status. The results indicated that recovering methamphetamine users experienced the greatest impairment in memory in comparison to both the control group and current users of methamphetamine. The current users of methamphetamine also experienced some impairment in memory functioning in visual acquisition and retention. The poor performance of the recovering addicts is explained by the juxtaposition of the stimulating and supplemental effect of methamphetamine as experienced by the current users versus the neurotransmitter depletion and structural changes in the brain experienced by the recovering addicts. The control group showed a superior performance since they did not suffer from the neurotoxic effects of methamphetamine.<hr/>Geheue is 'n komplekse sisteem wat 'n individu in staat stel om blootstelling aan 'n voorval of ervarings te registreer, stoor, behou en herroep. Leer- en geheueprobleme is van die mees algemene simptome van neurosielkundige uitvalle in neurologiese en psigiatriese pasiënte. Die literatuur dui aan dat metamfetamienafhanklike verbruikers tipies geheuedisfunksie ervaar. Die doel van die navorsing was om die moontlike voorkoms van verskille in geheuefunksie in huidige gebruikers van metamfetamien, rehabiliterende gebruikers, sowel as 'n kontrolegroep van dwelmmiddel-naïewe demografies-passende individue te bepaal. Uitvoerende funksie is gemeet met 'n neurokognitiewe toetsbattery wat die geheuefunksies van 14 huidige gebruikers van metamfetamien, 17 rehabiliterende metamfetamienverslaafde individue en 18 dwelmmiddel-naïewe deelnemers, gepas in terme van ouderdom, geslag en opvoedkundige status, bepaal het. Die resultate dui aan dat dat die rehabiliterende metamfetamiengebruikers die grootste geheueuitvalle getoon het in vergelyking met sowel die huidige gebruikers as die kontrolegroep. Die huidige metamfetamiengebruikers het ook matige geheueuitvalle getoon, spesifiek in visuele leer en retensie. Dit is moontlik dat die geheueuitvalle wat deur metamfetamiengebruikers ervaar word, verband hou met strukturele en funksionele verandering in die breingebiede wat met geheue geassosieer word, as gevolg van metamfetamienvergiftiging. Die swak prestasie van die rehabiliterende metamfetamienverslaafde persone in vergelyking met die huidige gebruikers word verduidelik in terme van die naasmekaarstelling van die stimulerende en aanvullende effek van metamfetamien soos ervaar deur die huidige gebruikers versus die neurotransmitteruitputting en strukturele breinveranderinge in die rehabiliterende individue. Die kontrolegroep het 'n beter resultaat getoon omdat hulle geen neurotoksiese effekte van metamfetamien gehad het nie. <![CDATA[<b>Audits of emergency trolleys' contents in selected hospitals in Botswana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100008&lng=pt&nrm=iso&tlng=pt Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana's hospitals' wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys' contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys' equipment and supplies had been up to standard.<hr/>Hartarres is 'n lewensbedreigende noodsituasie. Die uitkoms word bepaal deur tydige en effektiewe kardio-pulmonale resussitasie (KPR). Suksesvolle KPR pogings in hospitale vereis goed toegeruste noodtrollies en toerusting wat behoorlik funksioneer, asook personeellede wat bedrewe is in die uitvoering van KPR. Die studie het gepoog om te bepaal of die noodtrollies in Botswana se hospitaalsale of eenhede aan die verwagte standaarde voldoen. Die inhoud van die noodtrollies in 20 sale of enhede van twee van Botswana se hospitale is ge-ouditeer deur 'n gestandardiseerde kontrolelys te benut. Geen hospitaalsaal of eenheid het al die verwagte toerusting of drogerye op sy noodtrollie gehad nie, sommige eenhede het nie hulle noodtrollies se inhoud gereeld gekontroleer nie. Al 20 hospitaalsale of eenhede wat aan die studie deelgeneem het, moet die inhoud en instandhouding van hulle noodtrollies verbeter, anders kan in-hospitaal KPR pogings in Botswana tot mislukkings gedoem wees, waardeur lewens verloor word wat gered kon gewees het, indien die noodtrollies se inhoud op standaard was. <![CDATA[<b>Factors influencing access to pharmaceutical services in underserviced areas of the West Rand District, Gauteng Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100009&lng=pt&nrm=iso&tlng=pt The study examined demographic and socio-economic factors that may influence pharmaceutical services (PS) in underserviced communities of the West Rand District, Gauteng Province, South Africa. A quantitative survey was conducted using structured questionnaires administered to the general public (n = 2014) in Bekkersdal, Kagiso, Mohlakeng, Munsville and Diepsloot townships. The questionnaire explored demographic details, employment and education status, income levels, payment methods and convenience of services. Of the respondents, 54.0% were women, 52.0% were unemployed; 65.0% had secondary education or higher and &gt; 70.0% had no income or earned < R1000 p.m. Unemployment was higher amongst women. Only 13.9% of respondents had medical aid membership, which influenced their choice of health provider, with the exception of pharmacy services which are not affected by medical aid membership. Medical aid members were, however, more able to pay. Employment status and education also influenced the choice of provider, with most of the employed (66.0%) and educated (64.4%) preferring a pharmacy or GP. On pharmacist gender, 47.5% of respondents had no preference, 27.6% preferred male pharmacists, whilst 24.9% preferred female pharmacists. Men with preferences preferred male providers (77.0%), whilst female respondents preferred female providers (69.3%). Respondents with no formal education and those with low or no income expressed higher gender preferences rates than those with formal education or higher income, respectively. Thus, access to PS was influenced by gender, age, family income and education level. Whilst medical aid membership had no influence on access to PS, it influenced ability to pay. These factors should be considered by those wishing to offer PS in such areas.<hr/>Toegang tot farmaseutiesedienste (FD) bly 'n uitdaging in minderbevoorregte gebiede. Die huidige studie het demografiese- en sosio-ekonomiese faktore ondersoek, wat FD kan beïnvloed in onder-bediende gemeenskappe van die Wes-Rand Distrik, Gauteng Provinsie, Suid-Afrika. Om te bepaal watter faktore toegang tot FD in vyf dorpsgebiede aan die Wes-Rand beïnvloed. Kwantitatiewe opnames met behulp van gestruktureerde vraelyste wat aan die algemene publiek (n = 2014) in Bekkersdal, Kagiso, Mohlakeng, Munsville, en Diepsloot dorpsgebiede uitgedeel is. Die vraelys het areas insluitende demografiese besonderhede, indiensneming- en opvoedingstatus, inkomstevlakke, metodes van betaling, en die gerief van die apteekdienste ondersoek. Daar was 2014 respondente (54.0% vroulik); 52.0% was werkloos; 65.0% het sekondêre of hoër onderwysopleiding; en &gt; 70.0% het geen inkomste of verdien < R1000 p.m. Werkloosheid was hoër onder vroue, ongeag van vlak van opvoeding. Slegs 13.9% van die respondente het mediese fonds-lidmaatskap. Mediese fonds-lidmaatskap beïnvloed die keuse van gesondheidsverskaffer, maar toegang tot die apteekdienste is nie geraak deur mediese fonds-lidmaatskap nie. Mediese fondslede was egter meer in staat om te betaal. Die keuse van 'n verskaffer is deur indiensneming- en opvoedingstaus beïnvloed, met die meeste van die respondente wat werksaam was (66.0%) en die meer opgevoedes (64.4%), wat 'n apteker of 'n algemene praktisyn verkies het. Ten opsigte van die apteker se geslag het 47.5% van die respondente geen voorkeur gehad nie, 27.6% het manlike aptekers verkies, terwyl 24.9% vroulike aptekers verkies het. Mans met voorkeure het manlike verskaffers verkies (77.0%), en vroulike respondente het vroulike verskaffers verkies (69.3%). Respondente met geen formele opleiding, en diegene met 'n lae of geen inkomste het hoër geslagsvoorkeur resultate getoon. Toegang tot FD is beïnvloed deur geslag, ouderdom, gesinsinkomste en vlak van opvoeding. Mediese fonds-lidmaatskap daarenteen het geen beduidende invloed op die toegang tot FD gehad nie, maar wel op die vermoë om te betaal. Hierdie faktore moet in ag geneem word deur diegene wat belangstel om FD in soortgelyke gebiede te verskaf. <![CDATA[<b>Undergraduate nurses' experience of the family health assessment as a learning opportunity</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100010&lng=pt&nrm=iso&tlng=pt The practice of community health nursing (CHN) may enhance the life experiences of families and communities, particularly amongst the poor and socially marginalised. CHN provides for a deeper understanding of the health status of families living within communities, for example, where and how they live, their cultural context and their ability to identify resources available to assist with their health care (Allender, Rector & Warner 2010:17). This qualitative phenomenological study reflects on the self-reported lived experiences of undergraduate CHN students at the University of the Western Cape in the City of Cape Town, South Africa. These students conducted a family health assessment (FHA) learning task at the homes of families within communities. Purposive and convenience sampling was used by students who had conducted an FHA. Fourteen students agreed to participate in the study, of whom nine were interviewed, two withdrew and the remaining three were not interviewed since no new data were emerging during interviews, indicating that saturation had been reached. During in-depth interviews with seven female and two male students, data for the exploration of the lived experiences was gathered through the following question: 'How did you experience the FHA?' Field notes were taken and used to capture non-verbal communication of participants. The focus of the study was to explore the lived experiences of students and not those of the family on whom the FHA was completed. Data collected were categorised into themes, guided by the systematic data analysis process of Tesch (1990) cited in Cresswell (2003:192). Four themes emerged: challenges of family selection, challenges of safety, socio-cultural challenges and academic challenges experienced by the participants. This study will inform future research and curriculum planning for CHN education in a multifaceted context.<hr/>Die praktyk van gemeenskapsgesondheidverpleging (GGV) het die potentiaal om die lewenservaringe van families en gemeenskappe te verryk, veral in arm en voorheen benadeelde gemeenskappe. GGV verskaf 'n dieper begrip met betrekking tot die welstand van families in hulle gemeenskappe, byvoorbeeld, waar en hoe hulle leef, hul kultuur en hulle vermoë om beskikbare hulpbronne te identifiseer om sodoende hulle gesondheid te bevorder (Allender, Rector & Warner 2010:17). Hierdie kwalitatiewe fenomonologiese studie is 'n refleksie op die self-gerapporteerde persoonlike ervaringe van voorgraadse gemeenskapsgesondheidverpleging studente (VGVS) verbonde aan die Universiteit van Wes Kaapland, in Kaapstad, Suid-Afrika. Hierdie studente het as 'n werksopdrag 'n familie gesondheidsberaming (FGB) by wonings van gesinne in die gemeenskap voltooi. 'n Gerieflijkheids- en doelgerigte steekproefneming is gedoen met studente wat die FGB voltooi het. Veertien studente het ingestem om aan die studie deel te neem, waarvan daar onderhoude met nege gevoer is. Twee studente het onttrek en die oorblywende drie is nie genader nie weens die feit dat daar geen nuwe data na vore gekom het nie, wat daarop dui dat saturasie bereik was. Data vir die verkenning van persoonlike ervaringe is deur in-diepte onderhoude met sewe vroulike en twee manlike studente ingesamel deur die volgende vraag te vra: 'Wat was jou ervaring met die voltooing van die FGB?' Veldnotas was geneem om nie-verbale kommunikasie van die studente aan te teken. Die fokus van die studie was gerig om die persoonlike ervarings van die VGVS te verken met verwysing na die FGB wat hulle voltooi het. Die fokus was nie gerig op die ondervindinge van die familie op wie die FGB gedoen is nie. Die ingesamelde data is in temas gekategoriseer volgens die sistematiese data analitiese proses van Tesch (1990), soos omskryf in Cresswell (2003:192). Vier temas is geïdentifiseer naamlik: uitdagings ten opsigte van die keuring van 'n geskikte familie: uitdagings ten opsigte van veiligheid, sosio-kulturele uitdagings en akademiese uitdagings soos ervaar is deur die deelnemende studente. Die belangrikheid van die studie is om toekomstige navorsing en kurrikulumbeplanning in gemeenskapsgesondheidverpleging binne 'n diverse konteks te bevorder. <![CDATA[<b>Impact of nutrition education on nutrition knowledge of public school educators in South Africa: A pilot study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100011&lng=pt&nrm=iso&tlng=pt The Department of Basic Education (DBE) has not given nutrition education the necessary emphasis that it needs, despite its importance in South African schools. Nutrition is included as only one of many topics forming part of the Life Orientation syllabus. Educators are role models for learners in making healthy food choices, however, studies have shown that major gaps exist in the health and nutrition-related knowledge and behaviour of educators. The objective of this research was to undertake a pilot study to determine the impact of a nutrition education programme (NEP) on the nutrition knowledge of Life Orientation educators in public schools in South Africa (SA). An exploratory baseline survey, to determine the nutrition education practices in 45 purposively selected public schools, was carried out before the experimental nutrition education intervention study. A nutrition knowledge questionnaire was completed by 24 purposively selected educators, representing all nine provinces in SA, before and after a three-day NEP. Pre and post-NEP data were analysed on the Statistical Package for Social Sciences (SPSS) for a Windows program version 17.0 for descriptive statistics, version 17.0. Paired t-tests measured statistically significant differences (p < 0.05) before and after the NEP. The knowledge of the respondents improved significantly after the NEP as the mean±s.d. score of correctly answered questions (n = 59) improved from 63.3±30.2% before to 80.6±21.1% after the NEP. The results proved that nutrition knowledge of Life Orientation educators in primary schools is not optimal, but can be improved by NEP.<hr/>Die Departement van Basiese Opvoeding het nog nie die nodige aandag aan voeding voorligting in skole gegee nie ten spyte van die belangrikheid daarvan. Voeding word aangebied as een van vele aspekte in die Lewensoriëntasie sillabusse. Onderwysers is rolmodelle om gesonde voedsel keuses te maak vir kinders, maar studies het bewys dat tekortkominge bestaan in die gesondheid en voeding verwante kennis en optrede van onderwysers. Die doel van hierdie loods studies was om die impak van 'n voeding voorligting program op die voeding kennis van Lewensoriëntering onderwysers in publieke skole in Suid Afrika (SA) te bepaal. 'n Basislyn ondersoek was uitgevoer om die voeding praktyke van onderwysers uit 45 doelbewuste gekose publieke skole te bepaal voor en na die implementering van 'n eksperimentele voeding voorligting intervensie studie. 'n Voeding kennis vraelys is deur 24 doelbewuste gekose onderwysers, verteenwoordigend van al nege provinsies in SA, voltooi voor en na die drie-dag voeding voorligtingsprogram. Beide pre en post data is geanaliseer op die Statistical Package for Social Sciences (SPSS) vir Windows program, uitgawe 17.0, vir beskrywende statistieke. Gepaarde t-toetse is gebruik om statisties betekenisvolle verskille (p < 0.05) voor en na die intervensie te bepaal. Die kennis van die respondent het betekenisvol verbeter na die intervensie aangesien die gemiddelde ±s.d. uitslag van die vrae wat korrek geantwoord is (n = 59) van 63.3±30.2 persent voor tot 80.6±21.1 persent na die intervensie verbeter het. Die resultate het bewys dat die voeding kennis van Lewensoriëntering onderwysers in publieke skole in SA nie optimaal is nie, maar dat dit kan verbeter deur voeding voorligtingsprogramme. <![CDATA[<b>Incidence, severity and management of cancer chemotherapy related oral mucositis in Eastern Cape and Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100012&lng=pt&nrm=iso&tlng=pt This study explored the incidence, duration and severity of oral mucositis in patients receiving chemotherapy in the Eastern and Western Cape, how this symptom was managed and whether the patients considered the management to be effective. An exploratory, contextual, quantitative survey was conducted. The sampling method was convenience. One hundred and sixty patients were recruited, with 106, (66.3%) participating. Data were collected by means of self-reports, using a self-administered questionnaire. Oral mucositis was a common problem, with 71.7% (n = 76) reporting to have had mucositis. Pain was not effectively managed, as 69.8% (n = 53) of respondents experienced pain whilst only 17.1% (n = 13) reported to have used analgesics. More than half of the respondents used prescribed mouth and throat preparations, whilst 28.9% (n = 22) used non-prescribed self-care measures including potentially harmful products. A significant difference was found between using non-prescribed self-care measures and the duration of oral mucositis (χ2 = 0.81; p = 0.01). The reported grade of mucositis did not influence the use of non-prescribed self-care measures, whilst the more pain patients experienced the less inclined they were to use these measures. The management of oral mucositis remains a challenge. Failure to palliate this distressing symptom can lead to the use of potentially harmful self-care measures.<hr/>Die studie het die insidensie, tydsduur en intensiteit van orale mukositis in Oos en Wes Kaapse pasiënte wat kankerchemoterapie ontvang verken asook hoe hierdie simptoom hanteer is en die sukses hiervan volgens die pasiënte. 'n Kwantitatiewe, ekploratiewe, kontekstuele opname is onderneem. 'n Gerieflikheidsteekproef is gebruik om die deelnemers te verkry. Een hondered en sestig persone is genader en 66.3% (n = 106) het aan die studie deelgeneem. Die datainsamelingsmetode was self-rapportering met behulp van 'n vraelys en beskrywende statistiek is gebruik om die data te verwerk. Orale mukositis was 'n algemene probleem, aangesien 71.7% (n = 76) van die respondente die simptoom ondervind het. Pyn was nie goed beheer nie, aangesien 69.8% (n = 53) pyn ondervind het terwyl slegs 17.1% (n = 13) aangedui het dat hulle analgetika gebruik het. Meer as die helfte van die respondente het voorgeskrewe mond en keel preparate gebruik, terwyl 28.9% (n = 22) self gemedikeer het wat potensiële nadelige preparate ingesluit het. 'n Beduidende verskil is tussen die gebruik van nie voorgeskrewe medikasie en die duur van mukositis bevind (χ2 = 0.81; p = 0.01). Die graad van die mukositis het nie die gebruik van die self-medikasie beinvloed nie. Hoe meer pyn ondervind is, hoe minder was die neiging om die mukositis self te behandel. Die hantering van orale mukositis bly 'n uitdaging. Die onsuksesvolle palliasie van hierdie simptoom kan tot die gebruik van potensieel nadelige self-sorg maatreëls lei. <![CDATA[<b>Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100013&lng=pt&nrm=iso&tlng=pt Diabetes self-management education is crucial in diabetes care. Education that is tailored to the needs of the patient is considered the most effective in improving health outcomes. Diet, a critical element of diabetes treatment, is reported as the most difficult to adhere to by both patients and health professionals. Tailored nutrition education (NE) could benefit diabetic individuals with low socio-economic status, who are amongst those noted to have poor health outcomes. This qualitative interpretive phenomenological study aimed to explore and describe the NE needs of adults with type 2 diabetes mellitus to guide development of a tailored NE programme for resource-poor settings. Participants were 31 non-insulin-dependent type 2 diabetic patients (convenience sample) and 10 health professionals. Focus group discussions using semi-structured questions were held with the diabetics, and open-ended self-administered questionnaires were used with the health professionals. Data analysis was done using Krueger's framework approach. Disease-related knowledge deficits and inappropriate self-reported dietary practices, including intake of unbalanced meals, problems with food portion control and unsatisfactory intake of fruits and vegetables, were observed. Recommendations for the NE programme included topics related to the disease and others related to diet. Group education at the clinic, a competent educator and comprehensive education were indicated by the patients. Participation of family and provision of pamphlets were aspects recommended by patients and health professionals. Barriers that could impact the NE included financial constraints, food insecurity, conflict in family meal arrangements and access to appropriate foods. Support from family and health professionals and empowerment through education were identified as facilitators to following dietary recommendations by both groups of participants. Knowledge deficits, inappropriate dietary practices and barriers are issues that need addressing in an NE programme, whilst the suggestions for an NE programme and facilitators to dietary compliance need to be incorporated.<hr/>Onderrig in die selfbestuur van diabetes is essensieel in diabetessorg. Onderrig wat spesifiek ooreenkomstig die behoeftes van die pasiënt aangepas is, word die mees doeltreffend in die verbetering van gesondheiduitkomste geag. Dieet, 'n kritiese element in diabetesbehandeling, word deur pasiënte en gesondheidpraktisyns as die moeilikste beskou om na te volg. Spesifiek beplande voedingonderrig kan tot voordeel van lae sosio-ekonomiese diabete wees wat deel van diegene wat swak gesondheiduitkomste toon, uitmaak. Die doel van hierdie kwalitatiewe interpreterende fenomologiese studie was om die voedingonderrigbehoeftes van volwassenes met tipe 2 diabetes mellitus te ondersoek en te beskryf ten einde die ontwikkeling van 'n voedingonderrigprogram wat op hulpbrondbeperkte omgewings afgestem is, te rig. Een en dertig nie-insulien afhanklike tipe 2 diabetes pasiënte (geriefsteekproef) en 10 gesondheidpraktisyns was evalueer. Fokusgroepbesprekings deur gebruikmaking van semi-gestruktureerde vrae, is met die diabete gehou. Self-geadministreerde oop-eindigende vraelyste is deur die gesondheidpraktisyns voltooi. Data-analise is volgens Krueger se raamwerkbenadering gedoen. Siekteverwante kennisgapings en ontoepaslike self-gerapporteerde dieetpraktyke, insluitend ongebalanseerde maaltye, probleme met porsiekontrole en ontoereikende inname van groente en vrugte is gerapporteer. Aanbevelings vir die voedingonderrigprogram het onderwerpe verwant aan die siekte en die dieet ingesluit. Die pasiënte het groeponderrig by die kliniek, 'n bevoegde onderrigpraktisyn en omvattende onderrig verkies. Die pasiënte en die gesondheidpraktisyns het gesinsdeelname en die beskikbaarstelling van pamflette aanbeveel. Struikelblokke wat negatief op die voedingonderrigprogram kon inwerk, het finansiële beperkinge, voedselinsekuriteit, konflik met gesinsmaaltydreëlings en toegang tot geskikte voedsels ingesluit. Ondersteuning van die gesin en gesondheidpraktisyns, sowel as bemagtiging deur kennis is as fasiliteerders ter bevordering van die navolging van dieetaanbevelings deur beide groepe deelnemers geïdentifiseer. Tekortkominge in kennis, ontoepaslike dieetpraktyke en struikelblokke is aspekte wat in 'n voedingonderrigprogram aangespreek behoort te word. Voorstelle wat vir die voedingonderrigprogram en fasiliteerders gemaak is vir dieetnavolging, behoort in die program ingesluit te word. <![CDATA[<b>Perceptions of registered nurses regarding factors influencing service delivery in expanding programmes in a primary healthcare setting</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100014&lng=pt&nrm=iso&tlng=pt The aim of this study was to explore and describe the perceptions of registered nurses regarding factors influencing service delivery regarding expansion programmes in a primary healthcare setting, using a qualitative approach. The registered nurses, who have been working in the clinics for more than two years and have been exposed to the expansion programmes there, were purposively sampled. Two focus group interviews were conducted in a neutral place and the data collected by the researcher Nnoi A. Xaba (N.A.X.). Data were analysed by the researcher and an independent co-coder using the Tesch method. Categories, subcategories and themes were identified; those that formed the basis of discussion were disabling factors, enabling factors, client-related factors, service-related factors and solutions to problems. It is recommended that integration of programmes and coordination be done at a provincial level and planned together with the training centres in order to alleviate problems in service delivery. Training on expansion programmes in the form of in-service education should be carried out continually in the region.<hr/>Die doel van die studie was om die persepsie van geregistreerde verpleegkundiges met betrekking tot die faktore wat dienslewering van die uitbreidingsprogramme in 'n primêre gesondheid opset beinvloed; te eksploreer en te beskryf. 'n Kwalitatiewe benadering is gevolg in die iutvoering van die studie. 'n Doelgerigte steekproef is uitgevoer vanuit geregistreerde verpleegkundiges wat vir langer as twee jaar in die klinieke werksaam was en blootgestel is aan die uitbreiding programme. Twee fokus groep onderhoude is deur die navorser Nnoi A. Xaba (N.A.X.) in 'n neutrale opset uitgevoer. Data is deur die navorser en 'n onafhanklike kodeerder ontleed volgens Tesch se metode van analise. Kategorieë, sub-kategorieë en temas was geidentifiseer. Die kategorieë fundamenteel tot die bespreking behels: remmende faktore, bydraende faktore, kliënt-verwante faktore, diens-verwante faktore, en oplossing van probleme. Daar word aanbeveel dat die integrasie en koordinasie van programme op provisiale vlak beplan word in samewerking met opleidings instansies om die dienslewerings probleem te verlig. In die streek behoort opleiding met betrekking tot die uitbreidingsprogramme deurlopend deur middel van indiensopleiding gedoen word. <![CDATA[<b>The labour market for histopathologists in KwaZulu-Natal: Emerging issues</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100015&lng=pt&nrm=iso&tlng=pt The aim of this article was to assess the factors that shape the labour market for histopathologists in KwaZulu-Natal (KZN), South Africa. The literature on the labour market and labour processes of histopathologists is dominated by North American and European literature. This gap is most acutely felt on the African continent. This article attempts to fill this gap by shifting the focus towards understanding the factors that shape the professional milieu and labour market for histopathologists in South Africa. This study through a qualitative, descriptive and contextual design engaged in in-depth interviews with 70% of the population of histopathologists in KZN. The interviews were analysed thematically. These interviews were triangulated against labour market statistics for histopathologists in South Africa as well as a range of documentary evidence. The outcome of the study has demonstrated four key challenges facing the labour market for histopathologists: racial inequities persist in the labour market, gender inequities also persist, there is unfettered public-private sector mobility, and poor curriculum design at medical school level accounts for a limited input of registrars into the profession. The article concludes that there needs to be a shift from only studying the labour market and work organisation of clinical doctors to empirical research on the role of medical laboratory specialists in the healthcare chain, which will render South African histopathologists and their work visible. A set of labour market interventions is also suggested.<hr/>Die artikel bestudeer die faktore wat die arbeidsmark vir histopatoloë in KwaZulu-Natal (KZN), Suid-Afrika beïnvloed. Die literatuur oor die arbeidsmark en arbeidsprosesse van histopatoloë word gedomineer deur Noord-Amerikaanse en Europese literatuur. Hierdie gaping is veral akuut op die Afrika kontinent. Die artikel poog om hierdie gaping te vul deur die fokus te verksuif na die faktore wat die professionele millieu en die arbeidsmark van histopatoloë in Suid-Afrika beïnvloed. Die studie het gebruik gemaak van 'n kwalitatiewe, beskrywende en kontekstuele ontwerp. In-diepte onderhoude is gevoer met 70% van die histopatoloë in KZN. Die onderhoude is tematies geanaliseer. Hierdie onderhoude is getrianguleer teen arbeidsmark statistieke vir histopatoloë in Suid-Afrika, sowel as 'n reeks dokumentêre bronne. Die uitkoms van die studie het vier belangrike struikelblokke geïdentifiseer wat die arbeidsmark vir histopatoloë in die gesig staar: rasse-ongelykhede duur voort in die arbeidsmark, so ook geslagsongelykheid, daar is vrylike beweging tussen die publieke- en privaatsektors, en 'n sleg ontwikkelde kurrikulum by mediese skole het lae toetrede getalle vir registrateurs in die professie tot gevolg. Die artikel kom tot die gevolgtrekking dat dit onvoldoende is om slegs die mark en werksoraganisasies van kliniese dokters te bestudeer - empiriese navorsing is ook nodig om die rol van die mediese labaratorium spesialiste in die gesondheidsorg ketting te bestudeer. 'n Stel arbeidsmark ingrypings word ook voorgestel. <![CDATA[<b>Caring as a core concept in educating midwifery learners: A qualitative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100016&lng=pt&nrm=iso&tlng=pt Caring is the core business of nursing and midwifery, involving a relationship in which the carer is committed to the needs of the one being cared for (Mason-Whitehead, Mcintosh, Bryan & Mason). Caring is the emotion which drives a midwife to care, the motive aimed at assisting someone to grow and self-actualise (Watson). The concern in midwifery is that irrespective of caring being central to the midwifery profession, caring taught in theoretical learning does not always translate into caring behaviour in practice. A qualitative exploratory study examined how midwifery educators impart the skill of caring during theoretical learning and clinical accompaniment, in order to respond to the general complaint made both locally and internationally that midwives are uncaring. The aim was to explore caring during theoretical learning and clinical accompaniment from the perspective of midwifery educators. Participants in the study were midwifery educators teaching midwifery in institutions of learning in Tshwane, South Africa. The naive sketch was used to gather data, wherein one central question was asked and the educators were invited to narrate and respond. Three themes emerged: the meaning of caring; how caring was conveyed during theoretical learning; and how it was conveyed during clinical accompaniment. Although the midwifery educators expressed how they conveyed caring to the learner midwives, it was not evident how caring competencies were assessed in order to ensure caring midwives at the end of training.<hr/>Omgee is die kernwaarde van 'n verpleegkundige en vroedvrou. Omgee behels 'n verhouding waar die person wat omgee verbind is om in die behoeftes van die een wat sorg benodig te voldoen (Mason-Whitehead, Mcintosh, Bryan & Mason). Omgee is die emosie wat die vroedvrou noop om om te gee, om 'n person te help groei en self-aktualiseer (Watson). Die kwelpunt in verloskunde is dat ongeag van die sentrale belang van omgee vir verloskundiges, die teoretiese onderig oor omgee nie altyd uitgeleef word in die praktyk nie. 'n Kwalitatiewe ondersoekende studie het die wyse ondersoek waarop vroevrou opvoerders die vaardigheid om om te gee, oordra tydens teoretiese en kliniese begeleiding, ten einde te reageer op die plaaslike en internasionale algemene klagte, dat vroedvroue nie omgee nie. Om omgee tydens teoreties en kliniese onderrig vanuit die perspektief van die opvoedkundige verloskundige te ondersoek. Die deelnemers het bestaan uit verloskundige opvoedkundiges wat verloskunde doseer in hoer onderwys institusies in Tshwane, Suid-Afrika. 'n Naïewe skets is gebruik om data in te samel met een sentrale vraag. Drie temas het voortgespuit: die betekenis van omgee; hoe die konsep oorgedra is tydens teoretiese onderrig; en hoe die konsep oorgedra is tydens kliniese onderrig. Alhoewel die verloskundige opvoedkundiges kon verduidelik hoe hulle omgee oorgedra het aan die leerling vroedvroue, was daar geen bewyse van hoe omgee vaardighede evalueer is nie ten einde omgee vaardige vroedvroue aan die professie te lewer. <![CDATA[<b>A pilot study on the efficacy of <i>Valeriana officinalis</i> mother tincture and <i>Valeriana officinalis</i> 3X in the treatment of attention deficit hyperactivity disorder</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100017&lng=pt&nrm=iso&tlng=pt Attention deficit hyperactivity disorder (ADHD) is an increasingly prevalent behavioural disorder characterised by inattention, impulsivity and hyperactivity. Valeriana officinalis is a botanical medicine that has been found to be beneficial in the treatment of disorders characterised by restlessness. To date, no research has been conducted on homeopathic preparations of Valeriana officinalis for this condition. The aim of this three-week, double-blind, placebo-controlled pilot study was to determine the efficacy of homeopathic Valeriana officinalis mother tincture (MT) and 3X potency on ADHD. Thirty children between the ages of five and 11 years, pre-diagnosed with ADHD, were recruited. Valeriana officinalis MT (n = 10), 3X (n = 10) or placebo (n = 10) were administered orally three times a day for two weeks. Efficacy was assessed by the Barkley and DuPaul teacher rating scale, the children's checking task and the parent symptom questionnaire scores on day 1 (prior to treatment), at the end of weeks two and three (with treatment), and then after the third week following no treatment. A statistically significant improvement was found in the participants' behaviour in the MT and 3X groups, with particular reference to sustained attention, anxiety and impulsivity and/or hyperactivity. Preliminary findings suggested that Valeriana officinalis MT and 3X may have applications in the management of ADHD.<hr/>Aandagsgebrek-hiperaktiwiteitsindroom (AGHS) is toenemend 'n algemene gedragsongesteldheid, wat gekenmerk word deur onoplettendheid, impulsiwiteit en hiperaktiwiteit. Daar is vasgestel dat Valeriana officinalis 'n plantaardige medisyne is wat voordelig kan wees in die behandeling van ongesteldhede wat gekenmerk word deur rusteloosheid. Tot op hede is geen navorsing uitgevoer op die gebruik van homeopatiese preparate van Valeriana officinalis vir hierdie ongesteldheid nie. Die doel van hierdie drieweeklange, dubbelblinde, troosmedisyne-gekontroleerde loodsstudie was om die effektiwiteit van homeopatiese Valeriana officinalis Moertinktuur (MT) en 3X sterkte vir die behandeling van AGHS te bepaal. Dertig kinders tussen die ouderdomme van 5 en 11 jaar, wat vantevore gediagnoseer is met OGHO, is gewerf. Valeriana officinalis MT (n = 10), 3X (n = 10) of troosmedisyne (n = 10) is mondeliks drie keer per dag vir twee weke toegedien. Effektiwiteit is gemeet op dag 1 (voor behandeling), aan die einde van weke twee en drie (tydens behandeling), en na die derde week sonder behandeling deur middel van tellings wat behaal is op die Barkley and DuPaul teacher rating scale, die children's checking task en die parent symptom questionnaire. 'n Statisties beduidende verbetering is gevind in die gedrag van die deelnemers in die MT en 3X groepe, in die besonder met betrekking tot volgehoue oplettendheid, angstigheid en impulsiwiteit en/of hiperaktiwiteit. Voorlopige bevindinge dui daarop dat Valeriana officinalis MT en 3X moontlik gebruik kan word in die behandeling van AGHS. <![CDATA[<b>Facilitating nurses' knowledge of the utilisation of reflexology in adults with chronic diseases to enable informed health education during comprehensive nursing care</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100018&lng=pt&nrm=iso&tlng=pt An integrative literature review of identified scientific evidence, published from January 2000 to December 2008, of the utilisation of reflexology as complementary and alternative medicine (CAM) modalities to promote well-being and quality of life in adults with chronic diseases was done to facilitate nurses to give informed health education during comprehensive nursing care to patients with chronic diseases. Selected accessible databases were searched purposefully for research articles (N = 1171). Pre-set inclusion criteria were applied during the study selection process. The methodological study quality was reviewed and appraised with appropriate tools from the Critical Appraisal Skills Programme (CASP) and the American Dietetic Association's (ADA) Evidence analysis manual (n = 21). Evidence extraction, analysis and synthesis of studies (n = 18) were done through the evidence class rating and level of strength as prescribed in the manuals of ADA and CASP. Findings indicate statistically significant reduction in the frequency of seizures in patients with intractable epilepsy, an improvement of sensory and urinary symptoms associated with multiple sclerosis and clinically significant reduction of anxiety and pain in patients with cancer and fibromyalgia syndrome. These findings can be utilised by nurses to inform patients with these chronic diseases about alternative ways of treatment.<hr/>'n Geïntegreerde literatuur oorsig van ge-identifiseerde wetenskaplike bewyse, gepubliseer vanaf Januarie 2000 tot Desember 2008, was gedoen oor die gebruik van refleksologie as aanvullende en alternatiewe behandelingsmodalitieit om welsyn en lewenskwaliteit te bevorder by volwassenes met kroniese siekte om verpleegkundiges te fasiliteer om ingeligte gesondheidsvoorligting te gee gedurende omvattende verpleegsorg aan pasiente met kroniese siektes. Geselekteerde toeganklike databasisse was doelbewustelik deursoek vir navorsingsartikels (N = 1171). Vooraf bepaalde insluitingskriteria was toegepas tydens die selekteringsproses. Die studie gehalte is nagegaan en beoordeel met toepaslike instrumente van die Critical Appraisal Skills Programme (CASP) en die American Dietetic Association (ADA) se Evidence analysis manual (n = 21). Bewys uitreksel, analisering en sintese van studies (n = 18) was gedoen deur die bewysklas gradering en vlak van bewysterkte soos beskryf in die handleidings van ADA en CASP. Bevindings dui op 'n statisitese beduidenisvolle verlaging in die frekwensie van konvulsies by pasiënte met epilepsie, 'n verbetering van sensoriese en urinêre simptome ge-assosieer met veelvuldige sklerose en 'n kliniese beduidenisvolle afname in angstigheid en pyn by pasiënte met kanker en fibromialgiese sindroom. Hierdie bevindings kan deur verpleegkundiges gebruik word om pasiente met hierdie kroniese siektes in te lig omtrent alternatiewe maniere van behandeling. <![CDATA[<b>Where are we short and who are we short of? A review of the human resources for health in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362012000100019&lng=pt&nrm=iso&tlng=pt This review showed that thinking about the shortage of health care personnel merely in terms of insufficient numbers prevents sound strategic interventions to solve the country's human resources for health (HRH) problem. It revealed that the numbers shortage was one facet of a broader problem that included the mal distribution of HRH, production of the wrong skills in the nursing care, the attrition of staff from the public health services and, contextually, the ever-changing demands on the health services. The challenge in South Africa was furthermore to train and retain health care personnel with skills and expertise that are commensurate with the changing demands on the public health services.<hr/>Uit hierdie oorsig het dit duidelik geblyk dat die tekort van gesondheidsorgpersoneel slegs in terme van ontoereikende getalle val en 'n omvattende strategiese ingryping om die land se menslike gesondheidshulpbron krisis op te los, belemmer. Dit het aangedui dat die getalletekort maar slegs een fasset van 'n groter probleem uitmaak, wat onder andere die volgende insluit: die oneweredige verspeiding van menslike gesondheidshulpbronne, 'n fokus op ontoepaslike vaardighede in die opleiding van verpleegpersoneel, die behoud van personeel in die openbare gesondheidsektor, asook die konstant-veranderlike eise van die gesondheidsdienste. Verder was die uitdaging in Suid Afrika die opleiding en behoud van gesondheidsorgpersoneel met kennis en vaardighede wat tred hou met die veranderlike eise van die openbare gesondheidsdienste.