Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620130001&lang=es vol. 18 num. 1 lang. es <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Perceptions of health promoters about health promotion programmes for families with adolescents orphaned as a result of AIDS in the rural Hammanskraal region in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100001&lng=es&nrm=iso&tlng=es South African communities are still greatly affected by the high rate of infection with HIV or who are living with AIDS, mirrored in the 2008 overall national HIV prevalence of 29.3% (UNAIDS 2010:10). In addressing the challenge, the health system is dependent on community care level workers such as caregivers to render health promotion and education in the homes and communities. The caregivers based in the communities are the ones with first-hand information on what is needed for the success of health promotion programmes. This study, aimed at exploring the challenges faced by the health promoters, described their perceptions regarding a health promotion programme for families with adolescents orphaned as a result of AIDS. Data were collected on the purposively selected participants at the rural Hammanskraal region in South Africa and the research question: 'What is your perception regarding health promotion programmes for families with adolescents orphaned as a result of AIDS' was asked and discussed by participants in a focus group interview. Data were analysed using the adapted Tesch method to organize and isolate the main categories, sub-categories and themes. The following main categories were isolated: attitudes of adolescents, effectiveness of home visits, need for health education and limited resources. Based on the findings, it was therefore recommended that health care planners assist in the improvement of health promotion and education by using the community and national media, providing information material and providing access to the internet in order to allow more people, including young people, to access the information.<hr/>Suid-Afrikaanse gemeenskappe word steeds grootliks beïnvloed deur die hoë vlak van MIV en vigs, soos weerspieël in die algehele nasionale MIV-syfer in 2008 van 29.3% (UNAIDS 2010:10). In die aanspreek van hierdie uitdaging is die gesondheidstelsel afhanklik van gemeenskapsorgwerkers om gesondheidsbevordering en -opleiding aan huise en gemeenskappe te voorsien. Die versorgers wat in die gemeenskap werk, het eerstehandse inligting oor wat nodig is om die sukses van programme vir gesondheidsbevordering te verseker. Hierdie studie, wat ten doel het om die uitdagings van gesondheidspromotors te verken, beskryf hul persepsie ten opsigte van 'n gesondheidsbevorderingsprogram vir families met adolessente wat wees gelaat is as gevolg van vigs. Data is op die doelbewus geselekteerde deelnemers in die landelike Hammanskraal-streek in Suid-Afrika ingesamel en die volgende navorsingvraag is in 'n fokusgroep-onderhoud gevra en bespreek: 'Wat is jou persepsie oor die gesondheidsbevorderingsprogram vir families met adolessente wat ouerloos gelaat is as gevolg van MIV en vigs?' Die data is met behulp van die aangepaste Tesch-metode geanaliseer om die hoof- en sub-kategorieë, asook die temas te organiseer en isoleer. Die volgende hoof-kategorieë is uitgesonder: die houdings van adolessente, die doeltreffendheid van huisbesoeke, die behoefte aan gesondheidsopvoeding en beperkte hulpbronne. Gebaseer op hierdie bevindinge is die aanbeveling dat die gesondheidsorgbeplanners bydra tot die verbetering van gesondheidsbevordering en -opvoeding deur die gebruik van gemeenskapsen nasionale media, die beskikbaarstelling van inligtingsmateriaal en die voorsiening van internet om meer mense, insluitende jongmense, die geleentheid te bied om toegang tot die inligting te verkry. <![CDATA[<b>Factors influencing the uptake of contraception services by Vatsonga adolescents in rural communities of Vhembe District in Limpopo Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100002&lng=es&nrm=iso&tlng=es The aim of the study was to determine the factors that influence the uptake of contraception services by adolescents in the Vhembe district of Limpopo Province, South Africa. A qualitative research method which is explorative, descriptive and contextual in nature was used to investigate the phenomenon from the adolescents' perspective. The target population comprised of adolescents residing in one of the six villages of Vhembe District. Data was collected through six focus group discussions until data saturation was achieved. Data was analysed using an open coding method. The findings revealed that adolescents are aware of the availability of contraceptive services. However, they lack a comprehensive knowledge about contraception and contraceptives, which led to negative attitudes towards using the services. Cultural health beliefs and attitudes were also identified as a barrier to the uptake and use of contraceptives. Recommendations were made on interventions to increase the uptake of contraception services amongst adolescents.<hr/>Die doel met die studie was om te bepaal watter faktore beïnvloed adolessente in die Vembe distrik van Limpopo Provinsie, Suid Afrika se besluit om voorbehoedmiddels te gebruik. 'n Kwalitatiewe navorsingsmetode wat eksploratief, beskrywend en kontekstueel van aard is, is gebruik om die fenomeen vanuit die perspektief van die adolessent te ondersoek. Data is ingewin deur ses fokusgroepbesprekings todat 'n punt van dataversadiging bereik is. Data is met behulp van oop kodeering geanaliseer. Bevindinge het getoon dat die adolessente wel bewus is van die beskikbaarheid van voorbehoeddienste, alhoewel hulle kennis van voorbehoeding en voorbehoedmiddels gebrekkig is, en dit het tot 'n negatiewe houding jeens die gebruik van die dienste gelei. Kulturele en kulturele gesondheidsgelowe gelowe en houdings is ook geidentifiseer as 'n hindernis tot die gebruik van voorbehoedmiddels. Aanbevelings is gemaak ten opsigte van intervensies om die gebruik van voorbehoeddienste onder adolessente te bevorder. <![CDATA[<b>Commitment and the emigration intentions of South African professional nurses</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100003&lng=es&nrm=iso&tlng=es The emigration of skilled nurses from South Africa exacerbates the crisis in the provision of public health services. A descriptive, quantitative design was applied to investigate the relationship between intention to emigrate and employee commitment. Over 400 registered nurses (N = 419), working within public sector tertiary hospitals in the Western Cape, responded to a cross-sectional survey questionnaire. Three foci of employee commitment (organisational, professional and national) were examined but only national commitment significantly helped predict intention to emigrate from South Africa in the regression model (beta = -0.0525, p < 0.0001). The implications of the results obtained in this study are discussed.<hr/>Die emigrasie van verpleegkundiges uit Suid-Afrika vererger die krisis in die verskaffing van gesondheidsorgdienste in die land. 'n Beskrywende, kwantitatiewe ontwerp is gebruik om die verwantskap tussen werknemertoewyding en die voorneme om te emigreer te ondersoek. Meer as 400 verpleegsters (N = 419) wat in openbare tersiêre hospitale in die Wes-Kaap werk, het op die vraelys gereageer. Drie fokusareas van toewyding (organisatories, professioneel en nasionaal) is gemeet, maar net nasionale toewyding het daartoe bygedra om emigrasievoorneme te voorspel (beta = -0.0525, p < 0.0001). Die implikasies van hierdie resultate word bespreek. <![CDATA[<b>Plastination technology for anatomical studies in Nigeria: Opinion of teachers at medical institutions</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100004&lng=es&nrm=iso&tlng=es Dr. Gunther von Hagens developed plastination as a technique of tissue preservation in 1977. He used a delicate method of forced impregnation with curable polymers like silicone, epoxy or polyester resins for preservation of anatomical specimens. With plastination, every part of a biological tissue is treated, preserving it for educational purposes. Hence, there are vast applications in the medical field. We set out to survey the knowledge and opinion of lecturers of anatomy about plastinated specimen use in medical schools through the administration of questionnaires to respondents who participated at the Society of Experimental and Clinical Anatomists of Nigeria (SECAN) conference in 2011. It was found that 50.0% and 23.75% of respondents respectively, had their masters and doctorate degrees in Anatomy. Less than 8.0% utilised plastination as a tool for teaching as against 40% (plastic models), 36.25% (cadavers) and 15.0% (pathology pots). Conventional methods such as fixation by immersion (15.0%) and embalming (52.5%) with formaldehyde were commonly used for long term preservation of tissues in their various institutions. These methods were found to be less costly (25.0%), easy to use (56.25%) and the only method (12.25%) available, even though they posed some health hazards (96.0%). Whilst only 6.25% of the respondents did not know anything about plastination, 93.75% were aware of it. The advocacy for preservation of tissues by plastination has been gradual in developed countries. We recommend the use of plastinates in medical schools in Nigeria. <![CDATA[<b>HIV-positive patients' and their families' comprehension of HIV- and AIDS-related information</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100005&lng=es&nrm=iso&tlng=es Despite acknowledgement of the importance of sharing HIV- and AIDS-related information with people living with HIV, it is still unclear as to what their actual comprehension is of this information. This research was part of a larger project, Tswaragano, conducted in the North-West Province, South Africa, which explored and described the competence, ability and strengths of the family of the HIV-positive patient during home support. This research focused on Potchefstroom in the North-West Province. This article focuses on research with the objective being to explore and describe the comprehension of HIV-positive patients and their families with regard to HIV- and AIDS-related information, and to formulate recommendations to improve their comprehension of this information. A quantitative, explorative and descriptive survey design was followed. Data were collected by means of questionnaires completed by HIV-positive patients (n = 79) and their family members (n = 34). Descriptive statistical analysis by means of frequency analysis was conducted. Ethical considerations and mechanisms to enhance validity and reliability are discussed. The results indicated that both HIV-positive respondents and their families face social and financial challenges due to unemployment and low income. A strength found in this research is that the majority of respondents are linked to a church, which can be a valuable platform to share information on HIV and AIDS. With regards to sharing, sources and comprehension of HIV- and AIDS-related information, it is apparent that respondents perceived that pre- and post-counselling provided an opportunity for information sharing, but that they need health care workers to spend more time with them, to be non-judgemental and to make more use of visual aids. It furthermore seems that the majority of HIV-positive respondents in this study did comprehend the need for and negotiate for safer sexual practices. It was concluded that although HIV-positive patients and their families have relatively good levels of comprehension of HIV- and AIDS-related information, there are certain gaps in their comprehension of this information. Accordingly, recommendations regarding improving comprehension of HIV-related information were formulated. Recommendations for nursing education, research and practice were formulated. These recommendations highlight the importance of openness in communication, building trust relationships, collaboration, cultural sensitivity and empowering HIV-positive patients and their families.<hr/>Ondanks erkenning aan die belangrikheid om MIV- en VIGS-verwante inligting met mense wat geraak word deur MIV te deel, is dit steeds onduidelik wat die betrokkenes se begrip van dié inligting is. Hierdie navorsing was deel van die Tswaragano projek wat MIV-positiewe pasiënte se familie se bevoegdheid, vermoëns en sterktes om pasiënte tydens tuissorg te ondersteun, te verken en beskryf en is uitgevoer in die Noordwes-Provinsie, Suid Afrika. Hierdie navorsing het op Potchefstroom in die Noordwes-Provinsie gefokus.Hierdie artikel fokus navorsing wat ten doel gehad het tot MIV-positiewe pasiënte en hulle families se begrip van MIV-en VIGS-verwante inligting te verken en te beskryf, en om aanbevelings om hulle begrip te verbeter, te formuleer. 'n Kwantitatiewe, beskrywende en verkennende opname-ontwerp is gevolg. Data is ingesamel deur vraelyste, voltooi deur MIV-positiewe pasiënte (n = 79) en familielede (n = 34). Beskrywende statistiese analise is deur middel van frekwensie-analise uitgevoer. Etiese aspekte en meganismes om geldigheid en betroubaarheid te bevorder word bespreek. Die resultate het getoon dat beide MIV-positiewe deelnemers en hul families se sosiale en finansiële uitdagings ervaar as gevolg van werkloosheid en lae inkomste. 'n Sterkte bevind in hierdie navorsing is dat die meerderheid deelnemers gekoppel is aan 'n kerk, wat 'n waardevolle platform vir die deel van inligting oor MIV en VIGS kan wees. Met betrekking tot deel, bronne en begrip van MIV- en VIGS-verwante inligting is dit duidelik dat deelnemers van mening is dat pre- en post-berading 'n geleentheid vir die deel van inligting is, maar dat hul 'n behoefte het dat die gesondheidswerker meer tyd saam met hul spandeer, nie-veroordelend is en meer gebruik maak van visuele hulpmiddels. Verder het dit geblyk dat die meerderheid MIV-positiewe deelnemers wel die nut van en onderhandeling vir veiliger seksuele praktyke begryp. Die gevolgtrekking was dat alhoewel MIV-positiewe pasiënte en hul families betreklike goeie begrip van MIV- en VIGS verwante inligting toon, daar sekere leemtes in hul begrip is. Daarvolgens is aanbevelings ter verbetering van begrip van MIV- en VIGS verwante inligting geformuleer. Aanbevelings is geformuleer vir verpleegonderwys, navorsing en praktyk. Hierdie aanbevelings beklemtoon die belangrikheid van openheid in kommunikasie, die bou van vertrouensverhoudings, samewerking, kultuur-sensitiwiteit en die bemagtiging van MIV-positiewe pasiënte en hul families. <![CDATA[<b>Students' perceptions regarding the objective, structured, clinical evaluation as an assessment approach</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100006&lng=es&nrm=iso&tlng=es The nursing profession is characterised by the fact that a significant amount of time is spent on competency-related activities. The assessment of clinical competence is therefore an important issue in nursing education and the utilisation of objective structured clinical evaluation for that purpose was considered to be very important in this study. The objective of this research was to explore and describe the perceptions of first- and third-year student nurses with regard to the objective structured clinical evaluation assessment approach. A quantitative, cross-sectional, analytical research design was used. The instrument was a questionnaire (ordinal). This questionnaire focused on the perceptions of student nurses with regard to the objective structured clinical evaluation approach in particular, and with regard to aspects such as reality, execution, time allocation and student and assessor variables. The findings indicated that, as an assessment tool, the objective structured clinical evaluation approach was perceived as not being totally realistic, especially by the more senior nursing students (third-year) as compared with the first-year nursing students. Varying degrees of stress were experienced by the nursing students in their first and third years but, in general, the overall perception appeared to be that the approach was well organised and that the respective students would be able to perform equally well in the clinical field. It may be concluded that the majority of students appreciate the format of the objective structured clinical evaluation approach. However, the study further highlighted the fact that more extensive training of students on time management and the relief of emotional stress is necessary during the implementation of this approach.<hr/>Die verpleeg professie word gekenmerk dat 'n betekenisvolle typerk aan vaardigheids verwante aspekte bestee word. Dus is die evaluering van kliniese vaardighede 'n belangrike komponent in verpleegonderwys en die gebruik van objektiewe gestruktureerde kliniese evaluering was sodoende as noodsaaklik beskou in hierdie studie. Die doelwit van hierdie studie was om die persepsies van eerste en derde jaar verpleegstudente te ondersoek en te beskryf ten opsigte van die objektiewe gestruktureerde kliniese evaluerings benadering. 'n Kwantitatiewe analitiese deursnee studie was gebruik. Die instrument was 'n vraelys (ordinaal). Die focus van die vraelys was op die persepsies van die student verpleegkundiges met betrekking tot die objektiewe kliniese evaluering in besonder, asook op aspekte soos realiteit, uitvoering, tyd toewysing en student en evalueerder veranderlikes. Uit die bevindings blyk dit dat die objektief gestruktureerde kliniese evaluering benadering beskou word as nie volkome realisties nie, veral deur die senior (derde jaar) verpleegkundestudente in verhouding tot die eerstejaars. Wisselende vlakke van spanning is in die eerste en derde studiejare deur die studente ondervind, maar in die algemeen blyk die siening te wees dat die objektief gestruktureerde kliniese evaluering benadering goed georganiseer was en dat die studente in staat sou wees om ewe goed in die kliniese veld te vaar. Die meerderheid van die studente het waardering betyg vir die objektief gestruktureerde kliniese evaluering benadering. Nietemin is dit in die studie bevind dat die studente meer intensief voorberei moet word ten opsigte van tyd spandering, asook hoe om stress te verwerk tydens die evalauering. <![CDATA[<b>Aftercare to chemically addicted adolescents</b>: <b>An exploration of their needs</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100007&lng=es&nrm=iso&tlng=es Treatment of chemical addiction includes preparation for treatment, formal treatment and aftercare. The latter appears to be a neglected area in service delivery to chemically addicted adolescents, contributing to the high relapse potential following treatment. The current qualitative study aimed at both exploring and describing the aftercare needs of chemically addicted adolescents. The chemically addicted adolescents included in this study received in-patient treatment as well as aftercare, but nonetheless experienced a relapse; necessitating further in-patient treatment. Purposive sampling was implemented to recruit 31 participants between the ages of 14 and 20 years. The sample size was determined by data saturation. Data for this exploratory, descriptive and contextual study were collected by means of narrative inquiry. Tesch's framework for qualitative data analysis was employed and data verification was conducted through Guba's model. The findings illustrated a need to attend to adolescents intrapersonal and interpersonal as well as environmental needs following treatment. The results can provide service providers with focus areas to be included in aftercare services to these adolescents.<hr/>Die behandeling van chemiese afhanklikheid sluit die voorbereiding vir behandeling, formele behandeling en nasorg in. Laasgenoemde blyk 'n afgeskeepte area te wees in die lewering van dienste aan chemies-afhanklike adolessente, wat bydra tot die hoë terugvalpotensiaal wat op die behandeling volg. Hierdie kwalitatiewe studie was daarop gerig om die nasorgbehoeftes van chemies-afhanklike adolessente te verken, sowel as te beskryf. Die chemies-afhanklike adolessente wat by hierdie studie ingesluit was het vantevore beide binnepasiëntbehandeling en nasorg ontvang, maar ten spyte hiervan teruggeval; wat verdere binnepasiëntbehandeling genoodsaak het. Doelbewuste steekproefneming is geïmplementeer om 31 deelnemers tussen die ouderdomme van 14 en 20 jaar te werf. Die steekproefgrootte was deur middel van data versadiging bepaal. Data vir hierdie verkennende, beskrywende en kontektuele studie is versamel deur middel van narratiewe ondersoek. Tesch se raamwerk vir kwalitatiewe data-analise is toegepas en dataverifikasie is uitgevoer aan die hand van Guba se model. Die bevindings illustreer 'n behoefte om intrapersoonlike en interpersoonlike, asook omgewingsbehoeftes wat op behandeling volg, aan te spreek as deel van nasorg. Die resultate kan diensleweraars van fokusareas voorsien wat ingesluit kan word in nasorgdienste aan hierdie adolessente. <![CDATA[<b>Maintenance of the selected infant feeding methods amongst postnatal mothers at risk of HIV in the Eastern Cape Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100008&lng=es&nrm=iso&tlng=es The focus of this study was to explore and describe influences on decision making related to infant feeding methods in the context of HIV and AIDS. Study objectives were: (1) to explore and describe the influences on decision making related to infant feeding methods selected by the mother during the antenatal period and (2) to describe the reasons related to a change in infant feeding method in the postnatal period. This cross-sectional study used the quantitative approach and a descriptive design. A convenience sample of 60 mothers in the prevention of mother-to-child transmission programme participated in this study. Data were collected six weeks post-delivery and analysed using SPSS 17.0 software for Windows. The mean age of the mothers was 26.5 years, range 19 to 41 years (SD 5.3). At six weeks 73% (n = 44) of the mothers maintained the infant feeding method selected antenatally and 27% (n = 16) had changed methods. Using a Chi-square test, the difference between groups was significant (x² [df 1] = 19, p < = 28) continued with the method selected antenatally, compared with 50% (n = 16) of all HIV-negative mothers (n = 32). The reasons for deciding to change methods included going back to school or work; illness of babies; painful breasts; and advice from significant others. Most mothers maintained the feeding methods selected antenatally. HIV-positive mothers were more likely to adhere to the initial decisions made antenatally than HIV-negative mothers.<hr/>Hierdie studie is gedoen om deeglike navorsing uit te voer en om 'n beskrywende verslag te kan lewer rakende die invloed van besluitneming met die voedings metodes op babas in die konteks van MIV en VIGS. (1) Deeglike navorsing om beskrywende verslag te kan lewer rakende die besluitnemings met betrekking tot die baba voedings metodes wat deur die moeder geselekteer is gedurende die voorgeboorte periode, en (2) om die redes te beskryf aangaande die verandering in die baba voedings metode nageboortelike periode. Kwantitiewe benadering was gebruik, waartydens 60 moeders deelgeneem het, aan die oordraagbaarheid van moeder na baba. Inligting was ingewin ses weke na geboorte van die baba. Die gemiddelde ouderdom van die moeders was 26.5 jaar, gewissel tussen die ouderdomme van 19 tot 41 jaar (SD 5.3). Op ses weke het 73% (n = 44) van die moeders volgehou met die voedingsmetode wat hulle geselekteer het voorgeboortelik. Sewe-en-twintig (n = 16) het die verkose metodes verander. Die 'Chi-square' toets was gebruik, en die verskil tussen die groepe was beduidend (x² [df 1] = 19, p < = 28) het voortgegaan met die metode wat hulle voorgeboortelik verkies het, in vergeleke met 50% van moeders (n = 16) wat MIV negatief was (n = 32). Die redes vir die veranderings, was om teruggekeer na hul werk of skool, borste wat pyn en deur die invloed van ander invloedryke mense. Die meeste moeders het gebly by hul metode wat hulle voorgeboortelik gekies het, spesiaal MIV-positiewe moeders. <![CDATA[<b>A randomised pilot study on the efficacy of milking cream and a homeopathic complex topical cream on Diaper Dermatitis</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100009&lng=es&nrm=iso&tlng=es Diaper dermatitis (DD) is an acute inflammation of the skin in the diaper area and is the most common cutaneous disease among infants and children. Calendula officinalis, Atropa belladonna and Sulphuricum acidum are homeopathic remedies which have been purported to be beneficial in wound healing and conditions affecting the skin, however, to date, no research has been conducted on the use of these remedies for DD. The aim of this seven-day, double-blind, controlled pilot study was to assess the efficacy of milking cream and a homeopathic complex cream as topical treatments for DD. Forty children between the ages of three to 24 months with DD were recruited. The homeopathic complex cream (n = 20) or unmedicated milking cream (n = 20) was applied after every nappy change for seven days. Efficacy on the severity of symptoms and the percentage of area affected was assessed by means of the 4-Point Grading Scale and the Modified Lund and Browder Charts respectively, on days 1, 2, 4 and 7. The results revealed that both groups showed statistically-significant improvements on rash severity and the percentage of area affected between consecutive visits, as well as over the entire research study period. Trends indicated that the treatment group had a faster resolution of symptoms and outperformed the control in certain affected body regions. Preliminary findings suggest that both milking cream and the homeopathic complex cream may be effective alternative treatment options for DD, and further investigation is warranted.<hr/>Luier dermatitis (LD) is 'n akute inflammasie van die vel in die luier area en is die algemeenste velsiekte onder babas en kleuters. Calendula officinalis, Atropa belladonna en Sulphuricum acidum is beweerde homeopatiese middels wat voordelig is in wondgenesing en ander velkondisies. Tot ophede is daar geen navorsing gedoen op die doeltreffendheid van die bogenoemde middels op LD nie. Die doelwit van die sewe dag, dubbele-blinde, beheerde-loodsstudie was om die doelteffendheid van melksalf en 'n homeopatiese mengsel te evalueer as topikale behandelinge vir LD. Veertig babas tussen die ouderdomme van drie maande tot 24 maande was gewerf om deel te neem aan die studie. Die homeopatiese mengsel room (n = 20) of die melksalf (n = 20) was aangewend met elke luier vervanging vir sewe dae lank. Die doeltreffendheid van die room was beoordeel op dag 1, 2, 4 en 7 aan die erns van die simptome en die persentasie gebied wat geraak was, met behulp van 'n 4-Punt Graderingsskaal en die Gewysigde Lund en Browder Grafiek onderskeidelik. Uitslae het getoon dat die behandelingsgroep en die kontrolegroep albei statistiese, beduidende verbeteringe getoon het op die erns van die uitslag en die persentasie gebied wat geraak is, tussen opeenvolgende besoeke sowel as die hele studie tydperk. Tendense dui daarop dat die behandelingsgroep 'n vinniger oplossing van simptome getoon het en beter gevaar het as die kontrolegroep in sekere geaffekteerde liggaamstreke. Voorlopige bevindinge dui daarop dat beide melksalf en die homeopatiese mengsel room effektiewe, alternatiewe behandelings opsies vir LD is en dat verdere ondersoek geregverdig is. <![CDATA[<b>Initiation of antiretroviral therapy at rural primary health care clinics in KwaZulu Natal</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100010&lng=es&nrm=iso&tlng=es South Africa bears the greatest burden of HIV infection globally with the most infected people living in KwaZulu-Natal (KZN). Decentralised medical care for HIV positive patients and antiretroviral therapy (ART) delivery to primary health care facilities were proposed nationally to achieve adequate ART coverage for patients in need of treatment. This study described the HIV positive patients who accessed medical care and were initiated on ART at two existing government Primary Health Care (PHC) clinics with no added donor support, in Ilembe, KZN. This was an observational descriptive study of ART initiation from 01 April 2008 to 30 April 2009. Data were collected from clinical records kept on site. HIV Testing and the pre-ART programmes which consisted of medical care prior to ART initiation are briefly described. Socio-economic, demographic and clinical characteristics of patients who were initiated on ART were sampled and described. A minority (2.95%) of the study population tested for HIV of which 36.0% tested positive. Majority (60.0%) of patients who joined the pre-ART programme care did not return. The ART sample consisted of 375 patients of whom 65.0% were women, 85.9% were unmarried, 61.6% were unemployed and 50.4% had a secondary level of education. Tuberculosis (TB) prevalence and incidence at ART initiation were 22.1% and 14.7% respectively. The prevalence of Syphilis and Hepatitis B co-infections were 13.1% and 8.6 % respectively. Two thirds of female patients (66.4%) received a Pap smear result of which the majority (62.3%) were abnormal. Uptake for HIV testing followed by relevant CD4 testing was poor. High TB, Hepatitis B and Syphilis co-infection was noted amongst patients initiated on ART. Cervical cancer screening must be intensified. Although ART initiation with no added external resources was successful, record keeping was suboptimal.<hr/>Suid-Afrika dra die grootste las van MIV-infeksie ter wêreld met die meeste besmette mense in KwaZulu-Natal (KZN). Gedesentraliseerde mediese sorg vir MIV-positiewe pasiënte en dienslewering van antiretrovirale terapie (ART) aan primêre gesondheidsorg- fasiliteite is nasionaal voorgestel om optimale ART-behandeling aan behoeftige te verskaf. Hierdie studie beskryf MIV-positiewe pasiënte wat ART-behandeling ontvang by twee bestaande Primêre Gesondheidsorgklinieke (PGS) in Ilembe, KZN sonder enige bykomende skenkerondersteuning. Waarnemingstegnieke is in die studie gebruik om ART-bekendstelling van 01 April 2008 tot 30 April 2009 te bestudeer. Data van kliniese rekords wat op die perseel gehou is, is ingesamel. MIV-toetsing en mediese behandelingsprogramme voor die bekendstelling van ART word kortliks beskryf. Sosio-ekonomiese, demografiese en kliniese eienskappe van pasiënte wat aan ART bekendgestel is, is versamel en beskryf. Minimum (2.95%) respondente aan die studie is vir MIV getoets, waarvan 36.0% positief getoets het. Die Meerderheid (60.0%) van pasiënte wat by die voorafgaande ART-sorgprogram aangesluit het, het nie terugkeer nie. Die ART-steekproef het bestaan uit 375 pasiënte waarvan 65.0% vroue was, 85.9% was ongetroud, 61.6% was werkloos en 50.4% het 'n sekondêre vlak van onderwys gehad. Die bestaan (reeds onder behandeling) en voorkoms (diagnose tydens bekendstelling van die ART-program) van Tuberkulose (TB) tydens ART-bekendstelling was 22.1% en 14.7% onderskeidelik. Die voorkoms van sifilis- en hepatitis B-infeksies was 13.1% en 8.6% onderskeidelik. Twee derdes van die vroulike pasiënte (66.4%) het 'n Papsmeer ondergaan, waarvan die meerderheid (62.3%) se uitslae abnormaal was. Die begrip vir MIV-toetsing gevolg deur toepaslike CD4-toetsing was swak. Hoë TB-, Hepatitis B- en sifilisinfeksies was by pasiënte aangeteken wat met ART-behandeling begin het. Ondersoeke vir servikale kanker moet verhoog word. Hoewel die ART-bekendstelling met geen toegevoegde eksterne hulpbronne suksesvol was, was rekordhouding nie optimaal nie. <![CDATA[<b>Cardio-pulmonary resuscitation challenges in selected Botswana hospitals</b>: <b>Nurse managers' views</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100011&lng=es&nrm=iso&tlng=es Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources. The objectives of the study were to identify unit managers' perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana's hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years' nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.<hr/>Die slagoffers van padongelukke, asook persone wat hart- en ander mediese noodtoestande ervaar, kan hulle lewens verloor omdat daar nie opgeleide personeel met funksionele toerusting en voldoende hulpbronne beskikbaar is om effektiewe kardiopulmonale resussitasie (KPR) te doen nie. Die studie het ten doel gehad om eenheidsbestuurders se persepsies te bepaal oor uitdagings wat hulle in die gesig staan wanneer KPR-tussentredes plaasvind in die twee openbare hospitale in Botswana wat as verwysingshospitale dien. Die bevindings kan gebruik word om effektiewer KPR-strategieë vir Botswana se hospitale aan te beveel. Onderhoude bestaande uit twee kwantitatiewe afdelings met geslote vrae en een kwalitatiewe afdeling met semi-gestruktureerde vrae is met 22 eenheidsbestuurders gevoer. Die kwantitatiewe data het aangedui dat alle eenheidsbestuurders minstens agt jaar se verpleegervaring het en dat hulle die tekortkomings sover dit KPR in hulle hospitale aangaan, kon identifiseer. Slegs een persoon het nog nooit KPR toegepas nie. Die ontleding van die kwalitatiewe data dui daarop dat hospitaaleenhede soms te min personeel het en dat hulle nie ten volle toegeruste noodtrollies en/of toerusting het nie. Geen KPR-spanne en geen KPR-beleid of -riglyne bestaan nie. Verpleegkundiges en dokters het volgens die onderhoude 'n gebrek aan KPR-kennis en -vaardighede. Geen ontlontingsdienste is na KPR-voorvalle vir die personeel beskikbaar nie. Die deelnemende hospitale behoort die uitdagings aan te spreek wat KPR-uitkomste kan beinvloed. Hierdie uitdagings sluit in personeeltekorte, oorbesetting in hospitaaleenhede, tekortkomings in die noodtrollies en toerusting, die gebrek aan KPR-beleid en -riglyne, die afwesigheid van KPR-spanne, dokters en verpleegsters se beperkte KPR-vaardighede en die feit dat ontlontingsdienste nie na KPR-pogings vir personeellede beskikbaar is nie. <![CDATA[<b>AIDS awareness and VCT behaviour</b>: <b>An application of the integrated model of behaviour prediction</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100012&lng=es&nrm=iso&tlng=es In order to limit the expansion of the HIV and AIDS epidemic in South Africa, it is important to develop targeted prevention strategies. The voluntary HIV counselling and testing (VCT) programme appears to be effective for preventing the spread of the HI virus. This study adapted guidelines of the integrated model of behaviour prediction (IMBP) into a questionnaire and examined the extent to which it predicts behaviour. A sample of 92 sports team members from Limpopo ranging from 14 to 30 years of age completed the questionnaire. Results suggested that beliefs about the outcomes of behaviour and beliefs about the expectations of others had a direct influence on the intention to undergo HIV counselling and testing. Efficacy beliefs, namely beliefs that there are factors that can facilitate behaviour, can lead to actual testing behaviour if accompanied by self-efficacy. Knowledge, intention and stigma are not related to VCT behaviour. Findings show that some constructs influence intention and test behaviour, but in ways not predicted by the model. Thus, the adequacy of the IMBP to determine HIV and AIDS-preventative behavioural intentions is questioned.<hr/>Dit is belangrik om doelgerigte voorkomende strategieë te ontwikkel om die verspreiding van MIV en VIGS in Suid Afrika te bekamp. Die vrywillige MIV-voorligtings- en toetsingsprogram (VVT) blyk effektief te wees om die verspreiding van die MI virus te stuit. In hierdie studie is 'n vraelys ontwikkel wat op die geïntegreerde model van gedragsvoorspelling (GMG) gebaseer is. Die studie ondersoek die mate waarin die GMG gedrag kan voorspel. n Steekproef van 92 sport spanlede van Limpopo tussen die ouderdomme van 14 tot 30 jaar, het die vraelys voltooi. Resultate toon dat oortuigings oor die uitkoms van gedrag en oortuigings oor die verwagtings van ander 'n direkte invloed uitoefen op die intensie om VVT te ondergaan. Oortuigings dat daar faktore is wat gedrag kan fasiliteer het 'n invloed op die intensie slegs as 'n mens ook die gemak waarmee gedrag uitgevoer kan word insien. Kennis, intensie en stigma is nie verwant aan toetsgedrag nie. Die bevindinge toon dat sommige konstrukte wel intensie en toetsgedrag beinvloed, maar nie op die manier wat die model voorstel nie. Resultate bevraagteken die vermoê van die GMG om MIV en VIGS- voorkomende gedragsintensies te bepaal. <![CDATA[<b>An exploration of how spiritual nursing care is applied in clinical nursing practice</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100013&lng=es&nrm=iso&tlng=es Spiritual nursing care is a significant concept for nurses as they are expected to provide holistic care to patients. Many nurses have difficulty to understand and integrate it into practice and consequently neglect this aspect of care. The study was conducted to explore and describe how professional nurses provide spiritual care to patients. A generic qualitative, explorative and descriptive study was conducted based on Symbolic Interactionism as the philosophical base. The population comprised professional nurses from a public hospital. Participants were recruited through purposive and snowball sampling methods. Data were collected through the use of individual, focus group interviews and observation. Data analysis methods utilised included the NUD*IST computer program, coding, constant comparison method and Tesch's guidelines on data analysis. Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer with or for patients and singing spiritual songs had the highest count of interventions perceived to be effective. Recommendations suggest that the scope of practice and curriculum of training of nurses be reviewed to consider how spiritual nursing care can be evidenced and realised both in the classroom and in the clinical setting. Spiritual nursing care is still a neglected and seemingly complex component of patient care. However, the scientific worldview practices, beliefs and insufficient statutory endorsement of such care hamper its realisation in practice.<hr/>Geestelike verpleegsorg is 'n belangrike konsep omdat van verpleegkundiges verwag word om pasiënte holisties te versorg. Baie verpleegkundiges vind dié begrip en die integrering daarvan problematies en verwaardeloos gevolglik hierdie aspek van sorg. Die studie ondersoek en beskryf die mate waartoe verpleegkundiges geestelike sorg aan pasiënte verleen. 'n Basiese kwalitatiewe, ekploratiewe, beskrywende studie is uitgevoer met Simboliese Interaksionisme as die filosofiese basis. Professionele verpleegkundiges in 'n openbare hospitaal is vir die studie gebruik. Deelnemers is deur doelgerigte sneeubal-selekteringsmetodes gewerf. Data is deur individuele-, fokusgroeponderhoude en waarneming ingesamel. Metodes vir data-analise het die NUD*IST-rekenaarprogram, kodering, konstante vergelykingsmetode en Tesch se riglyne vir data-analise ingesluit. Resultate toon verpleegkundiges vind dit moeilik om geestelike verpleegsorg te konseptualiseer en van emosionele, sosiale of sielkundige sorg te onderskei. Nietemin het gebed met of vir pasiënte en die sing van geestelike liedere die hoogste telling wat as effektiewe intervensie beskou kan word. Aanbevelings suggereer die hersiening van die bestek van praktyk asook die kurrikulum vir die opleiding van verpleegkundiges ten einde sorg te dra dat geestelike verpleegsorg in die klaskamer sowel as in die kliniese praktyk sigbaar en verwesenlik word. Geestelike verpleegsorg is steeds 'n verwaarloosde en oënskynlik 'n komplekse komponent van pasiëntsorg. Desondanks word die praktykverwesenliking daarvan belemmer deur die wetenskaplike wêreldbeskouing, oortuigings en onvoldoende statutêre onderskrywing. <![CDATA[<b>Shaping the role of sub-Saharan African nurses and midwives</b>: <b>Stakeholder's perceptions of the nurses' and midwives' tasks and roles</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100014&lng=es&nrm=iso&tlng=es To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussions were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals) in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.<hr/>Om die rol verwagtings van verskillende rolspelers in die gesondheidsisteem aangaande die rolle en take van die verpleegkundiges en vroedvroue te ondersoek, om daardeur uitklaring en helderheid en bekragtiging van hierdie rolle te verkry, waardeur die toekoms van verpleeg-onderwys en praktyk in sub-Sahara Afrika gevorm kan word. Kwalitatiewe fokus groepe is met verskillende rolspelers (verpleegkundiges, gesondheidsdiens bestuurders, pasiënte en hulle versorgers, lede van die gemeenskap, leiers en lede van andere gesondheidsprofessies) in agt Afrika lande gehou om hul rolverwagtings van verpleegkundiges en vroedvroue te bepaal. Drie vrae is oor die rolverwagtings gevra. Die onderhoude is opgeneem, getranskribeer, in Engels vertaal, en geanaliseer. Daar was konsensus tussen rolspelers oor agt rol funksies: versorging van pasiënte; die gee van gesondheidsinligting; bestuur van die sorgomgewing; voorspraak vir pasiënte; dienste en beleid; voorsiening van nooddienste; samewerking met ander rolspelers; en voorsiening aan moeder en kindersorg vir vroue en hul gesinne. Ooreenstemming is nie bereik aangaande die rol van diagnose en voorskryf van behandeling nie. Verpleging kry sy mandaat van die gemeenskappe wat gedien word en daarom behoort die rolverwagtings deel te vorm van verpleeg-regulasie, onderwys en praktyk- standaarde. Gesondheidsdiensbeplanners behoort hierdie verwagtings as basis te gebruik vir werksbeskrywings en erkenning. Na die aanvaarding van hierdie verwagtings in verpleegopleiding en regulering, moet dit bekend gemaak word sodat die gemeenskap daarvan bewus is. <![CDATA[<b>Nurse educators and student nurse neophytes' perceptions of good interaction in the classroom setting</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100015&lng=es&nrm=iso&tlng=es The first session of interaction in the classroom often sets an atmosphere for the entire period of learning. In terms of nurse educator and student nurse neophyte relations, good interaction is essential in helping students to recognise their own responsibilities and to respond positively during the learning process. The purpose of this study was to determine the nurse educators' and student nurse neophytes' perceptions of good interaction in the classroom setting. The study attempted to answer the following specific question: 'What do nurse educators and student nurse neophytes regard as examples of good interaction in the classroom setting?' The accessible population in this study were all student nurse neophytes registered with the University of Venda for the Baccalaureus Curationis, and nurse educators responsible for teaching first-year student nurses in this programme. The study used probability stratified random sampling to obtain two heterogeneous groups of student participants. Forty first-year student nurses were divided into homogenous subsets of 15 male and 25 female students. A random sampling was conducted to arrive at 10 male and 15 female students. The sampling method relating to nurse educators was purposive sampling. Focus groups were used to interview students using individual in-depth interviews to gather data from nurse educators. Coding was used to organise the data collected during the interviews. The study revealed that nurse educators and student nurse neophytes concur that the ethical behaviours influencing good interaction are respect and support, good communication, honesty and openness. Age, gender and cultural background were also factors. The participants further indicated that good interaction has benefits such as improved co-operation levels, the enhancement of learning, the improvement of pass rates, and a reduction in dropout rates. In conclusion, there is a need for nurse educators and student nurses to develop good practices to promote good interaction in the classroom setting.<hr/>Die wyse waarop die interaksie tydens die eerste sessie in die klaskamer benader word, bepaal dikwels die atmosfeer vir die res van die leerperiode. Goeie interaksie is dus nodig tussen die verpleegopvoeder en die verpleegnuweling-studente om studente te help om verantwoordelikheid te aanvaar en om positief tydens die leerproses te reageer. Die doel met die studie was om te bepaal wat die persepsies van verpleegopvoeders en verpleegnuwelingstudente is ten opsigte van goeie interaksie in die klaskameropset. Die studie het gepoog om die volgende vraag te beantwoord: 'Wat word deur verpleegopvoeders en verpleegnuweling-studente beskou as voorbeelde van goeie interaksie in die klaskameropset?' Die toeganklike populasie vir die studie was al die verpleegnuweling-studente wat vir die Baccalaureus Curationis aan die Universiteit van Venda geregistreer is, sowel as die verpleegopvoeders wat verantwoordelik is vir die onderrig van die eerstejaar verpleegstudente. Die studie het gebruik gemaak van waarskynlike, ewekansige gestratifieerde steekproeftrekking om twee heterogene groepe studente te trek. Veertig eerstejaarstudente is opgedeel in homogene substelle van 15 manlike en 25 vrouike studente. Die steekproef van die verpleegoopvoeders is met behulp van doelbewuste steekproeftrekking getrek. Fokusgroepe is gebruik om onderhoude te voer met die studente. In-diepte onderhoude is met die verpleegopvoeders gevoer om inligting in te win. Kodifisering is gebruik om die data te organiseer wat tydens die onderhoude ingewin is. Die studie het getoon dat sowel verpleegopvoeders as verpleegnuwelinge saamstem dat respek, ondersteuning, goeie kommunikasie, eerliklheid en openheid etiese gedragspatrone is wat goeie interaksie beïnvloed. Ouderdom, geslag en kulturele agtergrond is ook faktore. Die deelnemers het verder aangedui wat goeie interaksievoordele inhou, soos verbeterde vlakke van samewerking, die verbeterde leerproses, verhoging in slaagsyfers en die afname in uitsakkingsyfers. Opsommenderwyse is daar 'n behoefte aan verpleegopvoeders en verpleegnuweling-studente om goeie praktyke ten opsigte van goeie interaksie in die klaskameropset te ontwikkel. <![CDATA[<b>Sportmen's experiences at a somatology clinic receiving a sport massage</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100016&lng=es&nrm=iso&tlng=es Sportsmen are increasingly visiting somatology clinics for massages prior to an aerobic sports event. Massage is frequently utilised prior to an athletic activity, as a means of enhancing performance. Massage is known to have both calming and stimulating properties, thereby possessing the potential to benefit performance in numerous different circumstances. In the context of sportsmen visiting somatology clinics, it is unclear how men experienced the benefits of a massage by a therapist in the somatology environment, prior to participating in an aerobic sports event. The purpose of this qualitative, exploratory, descriptive and contextual study was to explore and describe the experiences of men regarding sports massage in a somatology clinic prior to an aerobic sports event. Purposive sampling was used to select eight (8) men, aged between 25 and 50 years, who received two massages within two weeks prior to participating in an aerobic sports event. The data were collected through in-depth, unstructured, individual interviews and field notes until saturation of data was achieved. Trustworthiness was ensured by utilising the principles of Lincoln and Guba's model. The men experienced the sports massage as relaxing and giving perceived holistic beneficial effects. They described their experience during the massage and during and after participation in an aerobic sports event. A sports massage brings about psychological, physical, and spiritual effects during and after participation in an aerobic sports event.<hr/>Sportsmanne besoek toenemend somatologieklinieke vir masserings voor 'n aërobiese sportsbyeenkoms as 'n manier om prestasie te bevorder. Massering is bekend vir beide die kalmerende en stimulerende eienskappe daarvan, en daarom beskik dit oor potensiële voordele vir prestasie in verskeie omstandighede. In die konteks van sportsmanne wat somatologieklinieke besoek, is dit steeds onduidelik hoe mans die voordele van 'n massering by 'n somatologieterapeut voor hul deelname aan 'n aërobiese sportsbyeenkoms ervaar. Die doel van hierdie kwalitatiewe, ondersoekende, beskrywende en kontekstuele studie was om die ervaringe van mans ten opsigte van 'n sportsmassering in 'n somatologiekliniek voor 'n aërobiese sportsbyeenkoms te ontdek en te beskryf. Doelbewuste steekproefneming is gebruik om agt mans, tussen 25 en 50 jaar oud, wie twee masserings binne twee weke voor deelname aan 'n aërobiese sportsbyeenkoms ontvang het, te selekteer. Die data is deur in diepte, ongestruktureerde onderhoude en veldnotas ingesamel totdat dataversadiging bereik is. Vertrouenswaardigheid is deur die gebruik van die beginsels van Lincoln en Guba se model verseker. Die mans het hul ervaring tydens die massering, asook tydens en na hul deelname aan die aërobiese sportsbyeenkoms, beskryf. Hulle het die sportsmassering as ontspannend ervaar wat holisties voordelige effekte meebring. Die massering het psigologiese, fisiese en geestelike voordele teweeggebring. <![CDATA[<b>The South African Military Nursing College Pupil Enrolled Nurses' experiences of the clinical learning environment</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100017&lng=es&nrm=iso&tlng=es The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs) within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both challenging and exasperating for students, as the scopes are diverse. Being notably very hierarchical, the military's rules constantly take precedence over nursing rules. For the duration of nursing training, students are allocated in the clinical learning area to acquire competencies such as problem solving, cognitive and psychomotor skills (Kuiper & Pesut 2003:383). Students learn how to merge theory and practice and apply theories in the practical sense. This is however, not done in isolation from the military codes, as they are intertwined. Attendance of military parades and drills are incorporated during this phase. This could create missed opportunities from the clinical learning as students are expected to leave the clinical setting for this purpose. Three focus group sessions were conducted and the experiences of the students, as narrated by themselves, yielded valuable insights. The researcher wrote field notes and assisted with the management of the audio tapes for easy retrieval of information. Data was analysed by the researcher, independent of the cocoder. Two themes relating to the PENs' learning experiences emerged from the data analysed: (1) facilitators of clinical learning, (2) and barriers to clinical learning. The findings obtained depicted those factors which facilitated and obstructed student learning. These findings made it possible for the researcher to make recommendations concerning positive interventions which could be taken to enhance learning.<hr/>Die studie het gefokus op die kliniese leerervarings van leerling-ingeskrewe verpleegkundiges (LIV's) in die militêre gesondheidsdiens. Die doel met die navorsing is om die kliniese leerervarings van LIV's binne die militêre gesondheidsomgewing te verken en te beskryf. 'n Verkennende, beskrywende, kontekstuele ontwerp, kwalitatief van aard, is gebruik om die studie te rig. As 'n opleidingsinstituut roem die weermag hulle op die opleiding van verpleegkundiges as soldate, en nie slegs verpleegkundiges nie. Dit kan uitdagend sowel as frustrerend vir studente wees omdat die omvang van hierdie opleiding so divers is. In die weermag, bekend vir sy hiërargie, geniet militêre reëls gedurig voorrang bo verpleegkundige reëls. Vir die duur van die verpleegopleiding word studente aan die kliniese leerareas toegewys om vaardighede soos probleemoplossing en kognitiewe en psigomotoriese vaardighede te bekom (Kuiper & Pesut 2003:383). Studente leer hoe om teorie en praktyk te verenig en teorie in die praktyk toe te pas. Dit word egter nie geïsoleerd van militêre kodes gedoen nie, aangesien dit alles vervleg is. Bywoning van militêre parades en drilsessies moet in hierdie fase geïnkorporeer word. Dit kan tot verbeurde kliniese opleidingsgeleenthede lei, aangesien daar van studente verwag word om die kliniese omgewing vir hierdie doeleindes te verlaat. Drie fokusgroepsessies is gehou en die ervarings van die studente, soos deur hulleself vertel, het waardevolle insigte gelewer. Die navorser het veldnotas gemaak en was behulpsaam met die hantering van bandopnames om die herroeping van inligting te vergemaklik. Die navorser het die data onafhanklik van die medekodeerder geanaliseer. Twee temas met betrekking tot die leerervarings van LIV's het na afloop van die data-analise aan die lig gekom: (1) fasiliterende faktore vir kliniese leerervaring, (2) struikelblokke tot kliniese leerervaring. Die bevindinge dui op faktore wat die studente se leerervaring fasiliteer, asook struikelblokke tot leerervaring. Na aanleiding van hierdie bevindinge het dit moontlik gemaak vir die navorser om aanbevelings te maak aangaande positiewe intervensies wat toegepas kan word ter bevordering van die leerervaring. <![CDATA[<b>Nurses' experiences and understanding of workplace violence in a trauma and emergency department in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100018&lng=es&nrm=iso&tlng=es Violence in South African society has reached epidemic levels and has permeated the walls of the workplace. The aim of the study was to gain a deeper understanding of how nurses experience and understand workplace violence perpetrated by patients, and to make recommendations to reduce this type of violence. A qualitative, exploratory and descriptive study was conducted to explore the experiences and coping mechanisms of nurses regarding workplace violence. The purposive sample comprised eight nurses working in the Trauma and Emergency Department in the Western Cape, South Africa. Thematic analysis was done of the semi-structured interviews. Four main themes and 10 categories were identified. Nurses are experiencing physical threats, verbal abuse and psychological and imminent violence on a regular basis. They tend to 'normalise' abusive patient behaviour because of the perception that workplace abuse 'comes with the territory', which resulted in under-reporting. However, perpetrators received compromised care by being avoided, ignored or given only minimal nursing care. Coping mechanisms ranged from using colleagues as sounding boards, helping out with duties, taking a smoke break and using friends and family to get it 'off their chest'. The tolerance of non-physical violence and the absence of policies to deal with the violence, contribute to under-reporting.<hr/>Geweld in die Suid-Afrikaanse samelewing het epidemiese vlakke bereik en selfs werksplekke binnegedring. Die doel van die studie was om 'n dieper begrip te verkry van hoe verpleegsters geweld deur pasiënte by die werksplek ervaar en verstaan, en aanbevelings te maak om hierdie tipe van geweld te verminder. 'n Kwalititatiewe, eksploratiewe en beskrywende ontwerp is gebruik om die ervaringe en hanteringsmeganismes te verken van verpleegkundiges wat aan werkpleksgeweld blootgestel was. 'n Doelgerigte steekproef is gedoen bestaande uit agt verpleegkundiges werksaam in die Trauma en Nooddienste Departement in die Weskaap, Suid Afrika. Die semi-gestruktureerde onderhoude is kwalitatief ontleed vir temas. Vier hooftemas en 10 kategorieë is geïdentifiseer. Verpleegkundiges ervaar dreigemente van fisiese geweld, verbale misbruik en psigiese en dreigende geweld gereeld. Hulle is geneig om pasiënte se misbruikende gedrag te 'normaliseer' omdat hulle die persepsie het dat geweld of misbruik 'deel van die werksomgewing' is. Hierdie persepsie gee aanleiding tot onder-rapportering van nie-fisiese geweld en gekompromitteerde sorg deurdat skuldige pasiënte of vermy, geïgnoreer of minimale sorg gegee word. Hanterings meganismes sluit in reflektering teenoor kollegas, uithelp met take, die gebruikmaking van 'n rook breek, en ontlaaing teenoor familielede en vriende. Die toleransie van nie-fisiese geweld en die gebrek van beleidsriglyne dra by tot die onder-rapportering van werksplek geweld. <![CDATA[<b>The experiences of private somatology therapists on their self-management in a private practice</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100019&lng=es&nrm=iso&tlng=es Somatology therapists have a demanding occupation, both physically and emotionally. Long working hours coupled with handling clients on a daily basis, notwithstanding the strain of ensuring high quality client care, are all aspects that place pressure on the therapist. These aspects, in the backdrop of a lack of self-management of a therapist, could result in impaired judgement and substandard performance in the workplace. The purpose of this study included exploring and describing the experiences of private somatology therapists in self-management, from which recommendations for improved self-management within private somatology practices were described. For the purpose of this study, self-management was defined as a method of managing not only the interaction with clients and work stressors, but also the feelings of the therapists, by practising a variety of techniques such as self-discipline. A descriptive, exploratory and contextual qualitative design was followed. The accessible population consisted of therapists (n = 15) practising at six private somatology facilities in the Pretoria North region. Purposeful sampling was followed. Ten individual unstructured interviews as well as a pilot study were conducted in which field notes were taken. Open-coding data analysis identified four themes with subthemes. Lincoln and Guba's model was used to ensure trustworthiness and ethical considerations were followed throughout the process. Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment which we call the somatology practice.<hr/>Somatologie terapeute het 'n veeleisende werk hetsy fisies en emosioneel. Lang werksure, gekoppel met die hantering van kliënte op 'n daaglikse basis, asook die stremming om te alle tye 'n hoë gehalte kliëntesorg te verseker, is als faktore wat spanning op die terapeut plaas. Die gebrek aan selfbestuur van 'n terapeut - in die agtergrond van die bogenoemde bydraende faktore - kan tot 'n swak oordeelsvermoë en dienooreenkomstige substandaard optrede in die werkplek lei. Die doel van hierdie studie was onder andere om die ervarings van privaat somatologie-terapeute te ondersoek en te omskryf, waarvolgens aanbevelings vir verbeterde selfbestuur in privaat somatologie-praktyke beskryf was. Vir die doeleindes van hierdie study, word selfbestuur gedefinieër as 'n metode om nie alleenik die interaksies met die kliênte en die werkstressors te bestuur nie, maar ook om die gevoelens van die terapeute te bestuur, deur middel van die uitoefening van 'n verskeidenheid tegnieke, onder andere, self-dissipline. 'n Beskrywende, ondersoekende en kontekstuele kwalitatiewe ontwerp is gevolg. Die toeganklike populasie het uit terapeute (n = 15) in ses private somatologie-praktyke in die Pretoria-Noordstreek bestaan. 'n Doelgerigte steekproef is gevolglik geneem. Tien individuele ongestruktureerde onderhoude, asook 'n loodstudie is uitgevoer en veldnotas is geneem. Oop kodering het vier temas met subtemas geïdentifiseer. Die model van Lincolin en Guba is gebruik om betroubaarheid te verseker en etiese oorwegings is tydens die navorsingsproses gevolg. Ingeligte toestemming is deur die privaat kliniekpraktyke en deelnemers verleen. Een tema het inderdaad aangedui dat selfbestuurstrategieë gedemonstreer behoort te word om sodoende 'n gevoel van beheer te bekom. Hierdie studie het geidentifiseer dat daar 'n definitiewe behoefte is om die terapeut binne die veeleisende werksomgewing te koester wat ons die somatologiepraktyk noem. <![CDATA[<b>Staying well in old age</b>: <b>Predicting older adults' wellness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100020&lng=es&nrm=iso&tlng=es In an ageing world, the potential for ageing well in older people is still relatively unexplored. Literature has suggested that a sense of coherence (SOC) is an important factor with regard to retaining a good quality of life in old age. To explore whether satisfaction with life (SWL), as well as sociodemographic, health- and lifestyle-related variables, are predictors of SOC in a community-dwelling sample of older adults and to assess significant differences in SOC amongst the four nationalities studied. Cross-national research encompassing a community-dwelling sample of 454 older adults aged 75 years and above was undertaken. Sense of coherence was assessed using the Orientation to Life Questionnaire and Satisfaction with Life (SWL) was measured using the Satisfaction with Life Scale. Structural equation modelling was used to investigate a structural model of the self-reported SOC, comprising sociodemographic variables (age, gender, marital status, professional status, educational level, family's annual income and standard of living arrangements), as well as SWL, lifestyle and health-related (physical activity and recent disease) characteristics. Significant predictors were physical activity (β = 0.804; p < 0.001), recent disease (β = 0.501; p < 0.001) and SWL (β = 0.07; p = 0.004). These variables accounted for approximately 57.5% of the variability of SOC. Moreover, differences with regard to SOC were also found amongst the four nationality groups (F(3) = 5.204; p = 0.002). Physical activity is the strongest predictor of self-reported SOC. Other predictors are the absence of a recent disease and SWL. The four nationalities presented significant differences with regard to SOC. This study highlighted the need for understanding the potential factors (in particular physical activity and further health-related characteristics) that impact on older adults' SOC.<hr/>In 'n wêreld wat aan die verouder is, is die potensiaal van bejaardes om goed te verouder steeds relatief onbekend. 'n Toenemende literatuurbasis stel voor dat koherensiesin belangrik is om 'n goeie lewensgehalte vir bejaardes te verseker. Om te verken of lewenstevredenheid, sosio-demografiese, gesondheids- en lewenstylverwante veranderlikes voorspellers is van die koherensiesin in 'n steekproef van bejaardes wat nie in tehuise woon nie, asook om die beduidende verskille tussen die vier nasionaliteite met betrekking tot die koherensiesin te evalueer. Kruis-nasionale navorsing bestaande uit 'n steekproef van 454 volwassenes, 75 jaar of ouer, wat nie in tehuise woon nie. Koherensiesin is met behulp van die lewensoriëntasievraelys beoordeel en lewenstevredenheid is met behulp van die lewenstevredenheidskaal gemeet. Strukturele vergelykingsmodellering is gebruik om 'n strukturele model van die self-gerapporteerde koherensiesin te ondersoek. Die model bestaan uit sosio-demografiese veranderlikes (ouderdom, geslag, huwelikstatus, professionele status, opvoedkundige vlak, gesin se jaarlikse inkomste en lewensomstandighede), asook lewenstevredenheid, lewenstyl- en gesondheidsverwante (fisiese aktiwiteitsvlak en onlangse siekte) eienskappe. Beduidende voorspellers is fisiese aktiwiteitsvlak (β = .804; p < 0.001), onlangse siekte (β = .501; p < 0.001) en lewenstevredenheid (β = .07;p = 0.004). Die veranderlikes verklaar onderskeidelik 57.5% van die wisselvalligheid van die koherensiesin. Verder is daar ook verskille tussen die vier nasionaliteite met betrekking tot koherensiesin (F(3) = 5.204; p = 0.002) gevind. Fisiese aktiwiteitsvlak is die sterkste voorspeller van self-gerapporteerde koherensiesin. Ander voorspellers is lewenstevredenheid en die afwesigheid van onlangse siekte. Die vier nasionaliteite het duidelike verskille ten opsigte van koherensiesin getoon. Hierdie studie beklemtoon die noodsaaklikheid om die potensiële faktore - veral fisiese aktiwiteitsvlak en verdere gesondheidsverwante eienskappe - wat bejaardes se koherensiesin be'invloed, te verstaan. <![CDATA[<b>Factors influencing the quality of patient data captured by nurses for the tuberculosis control programme in Oshakati District, Namibia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100021&lng=es&nrm=iso&tlng=es Effective tuberculosis control relies heavily upon the general health system of the country, particularly on well-functioning primary healthcare services. This study investigated factors influencing the quality of data for the tuberculosis control programme in Oshakati district in Namibia. A quantitative, contextual, cross-sectional descriptive survey was conducted using 50 nursing personnel of different cadres who were sampled from five departments in Oshakati State Hospital. Data was collected by means of a self-administered questionnaire. Most participants reported that tuberculosis-related training improved correct recording and reporting amongst nursing personnel, which is a requirement for a quality tuberculosis control programme. The number of documents to be completed for each patient influences the quality of data recording and completeness. Factors such as the lack of resources and of adequate training as well as knowledge of tuberculosis control guidelines, in particular the use of records to capture the core tuberculosis indicators, influence the quality of data in the tuberculosis control programme. Knowledge, attitudes and practice are the main factors influencing the quality of data in the tuberculosis control programme in Oshakati district.<hr/>Die effektiewe beheer van tuberkulose steun grootliks op die algemene gesondheidstelsel van 'n land, veral op die goeie werkende primêre gesondheidsorgdienste. Die studie het faktore wat die gehalte van data vir die teringbeheerprogram in die Oshakati Distrik in Namibië ondersoek.'n Kwantitatiewe, kontekstuele, kruisseksionele, beskrywende opname was onderneem met 'n steekproef van 50 verpleegpersoneel van verskillende kadres uit vyf departemente in Oshakati Staatshospitaal. Data was deur middel van 'n selftoegediende vraelys ingewin. Die meeste deelnemers het genoem dat teringverwante opleiding die korrekte afneem en rapportering onder verpleegpersoneel verbeter het, wat 'n vereiste is vir 'n gehalte teringbeheerprogram. Die aantal dokumente wat vir elke pasiënt voltooi moet word, beïnvloed die gehalte van data-aantekening en volledigheid. 'n Tekort aan bronne en gepaste opleiding, en kennis van tering-beheerriglyne, veral die gebruik van teringrekords om die kern teringaanwysers op te neem, was ander belangrike faktore wat die gehalte van data in die teringbeheerprogram beïnvloed het. Kennis, houdings en praktyk is die vernaamste faktore wat die gehalte van data in die program in die Oshakati Distrik beinvloed. <![CDATA[<b>Location of community pharmacies and prevalence of oral conditions in the Western Cape Province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100022&lng=es&nrm=iso&tlng=es Community pharmacists are approached regularly for oral health advice; most commonly for ulcers which could be indicative of oral cancer, HIV, and various systemic diseases. Community pharmacists should know how to manage these conditions yet they have very limited training to manage these conditions appropriately. The area location and socioeconomic status (SES) of the pharmacy should be considered as it may influence patient management. A study of this nature has not yet been conducted in the Western Cape Province of South Africa. To determine the prevalence and frequency of oral complaints at community pharmacies and if these parameters differ by metropolitan location and SES. A cross-sectional survey of 162 randomly-selected private sector pharmacies was conducted. The sample (n = 121) was stratified by SES and metropolitan location. An open-ended structured questionnaire was faxed to pharmacists. A telephonic interview was conducted a day later. Community pharmacists were asked about the frequency and type of oral health problems they encountered. Most pharmacists (91%) dealt with oral health problems frequently, most commonly for ulcers (55.8%), thrush (49.2%), and toothache (33.3%). The results did not differ by metropolitan location and SES (Chi-squared, Fisher's Exact, p > 0.05), with the exception of toothache and mouth sores. Community pharmacists are an important part of an interdisciplinary team, and play a definite role in the early detection of oral health conditions, namely, caries, HIV and oral cancer. Training on common oral health conditions should be included in undergraduate pharmacy curricula and continuous professional development courses.<hr/>Gemeenskapsaptekers word gereeld genader vir advies rakende mondgesondheid, hoofsaaklik mondsere wat 'n aanduiding kan wees van mondkanker, MIV en verskeie sistemiese siektes. Gemeenskapsaptekers moet weet hoe om hierdie kwessies te hanteer. Die ligging van die area en die sosio-ekonomiese status (SES) van die apteek moet in ag geneem word aangesien dit 'n invloed mag hê op die hantering van die pasiënt. 'n Studie van hierdie aard is nog nie in die Wes-Kaap Provinsie van Suid-Afrika onderneem nie. Die doel van hierdie studie is om die voorkoms en herhaling van klagtes oor mondsiektes by gemeenskapsapteke te bepaal en of hierdie parameters verskil na gelang van metropolitaanse ligging en SES. 'n Deursnee-opname van 162 ewekansig geselekteerde privaat sektor-apteke is onderneem. Die steekproef (n = 121) is gestratifiseer ten opsigte van SES en metropolitaanse ligging. 'n Oopeinde gestruktureerde vraelys is aan apteke gefaks. 'n Telefoniese onderhoud is 'n dag later gevoer. Gemeenskapsaptekers is gevra na die herhaling van en die tipe mondgesondheidsprobleme wat hulle teëgekom het. Die meeste aptekers (91%) het dikwels met mondprobleme te doen gekry, meestal mondsere (55.8%), mondsproei (49.2%) en tandpyn (33.3%). Die bevindinge het nie verskil na gelang van metropolitaanse ligging en SES (Chi-kwadraat, Fisher se eksakte toets, p > 0.05) nie, met die uitsondering van tandpyn en mondsere. Gemeenskapsaptekers vorm 'n belangrike deel van 'n interdissiplinêre span, en speel 'n definitiewe rol in die vroeë opsporing van mondgesondheidstoestande, naamlik tandverrotting, MIV en mondkanker. Opleiding in algemene mondgesondheidstoestande behoort deel te vorm van voorgraadse aptekerskurrikulums en voortgesette professionele ontwikkelingskursusse. <![CDATA[<b>The BETA nursing measure</b>: <b>Its development and testing for nursing utility</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100023&lng=es&nrm=iso&tlng=es In the specialised nursing fields of rehabilitation, convalescence and gerontology requiring restorative nursing interventions, nurses are unable to measure, assess and evaluate accurately and routinely the outcomes of their patients' activities of daily living (ADLs) due to the lack of validated nursing measures. The purpose of this study was to develop a nursing scale, named the BETA, which can be used routinely and embedded into the nursing process and care plan, enabling the primary nursing carer to measure, assess and evaluate patients' ADLs. The first objective was to design and develop the BETA, a routine nursing scale, whereby caregivers and nursing auxiliaries can observe, score and record their patients' activities of daily living. The second objective was to test the BETA's nursing utility to be used routinely. Two qualitative studies were done sequentially. Firstly, individual interviews were conducted to collect descriptive data from registered nurses (n = 6), nursing assistants, (n = 8) and caregivers (n = 16), skilled in the field of restorative care. In the first study, the data were analysed using inductive content analysis techniques to design and construct the BETA nursing measure. In the second study, the BETA's nursing utility was studied by means of the training of and testing the application of the BETA by a new team of professional nurses (n = 6) and caregivers (n = 48) working in a geriatric frail care unit. After 6 months, two homogenous focus groups consisting of registered nurses (n = 3) and caregivers (n = 5) representing this team were interviewed to explore the BETA's nursing utility. Descriptive data in the second study were analysed using deductive content analysis. The initial results were promising. The high levels of agreement on its acceptance, usefulness and confidence, to be used routinely as a nursing scale, confirmed the BETA's nursing utility. The BETA nursing scale has the potential to introduce restorative nursing as a new specialisation field in South African nursing, a much needed service required by patients and multidisciplinary teams. This, however, will depend on the construct validity of the BETA, a study to be reported on in a follow-up article.<hr/>Gespesialiseerde verpleging vir rehabilitasie, herstelling en gerontologie benodig restoratiewe intervensies, maar verpleegsters kan nie die uitkomste van hul pasiênte se aktiwiteite van daaglikse lewe (ADLs) akkuraat en geroetineerd meet, assesseer en evalueer nie, asgevolg van 'n gebrek aan geldige meet instrumente. Die doel van hierdie studie was om die BETA, 'n verplegings meet skaal, te ontwikkel wat roetineweg deel kan word van die verplegingsproses en sorgplan en wat die primêre versorger in staat stel om pasiênte se ADLs te meet, assesseer en evalueer. Die eerste doelwitte was om die BETA skaal te ontwerp en ontwikkel vir primêre versorgers om hul pasiênte se ADLs roetineweg te kan waarneem en opteken. Die tweede doelwit was om die BETA skaal se nuttigheid vir verpleegsters te toets. Daar is twee opeenvolgende kwalitatiewe studies gedoen. Eers is daar individuele onderhoude gevoer om beskrywende data te versamel van geregistreerde verpleegsters (n= 6), verpleegassistente, (n = 8) en versorgers (n = 16), wat bedrewe is in die veld van restoratiewe verpleging. In die eerste studie is die data geanaliseer met behulp van induktiewe inhoudsanalisetegnieke om die BETA skaal te ontwerp en op te stel. In die tweede studie is die BETA se nuttigheid vir verpleging bestudeer deur opleiding en toetsing in die toepassing van die BETA deur 'n nuwe span geregistreerde verpleegsters (n = 6) en versorgers (n = 48) wat in 'n versorgingseenheid vir geriatriese verswaktes werk. Na ses maande is twee homogene fokusgroepe gehou, bestaande uit geregistreerde verpleêrs (n= 3) en versorgers (n= 5) wat hierdie span verteenwoordig, om die nuttigheid vir verpleging te ondersoek. Beskrywende data in die tweede studie is met behulp van deduktiewe inhoudsanalisetegnieke geanaliseer. Die aanvanklike resultate was belowend. Die BETA se nuttigheidsvlakke vir verpleging het hoê hoogtes van aanvaarding, betroubaarheid en vertroue bevestig. Die BETA-verplegingskaal het die potensiaal om restoratiewe verpleging as n nuwe spesialiseringsveld in Suid-Afrikaanse verpleging te bewerkstellig, n baie nodige diens vir beide pasiënte en multidissiplinêre spanne. Dit sal egter afhang van die geldigheid van die BETA, n studie waaroor daar in n opvolgartikel verslag gedoen sal word. <![CDATA[<b>Social and health determinants of gender differences in disability amongst older adults in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100024&lng=es&nrm=iso&tlng=es There has been an unprecedented increase in population ageing resulting in the increase in prevalence of various health conditions, including disability and associated risk factors. This study aimed to investigate the prevalence and predictors of functional status and disability amongst older South Africans. Little is known about disability amongst older South Africans because most previous health research has focused on younger individuals and infectious diseases. We conducted a national population-based cross-sectional study with a sample of 3840 subjects aged 50 years or older in South Africa. Multivariable regression analysis was performed in order to assess the association of social factors, health variables and functional disability. Overall, 37.2% of the respondents had moderate or severe and/or very severe functional disability, this being higher amongst women. The highest disability was found for the mobility, cognition and participation domains. In all domains, except for the self-care domain, women had a higher disability prevalence. Multivariable analysis amongst men revealed that older age, having some or primary education, being from Indian or Asian race, having chronic conditions, physical inactivity and a lower quality of life were associated with functional disability. Amongst women, older age, as well as having chronic conditions and a lower quality of life, were associated with functional disability. This study has implications for health-sector strategic plans aimed at preventing disabilities, ensuring access to curative and rehabilitative care. This study forms an evidence base upon which future policies and health care management systems can be based.<hr/>Daar was 'n ongekende toename in bevolkingsveroudering, wat 'n toename in die voorkoms van verskeie gesondheidstoestande tot gevolg gehad het, insluitende gestremdheid en gepaardgaande faktore. Die studie was daarop gemik om die voorkoms en voorspelbaarheid van die funksionele status en gestremdheid onder ouer Suid-Afrikaners te ondersoek. Daar is min bekennis oor gestremdheid onder ouer Suid-Afrikaners omdat vorige gesondheidsnavorsing meestal op jonger individue en oordraagbare siektes ingestel was. Ons het 'n nasionale bevokings-gebaseerde kruis-seksionele ondersoek uitgevoer op 'n studiemonster van 3840 Suid-Afrikaners, 50-jaar en ouer. Om die verband tussen sosiale faktore, gesondheidsveranderlikes en funksionele gestremdheid te bepaal, is veelvuldig veranderlike regressie-analise uitgevoer. In die algemeen het 37.2% van die respondente matig of ernstige funksionele gestremdheid ervaar wat hoër was onder vroue. Die hoogste vorm van gestremdheid was op die gebiede van beweeglikehid, waarneming en deelname. Die voorkoms van gestremdheid was op alle gebiede hoër in vroue, behalwe op die gebied van selfsorg. Multi-veranderlike ontledings onder mans het getoon dat funksionele gestremdheid geassosieer word met ouderdom, met 'n mate van primêre onderwys, met die Indiese of Asiatiese bevolkingsgroep, en met diegene wat ly aan kroniese toestande (beroerte, slaapprobleme snags), fisiese onaktiwiteit en 'n laer lewenskwaliteit. Die studie het implikasies vir strategiese planne in die gesondheidsektor wat daarop gemik is om gestremdheid te voorkom en om toegang tot genesende en rehabiliterende sorg te verseker. Hierdie studie verskaf 'n grondslag van bewyse waarop beleid- en gesondheidsorg-bestuurstelsels in die toekoms gebaseer kan word. <![CDATA[<b>In the eyes of older adults</b>: <b>Self-reported age and adjustment in African and European older adults</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100025&lng=es&nrm=iso&tlng=es To explore older adults' perceptions of subjective age and adjustment to ageing and to analyse the correlational structure of the pre-categories in our study: subjective age, indicators of adjustment to ageing and of personal age perception. An exploratory, descriptive mixed-methods design was utilised. A purposive sampling method was used to select 154 older adults aged between 75 and 99 years from three different nationalities. Semi-structured interviews were performed, addressing two core areas: subjective age and adjustment to ageing. Data was subjected to content analysis. Representation of the correlational structure of the precategories in our study (subjective age and indicators of adjustment to ageing) were analysed by a Multiple Correspondence Analysis. Standardised instruments measured regular cognitive abilities. Five categories derived from interviews for subjective age: 'adapted', 'disconnected', 'old', 'youthful' and 'tolerant'. A total of seven categories emerged as indicators of adjustment to ageing: 'social networking', 'health', 'time perspective', 'spirituality', 'financial autonomy', 'professional activities' and 'fulfilment and leisure'. These results supported a model for each pre-category. Subjective age was explained by a two-factor model: 'age-conscientious' and 'youthful'. A three-dimensional model formed by 'reconciled', 'satisficers' and 'maximisers' was indicated as a best-fit solution for adjustment to ageing. A three-dimensional overall model for PAP was formed by 'age-cognisant', 'fulfilled' and 'satisficers'. The findings highlighted the underdeveloped potential of subjective age, adjustment to ageing and a personal age perception overall model for this population. Enhancing subjective age and adjustment to ageing might be an important target to improve older adults' interventions' outcomes.<hr/>Hierdie artikel het ten doel om ouer volwassenes se persepsies aangaande subjektiewe ouderdom en aanpassing by veroudering te ondersoek en om die korrelatiewe struktuur van die pre-kategorieë te ontleed: subjektiewe ouderdom, indikators van aanpassing by veroudering en persepsies oor persoonlike ouderdom. Die artikel gebruik 'n eksploratiewe, deskriptiewe gemengdemetode-ontwerp. 'n Doelgerigte steekproefmetode is gebruik om 154 ouer volwassenes tussen die ouderdom van 75 en 99 uit drie verskillende nasionaliteite te kies. Semi-gestruktureerde onderhoude is met hulle gevoer en dit het op twee kerngebiede gefokus: subjektiewe ouderdom en aanpassing by veroudering. Die data is aan 'n inhoudsanalise onderwerp. Die representasie van die korrelatiewe struktuur van die pre-kategorieë in die studie (subjektiewe ouderdom en indikators van aanpassing by veroudering) is met behulp van 'n veelvuldige-ooreenkoms-analise gedoen. Gestandaardiseerde instrumente het reguliere kognitiewe vermoëns gemeet. Vyf kategorieë vir subjektiewe ouderdom is uit die onderhoude afgelei: 'aangepas', 'gediskonnekteer', 'oud', 'jeugdig' en 'verdraagsaam'. 'n Totaal van sewe kategorieë het as indikators van aanpassing by veroudering na vore gekom: 'sosiale netwerking', 'gesondheid', 'tydsperspektief', 'spiritualiteit', 'finansiêle outonomiteit', 'professionele aktiwiteite' en 'vervulling en vrye tyd'. Die resultate ondersteun 'n model vir elke pre-kategorie. Subjektiewe ouderdom is deur 'n tweefaktor-model verduidelik: 'ouderdomsbewustheid' en 'jeugdig'. 'n Driedimensionele model is as die beste oplossing vir aanpassing by verandering aangedui, te wete 'versoen, 'tevrede met wat voldoende is' (satisficers) en 'maksimaliseerder'. 'n Oorkoepelende driedimensionele model vir PAP (die Sielkundevereniging van die Filippyne) is gevorm deur die kategorieë 'ouderdom-bewus', 'vervul' en 'tevrede met wat voldoende is'. Die bevindings beklemtoon die onderontwikkelde potensiaal van subjektiewe ouderdom, aanpassing by veroudering en 'n oorkoepelende model vir persepsies oor persoonlike ouderdom in hierdie populasie. Die bevordering van subjektiewe ouderdom en aanpassing by veroudering sou belangrike doelwitte kon wees ten einde intervensie-uitkomste onder ouer volwassenes te verbeter. <![CDATA[<b>Evaluation of caregivers' knowledge, beliefs and practices regarding oral lesions in HIV-patients</b>: <b>A pilot study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100026&lng=es&nrm=iso&tlng=es Seventy to ninety percent of HIV-infected individuals have oral lesions that affect their quality-of-life. Caregivers play an important role in complementing the healthcare team. It is essential that the caregivers have optimal knowledge, beliefs and practices toward the management of care regarding oral-lesions in HIV-infected patients in caregiving institutions in Johannesburg, South Africa. To measure the knowledge, beliefs and practices relating to oral lesions in HIV infection amongst caregivers in caregiving institutions in Johannesburg. This cross-sectional pilot study conducted during 2005 and 2006 involved caregivers in palliative care institutions in Region 8, Johannesburg Metropolitan area (n = 52). Using a questionnaire, information obtained included demographics, knowledge, beliefs and practices with regard to oral care for HIV-positive patients. Principal component analysis was used to extract questionnaire items of the knowledge domain. The knowledge domain displayed excellent internal consistency (Cronbach α-score of &gt; 0.91). Of the caregivers, 65.4% had received training in oral care. Compared to caregivers not trained in oral care (NTOC), those caregivers trained in oral care (TOC) were more likely to be older (31 yrs vs. 44 yrs; p = 0.001), female (72% vs. 94%; p = 0.03) and were less likely to be employed on a full-time basis (94% vs. 68%; p = 0.03). Compared with NTOCs, TOCs had more knowledge regarding HIV-specific lesions and 'routine' oral-care for the patients (p < 0.005). Similarly, TOC caregivers had more positive beliefs about oral care for those living with HIV (p < 0.05). Offering training in oral healthcare to caregivers improves their knowledge of oral lesions and their beliefs about oral care.<hr/>Sewentig tot negentig persent van MIV-geïnfekteerde individue mondelinge letsels wat hul kwaliteit van lewe. Versorgers speel 'n belangrike rol in die aanvulling van die gesondheidsorg span. Dit is noodsaaklik dat die versorgers het 'n beter kennis, oortuigings en praktyke na die bestuur van sorg met betrekking tot mondelinge letsels in MIV-geïnfekteerde pasiënte in die versorgingstaak van instellings in Johannesburg, Suid-Afrika. Om die kennis, oortuigings en praktyke met betrekking tot mondelinge letsels in MIV-infeksie onder versorgers in die versorgingstaak van instellings in Johannesburg te meet. Hierdie deursnee-loodsstudie uitgevoer gedurende 2005 en 2006 betrokke versorgers in palliatiewe sorg instellings in Streek 8, Johannesburg Metropolitaanse gebied (n = 52). Met behulp van 'n vraelys, inligting ingesluit demografie, kennis, oortuigings en praktyke met betrekking tot mondelinge sorg vir MIV-positiewe pasiënte. Principal component analise is gebruik om vraelys items te onttrek van die kennis domein. Die kennis domein vertoon uitstekende interne konsekwentheid (Cronbach α-telling van &gt; 0,91). Van die versorgers, het 65.4% ontvang opleiding in mondelinge sorg. Vergeleke met versorgers wat nie opgelei in mondelinge sorg (NTOC), die versorgers opgelei in mondelinge sorg (TOC), was meer geneig om ouer (31 jaar teen 44 jaar; p = 0.001), vroue (72% teen 94%; p = 0.03) en is minder geneig om te word op 'n voltydse basis (94% teen 68%, p = 0.03) in diens geneem. Vergeleke met NTOCs, TOCs versorgers het meer kennis aangaande MIV-spesifieke letsels en roetine 'mondelinge sorg vir die pasiënte (p < 0,005). TOC versorgers het meer positiewe oortuigings oor mondelinge sorg vir diegene wat met MIV (p < 0.05). Aanbod opleiding in mondelinge gesondheidsorg te versorgers verbeter hul kennis van mondelinge letsels en hulle oortuigings oor mondelinge sorg. <![CDATA[<b>The DELTA<sup>®</sup> nursing measure</b>: <b>Its development and testing for nursing utility</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100027&lng=es&nrm=iso&tlng=es In the specialised nursing field of acute mental illness nurses expressed a need to measure and evaluate their patients' mental-health outcomes both empirically and routinely. The aim was to develop and test a measurement tool, named the DELTA nursing measure, which could be embedded routinely into the nursing process and care plans, enabling the psychiatric nurses to score and evaluate their patients' acute mental-health outcomes. A qualitative, exploratory study design was used to address two sequential objectives. Firstly, qualitative data that described observable behaviours in patients with acute mental illness were collected from psychiatric nurses (n = 5) who were experienced in acute mental healthcare. The data were analysed using inductive content analysis techniques to design and construct the DELTA nursing measure. In the second objective, the nursing utility of the DELTA nursing measure was studied. This was done by training and testing a new team of psychiatric nurses (n = 25) working in a 116-bed acute psychiatric hospital, in the application of the DELTA nursing measure. After 30 months a focus group (n = 6) representing this team was held to explore their perceptions and experiences of the nursing utility of the newly-developed measure. The descriptive data were analysed using deductive content analysis techniques. The outcome of the DELTA nursing measure as a routine nursing measure of acute mental illness provided good results. The nursing-utility characteristics have confirmed positive responses with regard to its acceptance, usefulness and confidence as a worthwhile tool to be used in expediting nursing services in acute mental healthcare. The positive responses to the DELTA nursing measure are noteworthy. It has the potential to add substantial value to the mental health care field in nursing by adding a measurable dimension to patient outcomes, a much needed requirement by patients, multidisciplinary teams and healthcare funders.<hr/>In die gespesialiseerde verplegingsveld van akute psigiatrie het verpleegkundiges 'n behoefte uitgespreek om roetineweg pasiênte se geestesgesondheidsuitkomste empiries te meet en te evalueer. Die doel van die studie was om 'n meetinstrument, genoemd die 'DELTA nursing measure', te ontwikkel en toets wat ingebed kan word in die verplegingsproses en versorgingsplan en wat psigiatriese verpleegkundiges in staat kan stel om roetine-weg die pasiênte se akute geestesgesondheidsuitkomste te meet en te evalueer. 'n Kwalitatiewe, eksploratiewe studie ontwerp is gebruik om twee opeenvolgende doelwitte aan te spreek. Eerstens is kwalitatiewe data wat observeerbare gedrag in pasiênte met akute geestessiektes beskryf ingesamel van psigiatriese verpleegkundiges (n= 5) wat ervaring het in akute geestesgesondheidsorg. Die data is geanaliseer met induktiewe inhouds analiese tegnieke om die ontwerp en konstruksie van die 'DELTA nursing measure' te bewerkstellig. In die tweede doelwit was die 'DELTA nursing measure' se bruikbaarheid vir verpleging bestudeer. Om dit te doen was 'n nuwe span psigiatriese verpleegkundiges (n = 25) wat werksaam was in 'n 116-bed akute psigiatriese hospitaal opgelei en getoets in die gebruik van die 'DELTA nursing measure'. Na 30 maande is 'n fokusgroep (n= 6) gehou wat verteenwoordigend was van die span om hulle persepsies en ervarings van die nuut-ontwikkelde meetskaal se bruikbaarheid te eksploreer. Beskrywende data is met behulp van deduktiewe inhouds tegnieke geanaliseer. Die uitkoms van die 'DELTA nursing measure' as 'n routine verplegingmeetskaal vir die bepaling van akuutheid in psigiatrie het baie goeie resultate opgelewer. Die bruikbaarheidseienskappe het positiewe response bevestig dat aanvaarding, betroubaarheid en vertroue bereik is en dat dit 'n nuttige instrument is om die verplegingsdiens te bevorder. Die positiewe response op die 'DELTA nursing measure' is merkwaardig. Dit het die potensiaal om 'n betekenisvolle bydrae te lewer tot die psigiatriese verplegingsveld omdat dit 'n meetbare dimensie toevoeg tot pasient uitkomste, 'n hoogs-benodigde vereiste van pasiênte, multidissiplinêre spanne en gesondheidsorgbefondsers. <![CDATA[<b>Perceptions of traditional health practitioners on violence in the Helderberg Municipal Area, Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100028&lng=es&nrm=iso&tlng=es This study on perceptions of violence was conducted with 56 traditional health practitioners (diviners: amagrirha) in the Helderberg Municipal Area of Cape Town Metro. It forms a subsection of a larger study on African medicine. This particular research focuses on how traditional health practitioners perceive violence, including gender-related violence. Individual, in-depth interviews were done with 21 traditional health practitioners and focus group discussions were held with 35 participants. The paper reports on their understanding of, as well as the meanings attached to, community and gender-based violence in an urban setting. The traditional health practitioners related violence to a range of disconnections in society, ranging from not adhering to traditional norms and practices, to breaks in relations between parents and children, within families and in marital- and sexual relations. They referred to a general sense of disjuncture between the living and the ancestral worlds. The accumulative effect of this sense of not being connected was seen as damaging and a precursor to violence. In two sites where there were high concentrations of violence, ceremonies were held to purify the areas by ritual. In addition to attending to the physical manifestations of illness, distress and violence, these traditional health practitioners attempted to enhance and restore proper social relationships between the living, as well as between the living and the dead.<hr/>Hierdie studie oor persepsies van geweld is gedoen met 56 tradisionele gesondheidspraktisyns (waarsêers: amagrirha) in die Helderberg Munisipale gebied van Kaapstad Metro. Dit vorm deel van 'n groter studie gerig op Afrika-medisyne. Hierdie spesifieke navorsing fokus op hoe tradisionele gesondheidspraktisyns geweld beskou, insluitende geslags-gebaseerde geweld. individuele, in-diepte onderhoude is gevoer met 21 tradisionele gesondheidspraktisyns en fokusgroepbesprekings is gehou met 35 deelnemers. Die artikel doen verslag oor hoe tradisionele gesondheidspraktisyns gemeenskaps- en geslags-gebaseerde geweld verstaan en daaran betekenis heg in 'n stedelike opset. Die tradisionele gesondheidspraktisyns verbind geweld met 'n reeks diskonneksies in die gemeenskap, wat wissel van 'n gebrek aan gehoor ten opsigte van tradisionale norme en praktyke tot verbrokkeling van verhoudings tussen ouers en kinders, binne families en in huweliks- en geslagsverhoudings. Hulle het verwys na 'n algemene persepsie van ontwrigting tussen die lewendes en die wêreld van die voorouers. Die akkumulatiewe effek van hierdie gevoel van verbrokkeling word gesien as afbrekend en 'n voorspel tot geweld. In twee plekke waar daar hoë konsentrasies van geweld was, is seremonies gehou om die areas ritueel te reining. Bykomend tot die aandag aan fisiese manifestasies van siekte, nood en geweld, het hierdie tradisionale gesondheidspraktisyns gepoog om behoorlike sosiale verhoudings tussen die lewendes te verbeter en te herstel, sowel as tussen die lewendes en die gestorwenes. <![CDATA[<b>Nurses and care workers' perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100029&lng=es&nrm=iso&tlng=es Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients' emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers' perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients' emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years' experience as nurses or care workers. Private general hospitals should therefore equip all nurses and care workers with the necessary skills to facilitate a therapeutic relationship and to understand the emotional needs of all patients with both physical and emotional needs.<hr/>Fasilitering van 'n terapetiese verhouding is 'n essensiële vaardigheid in verpleging en veral in geestesgesondheid. Verpleegkundiges in private algemene hospitale is blootgestel aan die emosionele gevolge van fisiese siekte asook die toenemende toelating van pasiente met geestesgesondheidsbehoeftes. Swak verpleegkundige-pasiënt verhoudings is deur pasiënte en in die media gerapporteer, terwyl die navorsers van oënskynlike misverstande tydens interaksies tussen verpleegkundiges en pasiente bewus geword het tydens hulle werk in private algemene hospitale. Geen studies is gedoen oor hoe verpleegkundiges en versorgers hulle terapeutiese verhouding met pasiënte in terme van hulle emosionele en geestesgesondheidsbehoeftes ervaar nie. 'n Kwantitatiewe, kontekstuele en deduktiewe studie was in drie private algemene hospitale in Gauteng, Suid Afrika gedoen, met 'n doelgerigte steekproef van 154 verpleegkundiges en 30 versorgers. Verpleegkundige persepsies van die fasilitering van 'n terapeutiese verhouding gebaseer op die konsepte van 'n terapeutiese verhouding, empatie, positiewe agting, opregtheid, konkreetheid en selfondersoek is met self-assessering op 'n vyf-punt skaal van 'n vraelys bepaal. Data was geanaliseer met beskrywende statistieke en nie-parametriese tegnieke. Spesifieke hipoteses was getoets om te identifiseer of daar statistiese-betekenisvolle verskille tussen twee of meer kategorieë van verpleegkundiges bestaan. Resulte dui op 'n algemene ongevoeligheid en lae bewustheidsvlak en refleksie van verpleegkundiges en versorgers ten opsigte van die pasiënte se emosionele behoeftes. Geen statistiese-betekenisvolle verskille is tussen die persepsies van die verskillende groepe in die navorsing gevind nie. Daar is 'n behoefte aan self-gewaarwording en voortdurende opleiding in interpersoonlike vaardighede en ondersteuning aan verpleegkundiges en versorgers. 'n Groot persentasie van die deelnemers was jonger as 40 jaar, sub-professioneel, met minder as 10 jaar ondervinding as verpleegkundiges. Private algemene hospitale moet dus alle verpleegkundiges en versorgers toerus met die nodige vaardighede om 'n terapeutiese verhouding te fasiliteer om al hulle pasiente se fisiese en emosionele behoeftes te verstaan. <![CDATA[<b>Voluntary counselling and testing for young adults in Limpopo Province - Counsellors' perceptions</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100030&lng=es&nrm=iso&tlng=es Counselling and testing services for HIV have long been a component of HIV prevention and care programmes in developed countries and have proved to be a cost-effective way of reducing risky behaviours. It is, therefore, important to document the perceptions of voluntary counselling and testing counsellors towards the use of counselling and testing amongst young adults. The purpose of the study was to describe the perceptions of these counsellors dealing with young adults in Vhembe District, Limpopo Province, where the study was conducted. Two themes emerged from the findings of the voluntary counselling and testing counsellors, namely that they feel that the programmes are inaccessible to young adults and that there are difficulties which might impact on the programmes' efficacy. The findings of this study should contribute to the reduction of HIV by promoting voluntary counselling and testing uptake by young adults.<hr/>Berading- en toestingsdienste vir HIV is lankal reeds 'n geintegreerde deel van die voorkoming en versorgingsprogramme van HIV in ontwikkelde lande en dit is bewys dat dit 'n koste-effektieve manier is om gevaarlike gedrag te verminder. Dit is dus belangrik om die persepsies van vrywillige berading en toesting deur beraders ten opsigte van die gebruik van beraders onder jong volwassenes, te staaf. Die doel van hierdie studie was om die persepsies van hierdie beraders wat met jong volwassenes in die Vhembe distrik, Limpopo provinsie, werk, te beskryf. Twee temas het uit die bevindinge te voorskyn gekom, naamlik: dat die programme ontoeganglik vir jong mense is, en dat daar moontlike probleme is wat op die doeltreffenheid van die programme inslaan. Die bevindinge van hiedie studie behoort 'n bydrae te maak tot die vermindering van HIV deur die vrywillige berading en toesting by jong mense aan te beveel. <![CDATA[<b>The nutrition situation of free-living elderly in Umlazi township, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100031&lng=es&nrm=iso&tlng=es The risk for non-communicable diseases such as hypertension, diabetes, stroke and ischaemic heart disease in the elderly continues to be on the increase. It is shaped and modified by factors such as economic status and experiences across the whole lifespan. Although malnutrition in this population could be due to poor dietary practices, the nutrition transition of communities in South Africa is partially responsible for nutritional problems. Because of the degree of dependency on others for help and care in communities, the elderly are at risk for malnutrition. The elderly of the Umlazi community are overburdened with the social responsibility of grandchildren and trying to bring stability by managing various households. This becomes a double burden and puts more strain on their quality of life, further impacting on their nutritional status.<hr/>Die risiko vir chroniese siektes soos hipertensie, diabetes, beroerte en hartkwaal is steeds baie hoog in die bejaardes in Suid Afrika. Dit word deur faktore soos ekonomiese status en ervarings oor die hele lewesiklus gevorm en verander. Voedings probleme wat geïndentifiseer is in die studie hou verband met dieettekorte, alhoewel probleme met oorvoeding verband kan hou met die voedings oorgang wat plaasvind in Suid Afrikaanse gemeenskappe. In verskeie gemeenskappe, as gevolg van die graad van afhanklikheid van ander vir hulp en sorg, is die bejaardes blootgestel aan die risiko van wanvoeding. Die bejaardes van die Umlazi gemeenskap is oorlaai met die sosiale verantwoordelikheid van kleinkinders en probeer om verskeie huishoudings te stabiliseer, wat 'n dubbele las op hulle plaas en dit kan hulle lewenskwaliteit affekteer wat dan hul voedingstatus verder kan vererger. <![CDATA[<b>Post-basic nursing students' reflections on their experiences of dialogic mediation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100032&lng=es&nrm=iso&tlng=es This article presents post-basic nursing students' reflections on the way they experienced the pedagogy of dialogic mediation. The study addressed current debates about appropriate teaching methodologies for students in such a degree course and the role of the nurse educator in this regard. The authors used a qualitative research approach and posed the following research question: What are students' reflections of their experiences of dialogic mediation and the influence of this on their ideas of teaching and learning? The study involved a cohort of students (n = 248) who were enrolled in a semester-long course in a post-basic nursing degree at a South African university. They were asked to respond to three open-ended questions regarding their experiences of a course that required engagement with a new teaching and learning strategy which expected active involvement. Data were collected from students' written reflections and were analysed by searching for recurring themes and patterns. The findings revealed that students experienced extreme levels of frustration at the beginning of the course as their existing ideas about teaching and learning were challenged. They also found the new teaching techniques associated with this pedagogy to be demanding. However, once they understood the underlying principles and ideas, they began to understand the implications for their own learning and teaching practices.<hr/>Hierdie artikel handel oor nabasiese-verpleegstudente se nadenke oor die wyse waarop hulle die pedagogie van dialogiese bemiddeling ervaar het. Hierdie studie het aandag gegee aan huidige debatte oor geskikte onderrigmetodologieë vir studente in so 'n graadkursus en die rol van die verpleegkundige-opvoeder in hierdie opset. Die outeurs het 'n kwalitatiewe navorsingsbenadering gebruik en het die volgende navorsingsvraag gestel: Wat is studente se nadenke oor hul ervarings van dialogiese bemiddeling en die invloed daarvan op hul idees van onderrig en leer? Die studie het 'n spesiefike kohort studente (n = 248) wat ingeskryf is by 'n semesterkursus in 'n nabasiese verpleeggraadprogram aan 'n Suid-Afrikaanse universiteit ingesluit. Hulle is gevra om op drie oop vrae te reageer oor hul ervarings van 'n kursus wat betrokkenheid by 'n nuwe onderrig- en leerstrategie vereis en waar aktiewe deelname verwag word. Data is uit studente se skriftelike nadenke ingesamel en is ontleed deur vir herhalende temas en patrone te soek. Die bevindings het getoon dat studente uiterste vlakke van frustrasie aan die begin van die kursus ervaar het, aangesien hul bestaande onderrig en leer uitgedaag is. Hulle het ook die nuwe onderrigtegniek wat met hierdie pedagogie gepaardgaan veeleisend gevind. Nadat hulle egter die onderliggende beginsels en idees verstaan het, het hulle begin om die implikasies van hul eie leer- en onderrigpraktyke te verstaan. <![CDATA[<b>Gender differences related to the health and lifestyle patterns of university students</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100033&lng=es&nrm=iso&tlng=es One of the transitions from adolescence to adulthood is the admission of students to a university setting. Accompanying this transition is a new-found independence which results in university students having more autonomy over their lifestyles and behaviours. The assumption in this setting is that many students are likely to engage in unhealthy and risky lifestyle behaviours which include alcohol abuse, tobacco use, physical inactivity and unhealthy dietary practices which may adversely affect their health in the long-term. In South Africa, research with regard to health and lifestyle patterns amongst both male and female young adults remains limited. The purpose of this study was, therefore, to investigate whether male and female students differed in relation to their health and lifestyles, as well as the related consequences thereof. A convenience sampling technique was used, where questionnaires were administered to 400 students at three university campuses in the Gauteng province of South Africa. An exploratory data analysis for health factors was used in order to retrieve relevant factors from a factor and regression analysis. Differences in gender were tested by using cross-tabulation for descriptive statistics and Chi-square analysis. The study found no statistically-significant differences between genders relating to the three emerging health factors, namely Gastrointestinal, Upper Respiratory Infections and Total Health Problems. However, descriptive statistics of lifestyle habits revealed that more female students exercised, smoked and binged on food than their male counterparts. It was also found that female students reported a higher incidence of stress than male students. It was concluded that university students do indeed engage in behaviours and lifestyles that place them at risk for serious health problems.<hr/>In die oorgang van adolessensie na jong volwassene, bevind studente hulself binne 'n universiteitsomgewing. Gepaartgaande met hierdie oorgang word nuutgevonde vryheid verkry, wat veroorsaak dat universiteitstudente meer beheer oor hul lewenstyl en gedrag uitoefen. Die waarskynlikheid bestaan dat baie studente in hierdie omgewing betrokke sal raak by 'n ongesonde en gewaagde lewenstyl, wat alkohol misbruik, tabak gebruik, fisieke onaktiwiteit en ongesonde eetgewoontes insluit. Bogenoemde is faktore wat student se gesondheid oor die langtermyn nadelig sal beïnvloed. Navorsing in Suid-Afrika oor gesondheid en lewenstylpatrone van verskillende geslagsgroepe onder jong volwassenes is skaars. Die doel van hierdie studie was dus om ondersoek in te stel aangaande geslagsverskille in gesondheid en lewenstyl van studente, asook die betrokke nagevolge daarvan. 'n Gerieflikheids-steekproeftegniek is gebruik waartydens 400 vraelyste aan studente by drie verskillende universiteitskampusse in die Gauteng provinsie in Suid-Afrika versprei is. 'n Ondersoekende data analiese vir gesondheidsfakore is gebruik om toepaslike faktore te verkry vanuit 'n faktoren regressie analiese. Geslagsverskille is getoets deur gebruik te maak van kruis-tabulering vir beskrywende statistiek asook 'n 'Chi-square' analiese. Die studie het geen statisties-betekenisvolle verskille tussen geslagte getoon ten opsigte van die drie gesondheidsfaktore naamlik Gastro-intestinale, Boonste Asemhalingstelsel en Totale Gesondheid Probleme nie. Nietemin het beskrywende statistiek ten opsigte van lewenstyl gewoontes egter onthul dat meer vroulike studente aan fisieke aktiwiteit delneem, rook en hul vergryp aan kos. Daar is ook gevind dat vroulike studente meer gevalle van spanning gerapporteer het as manlike studente. Die gevolgtrekking is dus dat universiteitstudente wel betrokke raak by gedrag en lewenstyle wat hul in gevaar stel vir ernstige gesondheidsprobleme. <![CDATA[<b>Home-prepared soymilk</b>: <b>Potential to alleviate protein-energy malnutrition in low-income rural communities in South Africa?</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362013000100034&lng=es&nrm=iso&tlng=es Research findings reported pronounced protein and some energy shortfalls for school-aged children and female caregivers in rural communities in Qwa-Qwa, South Africa. The household gardening project was expanded to include soy cultivation. Subsequently, a process was developed for home-preparation of soymilk to support macronutrient consumption. The limited explorative experimental approach included chemical analysis for total protein (Kjeldahl digestion, spectrophotometric determination), total carbohydrate (Anthone method) and total lipid content (extraction, Gravimetric method, separation). Total energy content was calculated. All results were benchmarked against equivalents. Duplicate analysis of samples, respectively prepared from 1:2 (n = 6) and 1:4 (n = 4) volume ratios of rehydrated minced soybeans : water for cooking of soy mash, indicated statistically-significant differences for reported nutrients (p < 0.05). Comparison between sourced commercial soymilk products for drinking indicated no statistical differences (p &gt; 0.05). Although statistically-significant shortfalls were indicated for nearly all such values for home-prepared soymilk (1:4 ratio) against industrial 'SoyCow' soymilk and values reported in the South African database for standardised nutrient composition of food (p < 0.05), a much-needed contribution will be made to protein (and energy) intake through consumption of the product. More efficient extraction (possibly double mincing of rehydrated soybeans and more efficient pressing of cooked soy mash) should be explored, followed by an intervention study to evaluate the impact of daily consumption of home-prepared soymilk on the nutritional status of children in low-income communities. The development of recipes to promote the inclusion of undissolved fibre from the soymilk extraction process (okara) in dishes prepared at household level, such as bread, is recommended.<hr/>Navorsing het beduidende proteïen en minder ernstige energie te korte uitgewys by skoolkinders en vroulike versorgers in plattelandse gemeenskappe in Kwa-Kwa. Die huishoudelike tuinbouprojek is uitgebrei om soja-verbouing in te sluit en 'n proses is ontwikkel vir die tuisbereiding van sojamelk om makronutriënt inname te bevorder. Die beperkte eksperimentele benadering het chemiese analise vir totale proteien (Kjeldahlvertering, spektro-fotometriese bepaling), totale koolhidraat (Anthonemetode) en totale lipied inhoud (ekstraksie, Gravimetriese metode, skeiding) ingesluit. Totale energie is bereken en alle resultate is met ekwivalente vergelyk. Duplikaatanalise van sojamelkmonsters, onderskeidelik berei van 1:2 (n = 6) en 1:4 (n = 4) volume verhoudings van gehidreerde gemaalde sojabone : water vir die kook van die sojapulp, het statisties-beduidende verskille uitgewys (p< 0.05). Geen statisties-beduidende verskille is gevind in die makronutriêntwaardes van kommersiêle sojamelkprodukte wat gedrink kan word nie (p &gt; 0.05). Alhoewel statisties-beduidende tekorte vir bykans alle soortgelyke waardes van tuisbereide sojamelk (1:4) teenoor die industrieel bereide 'SoyCow' produk en waardes gerapporteer in die Suid Afrikaanse databasis vir gestandardiseerde nutriêntsamestelling van voedsel (p< 0.05) waargeneem is, sal inname van die tuisbereide produk tog 'n belangrike bydrae tot proteïen (en energie) inname kan lewer. Die effektiwiteit van 'n verbeterde nutriëntekstraksie, byvoorbeeld deur 'n dubbel-maalproses en meer effektiewe pers van die gekookte sojapulp, moet ondersoek word. 'n Intervensiestudie om die effek van daaglikse sojamelk inname op die voedingstatus van kinders in lae-inkomste bemeenskappe te meet, word aanbeveel. Verder word aanbeveel dat resepte ontwikkel word om die onopgeloste vesel wat oorbly na die melkmaak proses (okara) in huishoudelike geregte in te sluit, byvoorbeeld in die bereiding van brood.