Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620140001&lang=pt vol. 19 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>The GAMMA<sup>®</sup> nursing measure: Its development and testing for nursing utility</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100001&lng=pt&nrm=iso&tlng=pt BACKGROUND: In the specialised nursing fields of gerontology, oncology, rehabilitation and home-based care where people live with permanent or temporary disabilities, nurses are I unable to perform routine and empirical scoring of their patients' abilities to live independently, because of the lack of valid nursing measures indicating patients' frailty or vulnerability. These independent living abilities are also referred to as the instrumental activities of daily I living (IADLs). OBJECTIVES: To provide nurses with a nursing scale, named the GAMMA, which enables nurses I to routinely observe, score and record their patients' IADLs and to test its nursing utility. METHOD: A study with two sequential phases was done. Firstly, descriptive data were collected I from key informants, namely a registered social worker and two registered nurses, skilled in caring for disabled persons living in long-term care facilities. The data were analysed using inductive content analysis techniques in order to design and construct the GAMMA nursing scale. In the second study, the utility of the GAMMA was studied by training and testing the application of the GAMMA within a group of registered nurses (n = 5) working in three I retirement villages. After four months, focus group interviews were conducted with the registered nurses in order to explore the GAMMA's nursing utility. Descriptive data were analysed using deductive content analysis techniques. RESULTS: The outcome of the study provided good results. High levels of agreement between I participants confirm the GAMMA's acceptance, usefulness and confidence as a nursing scale to empirically establish the transition of nursing care between independent living and assisted living. CONCLUSION: The GAMMA has the characteristics which allow it to be used routinely as a nursing scale in gerontology, oncology, rehabilitation and home-based care nursing processes.<hr/>OPSOMMING AGTERGROND: In die gespesialiseerde verpleegareas van gerontologie, onkologie, rehabilitasie en tuisversorging waar pasiënte leef met permanente of tydelike gestremdhede, is verpleegkundiges nie in staat om gereeld en empiries te bepaal wat hul pasiënte se vermoëns is om onafhanklik te lewe, as 'n aanduiding van hul verswaktheid of broosheid nie. Die vermoëns om onafhanklik te lewe word ook na verwys na as die instrumentele aktiwiteite van daaglikse lewe (IADLs). DOELWITTE: Om die verplegingswetenskappe te voorsien van 'n skaal, genoemd die GAMMA, wat die verpleegkundige in staat kan stel om as roetine prosedure pasiënte se IADLs waar te neem, te meet en te noteer, en om die nuttigheid van hierdie skaal vir verpleging te bepaal. METODE: 'n Studie met twee opeenvolgende fases was gedoen. Eerstens was 'n ondersoek geloods om beskrywende data te versamel van 'n geregistreerde maatskaplike werker en twee geregisteerde verpreegkundiges wat ervare is in die versorging van gestremde mense wat in lang termyn fasiliteite woon. Die data was geanaliseer met induktiewe inhoudstegnieke om die konstruksie van die GAMMA te ontwikkel. In die tweede studie was die GAMMA se bruikbaarheid vir verpleegkundiges bestudeer deur eers opleiding en toetsing aan geregistreede verpleegkundiges (n = 5) te bied in drie aftree oorde. Vier maande na implementasie het 'n fokus groep met die geregistreede verpleegkundiges vergader om die die GAMMA se nuttigheid vir verpleegkundiges te evalueer. Beskrywende data was geanaliseer met behulp van deduktiewe inhouds analiese tegnieke. RESULTATE: Die uitkoms van die GAMMA het goeie resultate opgelewer. Daar was hoë vlakke van aanvaarding, betroubaarheid en vertroue in die GAMMA as 'n empiriese verplegingsskaal om die oorgang tussen onafhanklike en ondersteunende lewenstyl te bepaal. GEVOLGTREKKING: Die GAMMA het die eienskappe om as roetine prosedure gebruik te word as 'n verplegingsskaal in die gerontologie, onkologie, rehabilitasie en tuisversorging verplegingsprosesse. <![CDATA[<b>The therapeutic use of music as experienced by cardiac surgery patients of an intensive care unit</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100002&lng=pt&nrm=iso&tlng=pt Patients perceive the intensive care unit (ICU) as being a stressful and anxiety-provoking environment. The physiological effects of stress and anxiety are found to be harmful and I therefore should be avoided in cardiac surgery patients. The aim of the study on which this I article is based was to describe cardiac surgery patients' experiences of music as a therapeutic I intervention in the ICU of a public hospital. The objectives of this article were to introduce I and then expose the cardiac patients to music as part of their routine postoperative care and to explore and describe their experiences of the music intervention. The findings of the research I are to be the basis for making recommendations for the inclusion of music as part of the routine postoperative care received by cardiac surgery patients in the ICU. A qualitative research I methodology, using a contextual, explorative and descriptive research design, was adopted. I The population of the study was cardiac surgery patients admitted to the ICU of a public hospital. An unstructured interview was conducted with each participant and content analysis and coding procedures were used to analyse the data. Four main themes were identified I in the results, namely practical and operational aspects of the music sessions; participants' I experiences; discomfort due to therapeutic apparatus and the ICU environment; and the role of I music and recommendations for music as a therapeutic intervention. Participants' experiences were mainly positive. Results focused on experiences of the music and also on the participants' I experiences of the operational aspects of the therapy, as well as factors within and around the participants.<hr/>Pasiënte se persepsie van die intensiewesorgeenheid (ISE) is dat dit 'n stresvolle en angswekkende omgewing is. Die fisiologiese effekte van stres en angs is skadelik en daarom moet dit vermy word in die geval van pasiënte wat hartchirurgie ondergaan. Die doel van die studie waarop hierdie artikel gebaseer is, was om hartchirurgiepasiënte se ervaring van musiek as 'n terapeutiese intervensie in die ISE van 'n openbare hospitaal te beskryf. Die doelwitte van hierdie studie was om hartchirurgiepasiënte bekend te stel aan musiek as deel van hul roetine- postoperatiewe sorg en hulle dan daaraan bloot te stel om sodoende hulle ervarings van die musiekintervensie te ondersoek en beskryf. Die bevindinge van die navorsing sal gebruik word om aanbevelings te maak vir die insluiting van musiek as deel van die roetine- postoperatiewe sorg wat hartchirurgiepasiënte in die ISE ontvang. 'n Kwalitatiewe navorsingsmetodologie, met behulp van 'n kontekstuele, verkennende en beskrywende ontwerp, is gebruik. Die populasie van die studie was hartchirurgiepasiënte in die ISE van 'n openbare hospitaal. 'n Ongestruktureerde onderhoud is met elke deelnemer gevoer en inhoud-analise en koderingprosedures is gebruik om die data te ontleed. Vier hooftemas is in die resultate geïdentifiseer, naamlik praktiese en operasionele aspekte van die musieksessies; die deelnemers se ervarings; ongemak as gevolg van terapeutiese apparaat en die ISE-omgewing; asook die rol van musiek en aanbevelings vir musiek as 'n terapeutiese intervensie. Deelnemers se ervarings was hoofsaaklik positief. Die resultate het gefokus op die deelnemers se ervaring van die musiek asook hul ervaring van die operasionele aspekte van die terapie, sowel as faktore binne en rondom die deelnemers. <![CDATA[<b>Patient-perceived factors contributing to low tuberculosis cure rate at Greater Giyani healthcare facilities</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100003&lng=pt&nrm=iso&tlng=pt BACKGROUND: Compliance with tuberculosis (TB) treatment is unpredictable. Most patients do not comply because they do not see the importance of doing so, which is usually influenced by lack of knowledge. OBJECTIVES: The purpose of the study was to explore and describe the factors contributing to low TB cure rates in Greater Giyani Municipality, as viewed by patients. METHOD: The study was conducted in the Greater Giyani Municipality in Limpopo Province which had a TB cure rate ranging from 14% to 94%. The research design in this study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of all TB patients diagnosed and referred for treatment and care in Primary Health Care (PHC) facilities. Non-probability purposive sampling was used to select TB patients and health facilities which had a cure rate lower than the national target of 85%. One patient was sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. RESULTS: The findings showed that most of the TB patients come from poor families, which makes it difficult for them to obtain financial and food security. The health facilities often run out of food supplements and TB medicine. Cultural beliefs about TB also lead to TB patients seeking assistance from traditional health practitioners and faith-based healers. CONCLUSION: There is a need to have a policy regarding how discharged tuberculosis patients on treatment are supervised when at home. Healthcare facilities should also ensure that there is enough medication for these patients as lack of medication can lead them to default.<hr/>AGTERGROND: Dit is onmoontlik om te bepaal of pasiënte by hulle tuberkulosebehandeling gaan hou. Die meeste pasiënte hou nie daarby nie omdat hulle nie die belangrikheid daarvan insien nie. DOELWITTE: Die doel van die studie was om die faktore wat in die Groter Giyani Munisipaliteit tot lae genesingskoerse onder TB-pasiënte lei, te ondersoek en te beskryf, soos deur pasiënte gesien. METODE: Die studie is in die Groter Giyani Munisipaliteit in die Limpopo Provinsie gehou, waar die genesingskoers vir TB tussen 14% en 94% is. Die navorsing in hierdie studie was kwalitatief, verkennend, beskrywend en kontekstueel van aard. Die populasie het bestaan uit alle gediagnoseerde TB-pasiënte wat vir behandeling en sorg na primêre gesondheidsorgfasiliteite verwys is. Nie-waarskynlikheid, doelgerigte steekproefneming is gebruik om TB-pasiënte en gesondheidsfasiliteite te kies wat 'n laer genesingskoers as die nasionale doelwit van 85% het. Een pasiënt uit elke primêre gesondheidsorgfasiliteit is by die steekproef ingesluit. 'n Diepgaande persoonlike onderhoud is gebruik om data met behulp van 'n onderhoudgids in te samel. RESULTATE: Die bevindinge toon dat die meeste van die TB-pasiënte uit arm gesinne kom, wat dit vir hulle moeilik maak om finansiële en voedselsekerheid te hê. Die gesondheidsfasiliteite se voedselaanvullings en TB-medisyne raak dikwels op. Kulturele oortuigings oor TB lei ook daartoe dat TB-pasiënte by tradisionele gesondheidsorgpraktisyns en geloofsgebaseerde genesers hulp soek. GEVOLGTREKKING: Dit is nodig dat 'n beleid oor toesig oor die behandeling van ontslaande TB-pasiënte wat tuis aansterk, opgestel word. Gesondheidsorgfasiliteite behoort ook seker te maak dat daar genoeg medisyne vir hierdie pasiënte is, aangesien 'n gebrek aan medisyne daartoe kan lei dat die pasiënte ophou om hulle medikasie te gebruik. <![CDATA[<b>The experiences of individuals with Multiple Sclerosis in the Western Cape, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100004&lng=pt&nrm=iso&tlng=pt BACKGROUND: Multiple Sclerosis (MS) is a debilitating and degenerative lifelong neurological disease that seems to be growing increasingly more prevalent in South Africa. OBJECTIVES: The aim of this qualitative study was to explore the personal experiences of individuals with MS in the South African context. The focus of this study was on the challenges faced by individuals with MS, as well as the resources that help them to cope with this debilitating, neurological condition. METHOD: Thematic analysis was used to explore the semi-structured interviews that were conducted with ten individuals with MS. RESULTS: Several themes emerged that related to the participants' experiences of living with MS. These themes included several challenges faced by the participants on a daily basis, such as the process of being diagnosed, daily life, invisible illness and medical aid schemes. Numerous resources that help these individuals to cope with MS also emerged from the data analysis and consisted of social support, mobility aids, religion and knowledge about MS. CONCLUSION: It is evident from the findings of this study that although individuals living with MS, which is a debilitating neurological condition, face several challenges on a daily basis, they often have several resources that help them to cope effectively with this condition. The findings of this study regarding knowledge of the challenges faced and the resources utilised by individuals with MS will hopefully create awareness of the disease and contribute to and inform the design and implementation of interventions for such individuals.<hr/>AGTERGROND: Veelvuldige Sklerose (VS) is 'n aftakelende en degerenatiewe lewenslange neurologiese toestand wat blyk of dit toenemend meer algemeen in Suid-Afrika voorkom. OBJEKTIEF: Die doel van hierdie kwalitatiewe studie was om die persoonlike ervarings van individue met VS binne die Suid-Afrikaanse konteks te ondersoek. Die fokus van hierdie studie was op die uitdagings wat individue met VS in die gesig staar, sowel as die hulpbronne wat hulle help met die hantering van hierdie ernstige neurologiese toestand. METODE: Tematiese analise is gebruik om die semi-gestruktureerde onderhoude te ondersoek, wat gevoer is met tien individue met VS. RESULTATE: Verskeie temas wat verband hou met die deelnemers se ervarings van 'n lewe met VS het na vore gekom. Hierdie temas het verskeie uitdagings ingesluit wat die deelnemers op 'n daaglikse basis in die gesig staar, soos die proses om korrek gediagnoseer te word, daaglikse lewe, onsigbare siekte en mediese fonds skemas. 'n Aantal hulpbronne wat hierdie individue help om VS te hanteer het ook na vore gekom en bestaan uit sosiale ondersteuning, mobiliteit hulpmiddels, geloof en kennis oor VS. GEVOLGTREKKING: Dit is duidelik uit die bevindinge dat alhoewel individue wat lewe met VS, wat 'n ernstige neurologiese toestand is, verskeie uitdaging op 'n daaglikse basis in die gesig staar, hulle beskik oor verskeie hulpbronne wat hulle help om hierdie toestand effektief te hanteer. Die bevindinge van hierdie studie rakende kennis van die uitdagings wat hierdie individue in die gesig staar en die hulpbronne wat individue met VS gebruik sal hopelik 'n bewustheid skep en bydra tot die ontwerp en implimentering van intervensies vir sulke individue. <![CDATA[<b>The perception of midwives regarding psychosocial risk assessment during antenatal care</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100005&lng=pt&nrm=iso&tlng=pt BACKGROUND: The physiological and psychological changes caused by pregnancy may increase a woman's vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing OBJECTIVE: The objective of this study was to explore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women METHOD: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used RESULTS: Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care CONCLUSION: The findings provided a basis for incorporation of psychosocial care into routine antenatal care.<hr/>AGTERGROND: Die fisiologiese en psigologiese veranderings wat deur swangerskap veroorsaak word, kan 'n vrou se kwetsbaarheid vir depressie verhoog. Dit kan op sy beurt negatiewe gevolge vir sowel die moeder as die fetus se welstand hê. As vroedvroue nie voldoende psigososiale riskio-assesserings op swanger vrouens doen nie, kan dit tot 'n gebrek aan psigososiale ondersteuning tydens die swangerskap en geboorte lei. Swanger vrouens wat 'n gebrek aan psigososiale ondersteuning het, kan stres, angs en depressie ervaar wat weer die fetus se welstand kan beïnvloed DOELWIT: Die doelwit van hierdie studie was om die persepsies van vroedvroue, wat voorgeboortesorg aan swanger vrouens bied, te ondersoek en te beskryf sover dit hulle persepsies oor psigososiale risiko-assessering en psigososiale aangaan METODE: 'n Interpretatiewe en beskrywende kwalitatiewe benadering is gevolg. Drie fokusgroep-onderhoude is deur middel van 'n gestruktureerde onderhoudsgids gevoer met verloskundiges wat in drie voorgeboorteklinieke in die Gauteng Provinsie werksaam is. 'n Benadering tot data-analise wat van voortdurende vergelyking gebruik maak, is gevolg RESULTATE: Die studie het aan die lig gebring dat verloskundiges bewus is van psigososiale probleme onder swanger vroue en dat die prevalensie van sulke probleme onder swanger vroue hoog is. Vroedvroue erken die belang van psigososiale sorg aan swanger vroue alhoewel hulle nie toereikend toegerus is om psigososiale assessering en -sorg te verleen nie GEVOLGTREKKING: Die bevindinge stel 'n basis daar vir die insluiting van psigososiale sorg in roetine voorgeboortesorg. <![CDATA[<b>Cracks in reproductive health rights: Buffalo City learners' knowledge of abortion legislation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100006&lng=pt&nrm=iso&tlng=pt BACKGROUND: The Choice on Termination of Pregnancy (CTOP) Act legalised abortion on request in South Africa until up to 12 weeks of gestation and thereafter under specified conditions. Within the context of liberal legislation, accurate information is a necessary (although not sufficient) requirement for women to exercise their reproductive rights OBJECTIVES: This research investigated Grade 11 learners' knowledge of the CTOP Act and its stipulations METHODS: Survey research was conducted with respondents drawn from a range of schools in Buffalo City, South Africa. Multi-stage sampling was used, namely stratified random sampling of schools and purposive sampling of grades used within schools. The data were collected by means of self-administered questionnaires in group situations RESULTS: Results indicate that knowledge of the legal status of abortion, as well as of the various stipulations of the law, was poor. Various misunderstandings were evident, including that spousal approval is required in order for married women to have an abortion. Significant differences between the knowledge of respondents at the various schools were found, with those learners attending schools formerly designated for African learners during Apartheid having the least knowledge CONCLUSION: Given the multiple factors that may serve as barriers to women accessing abortion, it is imperative that at least the most fundamental aspect of reproductive rights, that is, the right to information, is not undermine.<hr/>AGTERGROND: Die Choice on Termination of Pregnancy Act (CTOP) bewettig aborsie op aanvraag in Suid-Afrika tot en met 12 weke van swangerskap en daarna onder sekere voorwaardes. Binne die konteks van die liberale wetgewing is akkurate inligting 'n noodsaaklike (hoewel nie voldoende nie) vereiste vir vroue om hul reproduktiewe regte uit te oefen DOELWITTE: Die navorsing het graad 11-leerders se kennis van die CTOP Wet en dié se bepalings geondersoek METODES: Opname-navorsing is gedoen met respondente uit 'n verskeidenheid van skole in Buffalo City, Suid-Afrika. Multi-steekproefneming is gebruik, naamlik gestratifiseerde steekproefneming van skole en doelgerigte steekproefneming van grade in skole. Die data is ingesamel deur middel van self-geadministreerde vraelyste in groep situasies RESULTATE: Die resultate dui daarop dat die kennis van die wetlike status van aborsie, asook van die verskillende bepalings van die Wet, swak was. Verskeie misverstande was duidelik, insluitend dat 'n gade se toestemming nodig is vir getroude vroue se aborsie. Beduidende verskille tussen die kennis van die respondente by die onderskeie skole is gevind, met die swakste kennis onder dié leerders by skole wat voorheen aangewys is vir swart leerders tydens Apartheid. SLOT: Gegewedie verskeie faktore wat as hindernisse tot vroue se toegang tot aborsie kan dien, is dit noodsaaklik dat ten minste die mees basiese aspekte van reproduktiewe regte, naamlik, die reg tot inligting, nie geondermyn word nie. <![CDATA[<b>Comparison of trauma on survivors of sexual assault and intimate partner violence in Limpopo</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100007&lng=pt&nrm=iso&tlng=pt BACKGROUND: Gender-based violence is a challenge in South Africa, despite available interventions. Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery OBJECTIVES: To compare the effects of trauma on female survivors of sexual assault versus those experienced by survivors of physical assault by their intimate partners METHOD: A quantitative cross-sectional comparative study design was used to compare 30 sexually-assaulted women and 30 physically-assaulted women regarding depressive symptoms, posttraumatic stress disorder and coping styles three months after the incident. Semi-structured interviews were conductedwith the survivors of both types of assault and the Beck Depression Inventory posttraumatic stress disorder checklist and Brief COPE Inventory were administered in order to obtain quantitative data. Both parametric and non-parametric statistics were employed. Ethical measures were adhered to throughout the research process RESULTS: A significantly-higher proportion of sexually-assaulted women disclosed the incident to family (p = 0.021). The majority of sexually- (90%) and physically- (86%) assaulted women were likely to recall the incident. Sexually-assaulted women had a significantly-higher mean for avoidance/numbness (p < 0.001) and physical-assaulted women in arousal (p &gt; 0.051). About 41% of sexually-assaulted participants reported severe depression. Findings confirmed that sexual assault is more personal whilst physical assault is more interpersonal. If physically-assaulted women were removed from the perpetrators they recovered faster than sexually-assaulted women. Their stay with the perpetrators may perpetuate the violence CONCLUSION: The need for counselling and support for the survivors of both traumas was recommended. All stakeholders should be educated to provide support to survivors of both traumas.<hr/>AGTERGROND: Ten spyte daarvan dat daar intervensies beskikbaar is, bly geslagsgebaseerde geweld 'n uitdaging in Suid-Afrika. Die versorging van die oorlewendes geweld is van kritieke belang om die oorlewendes se spoedige herstel te verseker DOELWITTE: Die doel was om die gevolge van trauma op die vroulike slagoffers van seksuele aanranding te vergelyk met die trauma wat die oorlewendes van fisiese aanranding ervaar het METODE: 'n Kwantitatiewe dwarssnit ontwerp is gebruik om 30 seksueel aangerande vroue en 30 fisiek aangerande vroue te vergelyk sover dit depressiesimptome, posttroumatiese stresversteuring en coping styl betref drie maande na die voorval plaasgevind het. Semi-gestruktureerde onderhoude is gevoer met die oorlewendes van beide soorte aanvalle, terwyl die Beck depressie-inventaris, die kontrolelys vir posttroumatiese stresversteuring en die bondige COPE-inventaris afgeneem is om kwantitatiewe data te bekom. Sowel parametriese as nie-parametriese statistiek is gebruik. Etiese vereistes is regdeur die navorsingsproses nagekom RESULTATE: 'n Aansienlik hoër persentasie seksueel aangerande vrouens het hulle gesin oor die voorval ingelig (p = 0.021). Die meeste seksueel (90%) en fisiek (86%) aangerande vrouens het die voorval onthou. Seksueel aangerande vrouens toon 'n aansienlik hoër gemiddelde vir vermyding of gevoelloosheid (p < 0.001) en fisiese aangerande vrouens het 'n hoër gemiddelde vir opwekking (p &gt; 0.051). Sowat 41% van die seksueel aangerande deelnemers meld erge depressie. Die studie bevestig dat seksuele aanranding persoonliker is, terwyl fisieke aanranding meer interpersoonlik is. As fisiek aangerand vroue van die oortreders verwyder word, herstel hulle vinniger as die seksueel aangerande vroue. As hulle by die oortreders bly, kan die geweld voortduur GEVOLGTREKKING: Die noodsaak aan berading en ondersteuning vir beide groepe oorlewendes word aanbeveel. Alle belanghebbendes moet opgevoed word om ondersteuning aan oorlewendes te bied. <![CDATA[<b>The effect of psychological violence in the workplace on health: A holistic eco-system approach</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100008&lng=pt&nrm=iso&tlng=pt BACKGROUND: Psychological violence has emerged as a priority concern in all workplaces because of its adverse consequences on victims' health. So far, limited research has been conducted on the effect of psychological violence on the five interrelated contexts of human existence. OBJECTIVES: This qualitative study investigated the perceived effect of psychological violence in the workplace on staff members' holistic health at a multi-campus South African Further Education and Training College. By investigating the effect of psychological violence on these five interrelated contexts, the resultant effect on holistic health might be more fully understood and applicable recommendations formulated to ameliorate the perceived effects. METHOD: A qualitative, exploratory and descriptive research design was used to investigate the perceived effect of psychological violence on staff members' health. Purposeful sampling was used to select 29 participants to be interviewed individually, based on their experiences of psychological violence, as well as data saturation. The researcher analysed the data and a co-coder cross-checked the codes. RESULTS: The results pertaining to the perceived effects of psychological violence were positioned within the holistic eco-systemic approach as encompassing theory. Five themes were identified accordingly after data analysis, namely, psychological, biophysical, spiritual, ecological and metaphysical effects. CONCLUSION: Findings revealed that psychological violence impacts adversely on all five interrelated contexts of individual health, leading to an adverse cumulative effect on staff members' holistic health and on the systems in which psychological violence occurs. Based on the findings, recommendations could be made to ameliorate the perceived adverse effect of psychological violence.<hr/>AGTERGROND: Psigologiese geweld is tans besig om op die voorgrond te tree as 'n prioriteit in alle werksplekke as gevolg van die ernstige nadelige gevolge daarvan op die gesondheid van slagoffers. Tot dusver is beperkte navorsing gedoen rakende die effek van psigologiese geweld op die vyf interverwante kontekste van menslike bestaan. DOELWITTE: Hierdie kwalitatiewe studie het die waargenome effek van psigologiese geweld in die werksplek op die holistiese gesondheid van personeellede in 'n multi-kampus Verdere Onderwys en Opleiding Kollege ondersoek. Deur die effek van psigologiese geweld op hierdie vyf interverwante kontekste te ondersoek, kon die gevolglike effek op holistiese gesondheid; meer volledig verstaan word en toepaslike aanbevelings geformuleer word om die waargenome effek te verbeter. METODE: 'n Kwalitatiewe, verkennende en beskrywende navorsingsontwerp is gebruik om die waargenome effek van psigologiese geweld op personeellede se gesondheid te ondersoek. 'n Doelgerigte steekproef is gebruik om 29 deelnemers te selekteer om indivuele onderhoude mee te voer, gebaseer op hul ervarings van psigologiese geweld, asook data versadiging. Die navorser het die data geanaliseer en 'n mede-kodeerder het die kodes kruis-kodeer. RESULTATE: Die resultate rakende die waargenome effek van psigologiese geweld was geposisioneer binne die holisties eko-sistemies benadering as omvattende teorie. Vyf temas is dienoorkeenkomstig na afloop van die data-anelisering geidentifiseer naamlik psigologiese, biofisiese, spirituele, ekologiese en metafiese effekte. GEVOLGTREKKING: Bevindings het aangetoon dat psigologiese geweld 'n negatiewe impak het of al vyf interverwante kontekste van individuele gesondheid wat lei tot 'n negatiewe kumulatiewe effek op personeellede se holistiese gesondheid in die sisteme waar psigologiese geweld plaasvind. Aanbevelings, gebaseer op die bevindinge, kon gemaak word om die nadelige effek van psigologiese geweld te verbeter. <![CDATA[<b>Prevalence of stunting, wasting and underweight in grade 1-learners: The NW-CHILD Study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100009&lng=pt&nrm=iso&tlng=pt BACKGROUND: Child undernutrition remains a major public health concern in developing countries, with many negative consequences to child development. OBJECTIVES: To determine the prevalence of stunting, wasting and underweight amongst Grade 1-learners in the North West Province (NWP) of South Africa (SA), taking into account gender, race and school type. METHOD: Eight hundred and sixteen (419 boys, 397 girls) learners participated in the study (567 black, 218 white, 31 other races). Underweight, stunting and wasting (Weight-for-age, height-for-age, BMI-for-age) were determined using the z-scores of the 2007 WHO reference sample (-2 SD). RESULTS: A higher prevalence of wasting and underweight were found amongst the boys (8.35%; 5.97%) compared with the girls (6.30%; 2.52%), although this was only significant for underweight (p = 0.02), whilst stunting percentages were very similar amongst girls (4.53%) and boys (4.06%). Underweight was the highest in the black group (5.47%;p < 0.01), compared with the white group (0.46%) and the prevalence of the conditions is associated with school types which represent low socio-economic circumstances (Quintile 1-3 schools). Only black learners showed stunting (p < 0.01) and more black learners were wasted (n = 39) compared with white (n = 15; p = 0.08) learners. Quintile 1-3 schools had a significantly higher prevalence of underweight (5.14% - 8.18%) and stunting (3.88% - 10.7%) (p < 0.01) compared with Quintile 4 and 5 schools. CONCLUSION: The prevalence of stunting, wasting and underweight need improvement amongst school beginners, especially in Quintile 1-3 type schools but also amongst black learners living in the NWP of SA as it can have significant hampering effects on the future development and well-being of children.<hr/>AGTERGROND: Ondervoeding is steeds 'n publieke gesondheidsgevaar by kinders in ontwikklende lande, met heelwat negatiewe gevolge vir kinderontwikkeling. DOEL: Om te bepaal wat die voorkoms van groei-inperking, ondervoeding en ondergewig by Graad 1-leerders in die Noordwes-Provinsie (NWP) van Suid-Afrika (SA) is, met in ag neming van geslag, ras en skooltipe. METODE: Agt honderd en sestien leerders (419 seuns; 397 meisies) is ewekansig geselekteer vir deelname aan die studie (567 swart, 218 wit, 31 ander rasgroepe). Ondergewig, groei-inperking en ondervoeding is bepaal deur z-tellings vir massa-vir-ouderdom, lengte-vir-ouderdom en LMI-vir-ouderdom volgens die 2007 WHO verwysings (-2 SA). RESULTATE: 'n Hoër voorkoms vir ondervoeding en ondergewig is by seuns (8.35%; 5.97%) teenoor meisies (6.30%; 2.52%) gevind, alhoewel slegs betekenisvol vir ondergewig (p = 0.02), terrwyl persentasies van groei-inperking redelik dieselfde was by meisies (4.53%) en seuns (4.06%). Ondergewig het die hoogste voorkoms in die swart groep (5.47%; p < 0.01) getoon, en die voorkoms word geassosieer met skooltipes wat lae sosio-ekonomiese omstandighede verteenwoordig. Slegs swart leerders het groei-inperking getoon (p < 0.01) en meer swart leerders was ondervoed (n = 39) teenoor blanke (n = 15) leerders. Kwintiel 1-3 skole het 'n betekenisvolle hoër voorkoms vir ondergewig (5.14% - 8.18%) en groei-inperking (3.88% - 10.7%) getoon (p < 0.01) as die Kwintiel 4 en 5 skole. GEVOLGTREKKING: Groei-inperking, ondervoeding en ondergewig moet by skoolbeginners verbeter word, veral in Kwintiel 1-3 skooltipes en by Swart leerlinge in die NWP van SA, veral weens die negatiewe uitwerking wat dit op die toekomstige ontwikkeling en welstand van leerders wat daaronder gebuk gaan, kan uitoefen. <![CDATA[<b>Patients' knowledge and beliefs about antiretroviral treatment and factors associated with adherence in Mpumalanga Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100010&lng=pt&nrm=iso&tlng=pt BACKGROUND: Antiretroviral treatment (ART) improves the prognosis and quality of life for HIV patients by reducing the rate of disease progression and mortality. Although ART has been available in public health centres in South Africa since 2003, adherence to treatment still remains a challenge. To date, no study has investigated adherence and the factors that influence adherence to ART in rural settings in Mpumalanga Province. OBJECTIVE: This study described adherence to, knowledge and beliefs about ART and other factors associated with adherence amongst patients registered at Shongwe Hospital in Nkomazi Local Municipality. METHOD: A cross-sectional survey of 184 randomly selected patients on ART between ages of 15 and 65 years was conducted. RESULTS: The respondents completed a questionnaire on self-reported adherence, knowledge and beliefs about ART and other factors associated with adherence. The majority of the respondents were female (71.2%) and unemployed (83.7%). Most respondents reported optimal ART adherence (taking 95% or more of their medication as prescribed) over the past two (92.4%) and seven (84.2%) days, respectively. The level of knowledge about ART was high and most reported positive beliefs about the effectiveness of ART. However, slightly more than half (53.3%) believed that ART was harmful for the body. The most commonly-reported reasons for missing dosages were forgetfulness, business of the daily routine, having visitors, 'visiting a bar' and sleeping away from home. CONCLUSION: Although, the study found that most ART patients at Shongwe Hospital reported optimal adherence initially, the reasons for missing dosages, some incorrect knowledge and beliefs need to be addressed to ensure long-term adherence and persistence in care.<hr/>AGTERGROUND: Antiretrovirale (ARV) behandeling verbeter die prognose en lewenskwalitiet van pasiënte wat besmet is met MIV, deur 'n remmende effek op die ontwikkeling van VIGS te bewerkstellig. Alhoewel ARVbehandeling reeds sedert 2003 in openbare gesondheidsentrums in Suid Afrika beskikbaar was, bly die volgehoue en stiptelike navolging van die behandelingsplan 'n grootse uitdaging vir pasiënte. Daar is egter min navorsing oor die faktore wat navolging van ARV behandeling deur pasiënte in landelike gebiede in Mpumalanga gedoen. DOELWITTE: Hierdie studie ondersoek pasiënte se kennis, houdings en ander faktore wat die navolging van ARV behandeling beïnvloed by Shongwe-hospitaal in die Nkomazi distrik in Mpumalanga. METODE: 'n Bestekopname van 184 pasiënte, tussen die ouderdomme van 15 en 65 jaar, wat ARV behandeling ontvang is gedoen. Hulle is lukraak gekies en het 'n vraelys voltooi rakende hul kennis en oortuigings ten opsigte van ARV-middels, asook die faktore wat die stiptelike gebruik van die middels beïnvloed. RESULTATE: Die steekproef het hoofsaaklik uit vroue (71.2%) bestaan, en die meerderheid was werkloos (83.7%). Die meeste van die deelnemers het aangedui dat hulle hul ARV-medikasie die vorige twee dae (92.4%) en sewe dae (84.2%) grotendeels (ten minste 95% van medikasie) volgens voorskrif geneem het. Die meerderheid van die studie deelnemers het redelike kennis van en positiewe houdings teenoor ARV-behandeling getoon. Vergeetagtigheid, die besigheid van normale daaglikse roetine, die ontvang van besoekers, besoeke aan kroeë asook uitslaap was die redes wat aangevoer is vir vernalating om medisyne te neem. GEVOLGTREKKING: Alhoewel, die meeste pasiënte in hierdie studie aanvanklik redelik goed gevaar het met die navolging van die behandelingsplan, moet die probleme wat ervaar is met die neem van medikasie aangespreek word om lang-termyn navolging van behandeling en retensie te bewerkstellig. <![CDATA[<b>Child and youth care workers: profile, nutrition knowledge and food safety and hygiene practices</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100011&lng=pt&nrm=iso&tlng=pt BACKGROUND: Facilities concerned with children 'in need of care' should not only be considered as a last resort for a child's care, but also as an intervention that requires more than addressing a child's basic physical needs. The nutritional needs of children are particularly important to consider as they are a fundamental part of the care provided. OBJECTIVES: The purpose of this descriptive quantitative study was to investigate the profile, nutrition knowledge, food safety and hygiene practices of child and youth care workers (CCWs) in residential care settings in order to guide the development of a food preparation and nutrition manual. METHOD: The residential care settings included in this study were three that were selected randomly in Durban. CCWs (N = 40) employed permanently or part-time were included. Convenience purposive sampling of the CCWs was undertaken. A structured self-administered questionnaire, developed and tested for this purpose, was used to gather information on the profile, nutrition knowledge, food safety and hygiene practices. The data were analysed for descriptive statistics (means and frequencies). RESULTS: The majority of CCWs were women aged 18-34 years. Very few had completed a relevant tertiary qualification. The results indicated that the respondents' knowledge was fair on general nutrition guidelines, but there were areas of concern. Specifically, knowledge on recommended fruit and vegetable intake, correct serving sizes and importance of a variety in the diet were lacking. Some knowledge about food safety and hygiene practices was demonstrated, but not in totality. CONCLUSION: The overall findings supported the development of a comprehensive food preparation and nutrition manual for child residential care facilities.<hr/>AGTERGROND: Fasiliteite gemoeid met kinders 'in die behoefte van sorg' nie net beskou moet word as 'n laaste uitweg vir 'n kind se sorg nie, maar ook as 'n intervensie wat meer as net die basiese en fisiese behoeftes van kinders aanspreek. Die voedingsbehoeftes van kinders is veral belangrik om te oorweeg as 'n fundamentele element van versorging. DOELWIT: Die doel van hierdie beskrywende kwantitatiewe studie was om die profiel, voeding kennis en voedsel- veiligheid en higikne van kinder-en jeugsorgwerkers te ondersoek in residensikle sorg instellings met die doel om 'n voedsel voorbereiding en voedings handleiding te ontwikkel. METODE: Die residensikle sorg instellings het bestaan uit drie ewekansig gekiesde kinderhuise in Durban. Die studie het bestaan uit kinder-en jeugsorgwerkers (N = 40) in permanente of deeltydse poste. 'n Doelgerigte steekproef van die kinder-en jeugsorgwerkers is onderneem. 'n Gestruktureerde self-geadministreerde vraelys, ontwikkel en getoets vir hierdie doel, is gebruik om inligting oor die profiel, voeding kennis, voedselveiligheid en higikniese praktyke van die kinder- en jeugsorgwerkers in te samel. Die data is ontleed vir beskrywende statistieke. RESULTATE: Die meerderheid van die kinder- en jeugsorgwerkers was vroulik, tussen die ouderdomme van 18-34 jaar. Min het 'n toepaslike tersijre kwalifikasie gehad. Dit blyk uit die resultate dat die respondente se algemene voeding riglyne was aanvaarbaar. Die resultate het gedui op 'n gebrek aan kennis oor die aanbevole vrugte en groente inname, korrekte porsiegroottes en die belangrikheid van 'n verskeidenheid in die dieet. Die respondente het tot 'n mindere mate kennis oor voedselveiligheid en higikne gehad. GEVOLGTREKKING: Die algemene bevindinge ondersteun die ontwikkeling van 'n omvattende voedsel voorbereiding en voedings handleiding vir kinder residensikle sorg instellings. <![CDATA[<b>The psychological experience of women who survived HELLP syndrome in Cape Town, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100012&lng=pt&nrm=iso&tlng=pt BACKGROUND: Haemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) is a high-risk pregnancy condition that could be fatal to mother and / or baby. It is characterised, as the acronym indicates, by haemolysis, elevated liver enzymes and low blood platelets. OBJECTIVE: This study explored women in Cape Town's psychological experience of HELLP syndrome. METHOD: Six participants who previously experienced HELLP syndrome were interviewed. Using a grounded theory approach, themes emerged and a model illlustrating the psychological experience of HELLP syndrome was constructed. RESULTS: The major themes that emerged were the perceived lack of information, a need to assign blame and a shift in focus. Themes of not knowing and trance and/or surreal experience underpin the cognitive aspects of the HELLP syndrome experience. Themes that expressed feelings of an inability to control, whirlwind and/or rapid pace and support acted together to bind the experience. Finally, emotions such as anger, ambivalence, disbelief, anxiety, guilt, loneliness and fear were present throughout the experience. CONCLUSION: This study developed an initial exploratory model representing the psychological experience of HELLP syndrome in a sample of South African women. Underlying this entire experience was a perceived lack of information which had a profound effect on numerous aspects of the experience ranging from where to locate blame to the varied emotions experienced.<hr/>AGTERGROND: Die HELLP sindroom is 'n hoë-risiko swangerskap toestand wat kan dodelik vir moeder en/of baba wees. Dit word gekenmerk deur hemolise, verhoogde lewerensieme en lae bloedplaatjies. DOELWIT: Hierdie studie het Suid-Afrikaanse vroue se sielkundige ervaring van die HELLP sindroom ondersoek. METODE: Ses deelnemers wat voorheen HELLP sindroom ervaar het is ondervra. Met die gebuik van gefundeerde teorie as 'n teoretiese raamwerk en ontleding het temas na vore gekom en 'n model wat die sielkundige ervaring van HELLP sindroom illustreer, is gebou. RESULTATE: Die vernaamste temas wat na vore gekom het was die oënskynlike gebrek aan inligting, 'n behoefte om skuld toe te skryf en 'n verskuiwing in fokus. Die tema van nie weet en beswyming en/of surrealistiese ervaring ondersteun die kognitiewe aspekte van die HELLP sindroom. Temas wat gevoelens van geen beheer, warrelwind en/of vinnige tempo en ondersteuning uitgesprek het, het saam opgetree om die ervaring te bind. Ten slotte, emosies soos woede, teenstrydigheid, ongeloof, angs, skuldgevoelens, eensaamheid en vrees was teenwoordig in die hele ervaring. GEVOLGTREKKING: Hierdie studie het van'n aanvanklike ondersoekende model van die sielkundige ervaring van HELLP sindroom tot 'n steekproef van die Suid-Afrikaanse vroue ontwikkel. Onderliggend aan hierdie hele ervaring was 'n oënskynlike gebrek aan inligting wat 'n diepgaande uitwerking gehad het op talle aspekte van die ervaring wat gewissel het van waar om die blaam te plaas tot die uiteenlopende ervaarde emosies. <![CDATA[<b>Prevention of mother-to-child transmission of HIV data completeness and accuracy assessment in health facilities of the Nkangala district</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100013&lng=pt&nrm=iso&tlng=pt BACKGROUND: Even though significant progress has been made in the roll-out and quality of the prevention of mother-to-child transmission of HIV (PMTCT) services in South Africa, the quality of patient data recording remains a challenge. OBJECTIVES: To assess PMTCT data completeness and accuracy at primary healthcare level to district level in order to assist with the improvement of the PMTCT data recording. METHODS: This is a retrospective record review study which involved collecting PMTCT data on indicators which was for the period of August 2009 to January 2010. We conducted baseline facility assessments which included 72 PMTCT sites in one health district, Nkangala. We assessed the data completeness and accuracy of the data values recorded on the seven PMTCT data elements. RESULTS: Data were only complete for less than a quarter of the time for most of the antenatal indicators (0.5% - 44%) and for the maternity indicators, data were only complete 11% of the time. Data inaccuracy was a result of recording of data values in the District Health Information System (DHIS) which were not within 10% of the data values recorded in the case registers. The results show that data were missing from the case registers, monthly summary sheets and DHIS between 30% and 99% of the time and that data elements had values recorded in the DHIS which were > 10%. CONCLUSION: There is a need for ongoing training on data recording procedures at all levels. To maintain data quality, healthcare data must be appropriate, organised, timely, available, accurate and complete.<hr/>AGTERGROUND: Selfs al is beduidende vordering gemaak met die bekendstelling en die kwaliteit van die voorkoming van moeder-na-kind-oordrag van MIV (PMTCT) dienste in Suid-Afrika, bly die kwaliteit van die pasiëntdataopname 'n uitdaging. DOELWITTE: Om PMTCT datavolledigheid en akkuraatheid van primêre gesondheidsorg vlak tot distriksvlak te bepaal ten einde te help met die verbetering van die PMTCT data opname. METODES: Dit is 'n terugwerkende hersieningstudie wat die versameling van PMTCT data op aanwysers vir die tydperk van Augustus 2009 tot Januarie 2010, behels het. Ons het basislyn fasiliteitsramings en/of skattings uitgevoer wat 72 PMTCT webwerwe in een gesondheid distrik, Nkangala, ingesluit het. Ons het data volledigheid en akkuraatheid van datawaardes op die sewe PMTCT data-elemente, beoordeel. RESULTATE: Data was slegs voltooi vir minder as 'n kwart van die tyd vir die meeste van die voorgeboortesorg aanwysers (0.5% - 44%) en vir die kraamaanwysers, data was slegs volledig vir 11% van die tyd. Onakkuraate data was die resultaat van die opname van datawaardes in die Distrik Gesondheid Inligting System (DHIS) wat nie binne 10% van die datawaardes in die gevalleregisters aangeteken was nie . Die resultate het getoon dat data in die gevalleregisters, maandelikse opsommings en DHIS tussen 30% en 99% van die tyd ontbreek het en dat dataelemente waardes in die DHIS opteken het wat > 10% was. GEVOLGTREKKING: Daar is 'n behoefte vir voortgesette opleiding ten opsigte van datavasleggingsprosedures op alle vlakke. Om datakwaliteit te handhaaf, moet gesondheidsorgdata gepas, georganiseerd, tydig, beskikbaar, akkuraat en volledig wees. <![CDATA[<b>HIV epidemic in South Africa: A comparison of HIV epidemic patterns of two extreme provinces in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100014&lng=pt&nrm=iso&tlng=pt BACKGROUND: South Africa is experiencing one of the worst HIV epidemics, which varies by province and by districts within each province. OBJECTIVE: To explore and compare HIV trends and patterns between two provinces in South Africa. METHOD: 'Know your epidemic' synthesis suggests that HIV prevalence is rising in older age groups and falling in younger people. Using secondary data analyses of population-based and antenatal care surveillance (ANC) surveys, we explored trends and patterns in HIV prevalence in KwaZulu-Natal and Western Cape. RESULTS: Even though KwaZulu-Natal has the highest HIV prevalence in the country (15.5% compared with 3.8% in the Western Cape), there is considerable recent decline (6%) in HIV prevalence in KwaZulu-Natal, compared with a 2% increase in the Western Cape, based on ANC data, in youth aged 15 to 24 years. These results are consistent with those from a population-based survey where a decline of 0.3% in HIV prevalence in KwaZulu-Natal was observed as compared with an increase of 0.7% in Western Cape youth. Both ANC results and population-based surveys conducted in different years show a decline in HIV prevalence amongst youth in KwaZulu-Natal compared with an increase in the same age group in the Western Cape. HIV infection in this age group is associated with recent infection, thus indicating an increasing epidemic in the Western Cape compared with KwaZulu-Natal. CONCLUSION: Interventions aimed at curbing infections such as sexual abstinence and condom promotion in this age group need to be implemented extensively in the Western Cape. These should include HIV counseling and testing campaigns.<hr/>AGTERGROND: Suid-Afrika ondervind een van die ergste MIV-epedemies, wat verskil ten opsigte van elke provinsie en distrik en binne elke provinise. DOELSTELLING: Om MIV-voorkoms en -patrone tussen twee provinises in Suid-Afrika te ondersoek en vergelyk. METODE: 'Ken jou epidemie' sintese dui daarop dat die voorkomssyfer van MIV in ouer ouderdomsgroepe styg en daal by jonger mense. Ons het sekondêre data analieses van bevolkingsgebaseerde en swangerskapsorg waarnemingsopnames (ANC) gebruik om neigings en patrone in MIV-voorkoms in Kwa-Zulu Natal en die Wes-Kaap, vas te stel. RESULTATE: Ofskoon Kwa-Zulu Natal die hoogste voorkoms in Suid-Afrika (15.5% vergelyk met 3.8% in die Wes-Kaap) het, is daar 'n aansienlike onlangse afname (6%) in die voorkoms van MIV in Kwa-Zulu Natal waargeneem, vergelyk met die 2% verhoging in die Wes-Kaap, gebasseer op ANC data, in jongmense in die ouderdomsgroep 15-24 jaar. Hierdie resultate is konsekwent met dié van die bevolkingsgebaseerde opname, waar 'n afname van 0.3% in MIV-voorkoms in Kwa-Zulu Natal waargeneem is, vergelyk met 'n toename van 0.7% in die jeug van die Wes-Kaap. Altwee die ANC-resultate en die bevolkings-gebaseerde opnames wat in verskillende jare uitgevoer is, wys 'n afname in MIV-voorkoms onder die jeug in Kwa-Zuly Natal vergelyk met 'n toename onder dieselfde ouderdomsgroep in die Wes-Kaap. MIV-infeksie onder hierdie ouderdomsgroep word verbind met 'n onlangse infeksie, wat 'n toename van die epidemie in die Wes-Kaap, vergelyk met Kwa-Zulu Natal aandui. GEVOLGTREKKINGS: Ingryping, wat daarop gemik is om infeksies soos seksuele onthouding en die reklame van kondome vir hierdie ouderdomsgroep, behoort wyd in die Wes-Kaap geimplementeer te word. Hierdie behoort voorligtings- en toetsveldtogte in te sluit. <![CDATA[<b>The effects of rehabilitation on intellectually-disabled people - a systematic review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100015&lng=pt&nrm=iso&tlng=pt BACKGROUND: Rehabilitation has emerged as a comprehensive approach to addressing intellectually-disabled peoples' skill deficits, improving competencies and facilitating optimal functioning in order to provide the greatest possible measure of social and economic participation, self-reliance and independence. OBJECTIVE: To synthesise critically and summarise the best available evidence of the effects of rehabilitation on intellectually-disabled people. METHOD: Literature searches of different electronic databases and manual searches were conducted using selected keywords. Studies on the effects of rehabilitation on intellectually-disabled people were selected systematically, appraised critically for methodological quality and summarised. RESULTS: Rehabilitation interventions indicated good outcomes with regard to intellectually-disabled people. Findings showed that people with mild to moderate intellectual disabilities improved in terms of activities of daily living (ADL) after rehabilitation. Improvement was noted in ADL, self-care skills, communication skills and cognitive achievements. CONCLUSION: Findings demonstrated positive rehabilitation effects on intellectually-disabled people. This study contributes to the comprehensive nursing care of intellectually-disabled people by endorsement of the effectiveness of rehabilitation in terms of ADL, self-care skills, communication skills and cognitive achievements. The collected evidence of this study may contribute to the education of more effective nurse practitioners involved in the daily care and rehabilitation of intellectually-disabled people.<hr/>AGTERGROND: Rehabilitasie het ontwikkel in 'n omvattende benadering met 'n kombinasie van behandelingsmetodes om die veelvoudige hindernisse wat met intellektuele gestremdheid geassosieer word die hoof te bied. Rehabilitasie word gebruik om die intellektueel gestremde mense se vaardigheidstekorte aan te pak, bevoegdheid te bevorder en optimal funksionering te fasiliteer met die beste moontlike sosiale en ekonomiese deelname, onafhanklikheid, selfstandigheid en selfbeskikking as doelwit. DOELSTELLING: Hierdie sistematiese literatuuroorsig het die beskikbare bewyse van die effek van rehabilitasie op intellektueel gestremde mense ondersoek en beskryf. METODE: Literatuur soektogte van verskillende elektroniese databasisse en handsoektogte was gedoen deur geselekteerde sleutelwoorde te gebruik. Studies oor die effekte van rehabilitasie op die intellektueel gestremde persone was stelselmatig geselekteer, krities ontleed vir metodologiese kwaliteit en opgesom. RESULTATE: Rehabilitasie-intervensies het goeie uitkomste op intellektueel gestremde mense getoon. Bevindinge het getoon dat mense met ligte tot matige intellektuele gestremdhede ten opsigte van daaglikse aktiwiteite na rehabilitasie verbeter het. Vordering is opgemerk in daaglikse leefaktiwiteite, selfsorgvaardighede, kommunikasievaardighede en kognitiewe prestasie. GEVOLGTREKKINGS: Bevindinge het positiewe rehabilitasie effekte op die intellektueel gestremde mense getoon. Hierdie studie dra by tot die omvattende verpleging van intellektueel gestremde mense deur ondersteuning van die doeltreffendheid van rehabilitasie met betrekking tot daaglikse leefaktiwiteite, selfsorgvaardighede, kommunikasievaardighede en kognitiewe prestasie te gee. Die bewyse wat in hierdie studie ingesamel is, kan bydra tot die opleiding van doeltreffender verpleegkundiges wat by die daaglikse versorging en rehabilitasie van intellektueel gestremde mense betrokke is. <![CDATA[<b>Directly-Observed Treatment Strategy implementation practices in a hospital in eThekwini health district</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100016&lng=pt&nrm=iso&tlng=pt BACKGROUND: The incidence rate of tuberculosis (TB) in South Africa remains high, with the country ranked as having the 14th-highest incidence rate internationally; 646 per 100 000 people are infected with TB nationally, whilst KwaZulu-Natal has a provincial incidence of 1466 per 100 000. The Directly-Observed Treatment Strategy (DOTS) programme is intended to ensure both treatment completion and cure of TB, as well as its evaluation. Despite improved DOTS coverage - the focus of most DOTS studies - the incidence of drug-resistant TB suggests that issues of non-compliance are centrally responsible for ongoing concerns about the implementation and practices related to DOTS. OBJECTIVES: The aim of the study was to explore and describe DOTS implementation practices. The objectives of the study were to explore and describe the DOTS implementation practices of professional nurses and to describe modifiable barriers to DOTS. METHOD: A qualitative, descriptive, explorative study was conducted through individual interviews until saturation was reached. RESULTS: The study revealed that DOTS implementation was not in accordance with World Health Organization prescripts. Participants reported barriers such as limited human and material resources, ineffective communication of policy and procedural guidelines, ineffective communication between service delivery institutions and lack of continuity of care, as well as a lack of recording and reporting. CONCLUSION: The study recommended a comprehensive recruitment process to facilitate greater training and employment of more permanent health professionals to combat TB in the community; and to re-launch the DOTS programme in underperforming facilities. This would give much needed momentum to efforts targeted at preventing treatment defaults amongst patients.<hr/>AGTERGROND: Die voorkomskoers van tuberkulose (TB) in Suid-Afrika bly steeds hoog, waar die land internasionaal beskou word as met die 14de hoogste voorkomskoers; 646 per 100 000 mense is nasionaal met TB besmet, terwyl KwaZulu-Natal 'n provinsiale voorkoms van 1466 per 100 000toon. Die punte program (DOTS) is bedoel om beide die voltooiing van behandeling en genesing van TB en die evaluering daarvan te verseker. Ten spyte van verbeterde DOTS-dekking, wat die fokus van die meeste DOTS studies is, dui die voorkoms van dwelm-weerstandige TB daarop dat die kwessie van nie-nakoming sentraal verantwoordelik is vir voortgesette kommer oor die implementering en praktyke wat verband hou met DOTS. DOELWITTE: Die doel van die studie was om die implementering van DOTS - praktyke te ondersoek en te beskryf. Die doelwitte van die studie was om die DOTS- implementeringspraktyke van professionele verpleegkundiges te ondersoek en te beskryf asook om veranderbare hindernisse ten opsigte van DOTS te beskryf. METODE: 'n Kwalitatiewe, beskrywende, ondersoekende studie is uitgevoer deur middel van individuele onderhoude tot die versadigspunt bereik was. RESULTADE: Die studie het getoon dat DOTS-implementering nie in ooreenstemming is met die WHO voorskrifte nie. Deelnemers berig struikelblokke soos beperkte menslike en materiële hulpbronne, oneffektiewe kommunikasie van beleid- en prosedureriglyne, oneffektiewe kommunikasie tussen dienslewerings-instellings en die gebrek aan kontinuïteit van sorg, sowel as ‚n gebrek aan optekening en verslaggewing. GEVOLGTREKKING: Die studie beveel 'n omvattende werwingsproses aan wat groter opleiding en indiensneming van meer permanente gesondheidswerkers om TB te bekamp in die gemeenskap sal fasiliteer, asook om die DOTS-program in gemeenskappe met onderpresterende geriewe herbekend te stel. Dit sal broodnodige momentum gee aan pogings wat gerig is op die voorkoming van onderbreekte behandeling onder pasiënte. <![CDATA[<b>Community-physician-based versus hospital-based antenatal care: A comparison of patient satisfaction</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100017&lng=pt&nrm=iso&tlng=pt BACKGROUND: Strategies to meet the healthcare needs of pregnant women are made available throughout antenatal, intra-partum and post-natal periods. These strategies are aimed at reducing perinatal and maternal mortality amongst women who access and utilise healthcare at an early stage. Late visits with irregular antenatal attendance result in failure to adequately use antenatal interventions. OBJECTIVES: This study intended to compare and describe the level of patient satisfaction with antenatal care between two groups of women who received free antenatal care from community private physicians and public midwives. METHODS: A quantitative comparative descriptive design with a Likert-scale measure was used. Sixty women, half from each group, participated in the study. Structured questionnaires with closed-ended response options were used to obtain data. RESULTS: The midwives' group was less satisfied with antenatal care than the physicians' group, with the former citing long waiting times as contributing to their dissatisfaction with antenatal care. CONCLUSION: Addressing long waiting times improves satisfaction with antenatal care. Daily antenatal visits, rather than visits on a specific day, may reduce long waiting times as women's visits are spread over all clinic days. Satisfaction with antenatal care has implications for access to healthcare, resulting in positive pregnancy outcomes.<hr/>AGTERGROND: Strategien om in die gesondheidsorgbehoeftes van swanger vroue te voorsien, word dwarsdeur die voorgeboorte, intra-partum en nageboorte periodes beskikbaar gestel. Hierdie strategien beoog om die perinatale en moederlike sterfstesyfers te verlaag onder vroue wie reeds op 'n vroeë stadium gesondheidsorg benut. Onrenlmatige en laat voorgeboortebesoeke lei daartoe dat voorgeboorte ingrypings nie voldoende benut word nie. DOELWITTE: Hierdie studie het beoog om twee groepe vroue se vlak van tevredenheid met die gratis voorgeboortesorg wat hul by privaat praktisyns uit die gemeenskap en vroedvroue uit die openbare sektor ontvang het, te vergelyk en beskryf. METODE: 'n Kwantitatiewe vergelykende beskrywende ontwerp met 'n Likert-skaal is gebruik. Sestig vroue, die helfte van elke groep, het aan die studie deelgeneem. Gestruktureerde vraelyste met geslote-vrae opsies is gebruik om die data te verkry. RESULTATE: Die praktisyns se groep was meer tevrede met die voorgeboortesorg as die vroedvroue se groep, veral ten opsigte van wagtye. GEVOLGTREKKINGS: Deur die probleem van wagtye aan te spreek, kan die tevredenheid met voorgeboortesorg verhoog word. Daaglikse voorgeboortesorgbesoeke, eerder as besoeke op spesifieke dae, kan lang wagtye verminder aangesien besoeke dan oor al die kliniekdae versprei word. Tevredenheid met voorgeboortesorg hou implikasies in vir toegang tot gesondheidsorg, wat positiewe swangerskapsuitkomste tot gevolg het. <![CDATA[<b>Views of pharmacists on involvement in ward rounds in selected public hospitals in Limpopo Province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100018&lng=pt&nrm=iso&tlng=pt BACKGROUND: Pharmacist participation in ward rounds is of increasing interest for better pharmaceutical care, yet most pharmacists do not engage in this activity. OBJECTIVE: The objective was to obtain public sector pharmacists' views and perceptions on their involvement in ward rounds. METHOD: A rapid assessment was conducted using a semi-structured questionnaire sent to five hospitals in Limpopo Province. RESULTS: There were 55 respondents (61.8% female), mainly from the Polokwane-Mankweng Hospital Complex (69.1%); 45 (82%) were young pharmacists aged 25 to 34, whilst experience varied from 0 < 5 years (69.1%), 5 < 10 years (16.4%) to &gt; 10 years (14.5%). The respondents included interns (n = 21), community service pharmacists (n = 7) and junior pharmacists (n = 8). Most had trained at University of Limpopo (n = 49), with a few from North-West University (n = 4), Wits (n = 1) and Durban - Westville (n= 1). The majority (94.5%) felt that it was necessary for pharmacists to be involved in ward rounds. Twenty-seven respondents (49.1%) said that pharmacists were involved in ward rounds and 21 of these (77.8%) said ward visits were to check on drug stocks, but not for direct patient care. Proposals to prepare pharmacists better for ward rounds included pre-service training (34.9%), internship (37.2%), community service (4.7%), post-graduate courses (8.1%) and continuing professional development (15.1%). CONCLUSION: Pharmacists in the public hospitals studied in Limpopo were willing to be involved in clinical ward rounds and suggested that this be introduced during undergraduate training. These findings support the plans for the Turfloop BPharm programme to introduce clinical ward rounds.<hr/>AGTERGROUND: : Die teenwoordigheid van aptekers tydens saalrondtes is van toenemende belang vir beter farmaseutiese sorg, maar baie aptekers is nie betrokke by by hierdie aktiwiteit nie. DOELSTELLING: Die doel van die studie was om die menings en persepsies van aptekers in die openbare sektor te verkry oor hulle betrokkenheid by saalrondtes. METODE: 'n Vinnige assessering was gedoen met behulp van 'n semi-gestruktureerde vraelys wat na vyf hospitale in Limpopo gestuur is. RESULTATE: : Daar het 55 respondente aan die studie deelgeneem (61.8% vroue). Die meerderheid was van die Polokwane-Mankweng hospitaalkompleks (69.1%). Daar was 45 (82%) jong aptekers tussen die ouderdomme van 25 en 34, terwyl ervaring gewissel het van 0 tot 5 jaar (69.1%), 6 tot 10 jaar (16.4%), tot 10 jaar of meer (14.5%). Die respondente het die volgende ingesluit: interns (n = 21), gemeenskapsdiensaptekers (n = 7) en junior aptekers (n = 8). Die meeste het hul tersiêre opleiding aan die Universiteit van Limpopo verkry (n = 49), met 'n paar van die Noord-Wes Universiteit (n = 4), Wits (n = 1) en Durban-Westville (n = 1). Die meerderheid (94.5%) het gevoel dat dit wel nodig is vir aptekers om in saalrondtes betrokke te wees. 'n Totaal van 27 respondente (49.1%) het aangedui dat aptekers betrokke is by saalrondtes, maar 21 uit die 27 (77.8%) het saalbesoek omskryf as die nagaan van saalvoorraad en nie direkte pasiëntesorg nie. Voorstelle om aptekers beter voor te berei vir saalrondtes het die volgende ingesluit: pre-diens opleiding (34.9%), internskap (37.2%), gemeenskapsdiens (4.7%), nagraadse kursusse (8.1%), en deur middel van voortgesette professionele ontwikkeling (15.1%). GEVOLGTREKKINGS: Aptekers in die openbare hospitale bestudeer in Limpopo was bereid om in die kliniese saalrondtes betrokke te wees en het voorgestel dat dit tydens voorgraadse opleiding ingestel word. Hierdie bevindings ondersteun die planne vir die Turfloop BPharm program om kliniese saalrondtes in te stel. <![CDATA[<b>Measuring compliance of conducting an occupational health risk assessment in the occupational health nurse's practice</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100019&lng=pt&nrm=iso&tlng=pt Occupational health nurses (OHNs) are qualified registered nurses with a postgraduate qualification in occupational health nursing. An important activity of OHNs is to identify and assess health risks in the workplace. Health risk assessments (HRAs) are conducted by OHNs to determine all the occupational health stressors, for example noise, vibration and chemical substances. The authors conducted legal compliance occupational health audits and observed that 85% (n = 23) of OHNs in different settings conduct HRAs only to a limited extent. The following objective was formulated for the study: To explore and describe the extent to which OHNs conduct HRAs as it is a legal requirement for compliance; and the possible reasons for not adhering to the regulation and conduct them only to a limited extent. A quantitative, descriptive design was used in this study. A sampling frame was developed from a list of all the members of the South African Society of Occupational Health Nursing Practitioners (SASOHN) in Gauteng. From the target population of OHNs in Gauteng, a systematic cluster sampling method was used. A self-developed questionnaire was distributed by mail and e-mail, and authors sent respondents reminders. The authors ensured that validity, reliability and ethical standards were adhered to. The findings revealed that OHNs are mature, experienced, predominately female practitioners who operate on behalf of a disproportionately large number of workers. Four factors influencing these nurses in conducting an HRA to a limited extent were identified: competence, ignorance about the role of the OHN, workload and attitude.<hr/>Beroepsgesondheidverpleegkundiges (BGV's) is gekwalifiseerde geregistreerde verpleegkundiges met 'n nagraadse kwalifikasie in beroepsgesondheidsverpleging wat basiese gesondheidsorg in die beroepsgesondheidsprogram lewer. 'n Belangrike aktiwiteit van die BGV is om alle gesondheidsrisiko's in die werksplek te identifiseer en te assesseer. Die BGV doen ook ʼn gesondheidsrisiko-analise (GRA) om stressors soos geraas en vibrasie te identifiseer. Die navorsers het met besoeke aan verskillende fabrieke bevind dat 85% (n = 23) van BGV's GRA's net in 'n sekere mate doen, alhoewel 'n GRA wetlik vereis word. Die volgende doelwit is vir die studie geformuleer: Om te ondersoek en te beskryf in watter mate BGV's GRA's uitvoer, en om die moontlike redes vir die nie-nakoming van die regulasie te ondersoek. 'n Kwantitatiewe, beskrywende navorsingsmetode is gebruik. 'n Sistematiese groepsteekmetode is gebruik om ʼn steekproefraamwerk uit 'n lys van die SASOHN-lede in Gauteng saam te stel. 'n Selfontwikkelde vraelys is aan respondente gestuur. Die navorsers het geldigheid, betroubaarheid asook etiese standaarde gehandhaaf. Daar is bevind dat BGV's ouer, hoofsaaklik vroulike praktisyns met bo-gemiddelde ondervinding is wat vir ʼn groot getal werkers verantwoordelik is. Vier faktore is geïdentifiseer wat BGV's beïnvloed om GRA's net in ʼn sekere mate uit te voer, naamlik bevoegdheid, onduidelikheid betreffende die rol van die BGV, werkslading en houding. <![CDATA[<b>The exploration of in-service training needs of psychiatric nurses</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100020&lng=pt&nrm=iso&tlng=pt BACKGROUND: New research findings, changes in legislation and the use of information technology in nursing, require continuous in-service training of psychiatric nurses to cope with, reflect on and modify their clinical practice based on emerging knowledge. Many international studies have been conducted on the importance of in-service training and authors agree that in-service training improves the quality of nursing care. However, few studies have been conducted on in-service training in South Africa and psychiatric nursing. OBJECTIVES: The objectives of the study were to explore and describe the needs and benefits of in-service training for psychiatric nurses; and to formulate recommendations for in-service training. METHOD: The research project followed a qualitative, explorative, descriptive and contextual approach. Six focus group interviews were conducted and the following questions were asked: 'What are your in-service training needs as psychiatric nurses?', 'What are the benefits of doing in service training?' and 'What can be done to ensure that in-service training is done continuously?' Data were analysed through the use of content analysis and Tesch's eight steps of data analysis were used. RESULTS: The findings of this research included three main themes, namely, that on-going in-service training is necessary, in-service training is beneficial to psychiatric nurses and that challenges exist with regard to in-service training. CONCLUSION: The findings confirmed the need for ongoing in-service training which has many advantages for psychiatric nurses. Aspects that hinder in-service training need to be addressed by planning ahead and by implementing the recommendations as identified by the psychiatric nurses and their managers.<hr/>AGTERGROUND: Nuwe navorsingsbevindinge, veranderinge in wetgewing en die gebruik van inligtingstegnologie in verpleegkunde, vereis deurlopende indiensopleiding van psigiatriese verpleegkundiges om hulle kliniese praktyk soos gebaseer op opkomende kennis, te hanteer, daarop te reflekteer en dit aan te pas. Internasionaal is daar baie studies gedoen oor die belang van indiensopleiding en outeurs stem saam dat indiensopleiding die kwaliteit van verpleegsorg verbeter. Daar is egter nog net 'n paar studies oor indiensopleiding in Suid-Afrika en psigiatriese verpleegkunde gedoen. DOELWITTE: Die doelwitte van die studie was om die behoeftes en voordele van indiensopleiding vir psigiatriese verpleegkundiges te verken en te beskryf en om aanbevelings te formuleer vir indiensopleiding. METODE: Die navorsingsprojek het 'n kwalitatiewe, verkennende, beskrywende en kontekstuele benadering gevolg. Ses fokusgroeponderhoude was gedoen en die volgende vrae was gevra: 'Wat is jou indiensopleiding behoeftes as 'n psigiatriese verpleegkundige?', 'Wat is die voordele daarvan om indiensopleiding te doen?' en 'Wat kan gedoen word om te verseker dat indiensopleiding deurlopend gedoen word?'. Data was ontleed deur die gebruik van Tesch se agt stappe van data analise. RESULTATE: Die bevindinge van die navorsing sluit drie hooftemas in, naamlik, dat deurlopende indiensopleiding is nodig, indiensopleiding is voordelig vir psigiatriese verpleegkundiges en daar is verskeie uitdagings in indiensopleiding. GEVOLGTREKKING: Die bevindinge bevestig die behoefte aan indiensopleiding wat baie voordele het vir psigiatriese verpleegkundiges. Aspekte wat indiensopleiding verhinder moet aangespreek word deur vooruit te beplan en deur aanbevelings, soos geïdentifiseer deur psigiatriese verpleegkundiges en hulle bestuurders, te implementeer. <![CDATA[<b>Refugees' perceptions regarding HIV and AIDS in Ba-Phalaborwa Municipality in Limpopo Province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100021&lng=pt&nrm=iso&tlng=pt BACKGROUND: Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS) remain a serious threat to population health and economic well-being of individuals in conflict societies. Sub-Saharan Africa (SSA) is overwhelmingly affected by HIV and is the region with the highest number of armed conflicts worldwide. AIM: The research aimed at exploring and describing the perceptions of the refugees at Humulani Village in Ba-Phalaborwa municipality, Limpopo province, about HIV and AIDS. OBJECTIVES: The objectives included determining the gender perceptions about HIV and AIDS and also providing recommendations for ways to increase the refugees understanding of this disease. METHODS: The approach used for the research was quantitative. The target population of the study was all the refugees at Humulani Village. The sample comprised both men (n = 78) and women (n = 122) who participated by completing questionnaires. The sample of the refugees consisted of different ethnic groups from Mozambique, Nigeria, Ghana and Zimbabwe. The questionnaire consisted of two sections, section A contained the biographic data and section B interrogated the refugees' knowledge of HIV. RESULTS: The findings of the study revealed that the participants had low levels of knowledge regarding HIV which could be attributed to their believing the myths about HIV and AIDS. CONCLUSION: The HIV-infected refugee population in Limpopo may continue to grow unless the unique needs of the refugees, such as strengthening the reproductive health services, maternal and child care and family planning, improving the educational and socio-economic status, are not addressed.<hr/>AGTERGROND: Menslike immuniteitsgebrekvirus (MIV) en verworwe immuniteitsgebrek-sindroom (vigs) bly 'n ernstige bedreiging vir die gesondheid van die bevolking, asook die ekonomiese welstand van individue in konflik-samelewings. Sub-Sahara Afrika (SSA) word oorweldigend deur MIV geraak en is die streek met die hoogste aantal gewapende konflikte wêreldwyd. DOELWITTE: Die navorsing het ten doel gehad om vlugtelinge te Humulani dorpie in Ba-Phalaborwa munisipaliteit, Limpopo provinsie, se persepsies oor MIV en vigs te ondersoek en beskryf. Die doelwitte het die bepaling van geslagspersepsies oor MIV en vigs ingesluit, asook om aanbevelings te bied vir maniere om die vlugtelinge 'n beter begrip van MIV en vigs te gee. METODE: 'n Kwantitatiewe benadering tot hierdie navorsing is gevolg. Die teikenpopulasie van die studie was al die vlugtelinge te Humulani dorpie. Die steekproef het uit beide manlike (n = 78) en vroulike (n = 122) deelnemers bestaan wat vraelyste voltooi het. Die steekproef vlugtelinge was van verskillende etniese groepe afkomstig: Mosambiek, Nigerië, Ghana en Zimbabwe. Die vraelys het twee afdelings gehad: Afdeling A het die biografiese data bevat en Afdeling B het die vlugtelinge se kennis van MIV ondersoek. RESULTATE: Die bevindinge van die studie het onthul dat die deelnemers oor lae kennisvlakke rakende MIV beskik - dit kan toegeskryf word aan hul geloof in die mites aangaande MIV en vigs. GEVOLGTREKKING: Die populasie van MIV-besmette vlugtelinge in Limpopo mag steeds groei indien daar nie aandag geskenk word aan die unieke behoeftes van die vlugtelinge nie, soos die versterking van voortplantingsgesondheidsdienste, gesinsbeplanning, en moeder- en kindersorg, asook die verbetering van hul opvoedkundige en sosio-ekonomiese welstand. <![CDATA[<b>Women's perceived susceptibility to and utilisation of cervical cancer screening services in Malawi</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100022&lng=pt&nrm=iso&tlng=pt BACKGROUND: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. OBJECTIVES: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services. METHOD: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi. RESULTS: A statistically-significant association existed between women's intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages. CONCLUSION: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi's women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.<hr/>AGTERGROND: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand. DOELWITTE: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. 'n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies. METODE: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het. RESULTATE: 'n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003) en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df= 1; p = 0.041) op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar 'n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is. GEVOLGTREKKINGS: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien 'n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging aangaande servickale kanker verskaf word. Gevolglik behoort die vrouens ingelig te word oor servikale siftingstoetse wanneer hulle enige gesondheidsdienste benut. <![CDATA[<b>Learners' experiences of teachers' aggression in a secondary school in Gauteng, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100023&lng=pt&nrm=iso&tlng=pt BACKGROUND: Research shows that one third of all persons in South Africa have been exposed to one or more types of aggression. It has been observed that learners frequently experience aggression from teachers in the secondary school environment, which has a negative effect on their experience of general wellbeing and mental health. OBJECTIVES: The objectives set for this research were to explore and describe learners' experiences regarding teachers' aggression toward them and to formulate guidelines for learners and teachers to facilitate their mental health. METHOD: The population consisted of school learners at a secondary school. Inclusion criteria for sampling were that participants should be grade 11 and 12 learners, between 16 and 18 years of age and should have experienced aggression from teachers in the school. A purposive sample was taken of learners who complied with the inclusion criteria. Data were collected by means of four in-depth phenomenological interviews, 88 naïve sketches, observation and field notes. One central question was posed to the secondary school learners: 'What are your experiences of teacher aggression toward you in your schooling environment?' Open coding was used for data analysis. Measures to ensure trustworthiness were applied to ensure the rigour of the research. Ethical principles were adhered to throughout the research process. RESULTS: The secondary school learners were belittled, as well as emotionally and verbally abused. They also experienced fear and anger. Guidelines were derived from these findings for learners and teachers. CONCLUSION: This research found that learners experience aggression in their school environment and need support to facilitate their mental health.<hr/>AGTERGROND: Navorsing toon dat een derde van alle mense in Suid-Afrika al aan een of ander vorm van geweld blootgestel is. Daar is waargeneem dat leerders dikwels aggressie by onderwysers in die sekondêre skool beleef, wat 'n negatiewe uitwerking op hul algemene welsyn en geestelike gesondheid het. DOELSTELLINGS: Die doelstellings vir hierdie navorsing was om leerders se belewing van onderwysers se aggressie te verken en om riglyne te formuleer vir leerders en onderwysers om hulle geestesgesondheid te fasiliteer. METODE: Die populasie het uit leerders by 'n sekondêre skool bestaan. Die kriteria vir insluiting by die steekproef was dat deelnemers in graad 11 of 12 moet wees, tussen 16 en 18 jaar oud, en moes aggressie by onderwysers aan die skool beleef het. 'n Doelgerigte steekproef van leerders wie aan die insluitingskriteria voldoen, is geneem. Data is ingesamel deur middel van vier diepgaande fenomenologiese onderhoude, 88 naïewe sketse, waarneming en veldnotas. Een sentrale vraag is aan die sekondêre skool leerders gestel: 'Wat is jou belewing van onderwysers se aggressie teenoor jou in jou skoolomgewing?'. Oop kodering is gebruik om die ingesamelde data te analiseer. Maatreëls om vertrouenswaardigheid te verseker is toegepas om die wetenskaplikheid van die navorsing te verseker. Etiese beginsels is dwarsdeur die navorsingsproses toegepas. RESULTATE: Die sekondêre skool leerders beleef dat hulle verneder word, asook emosioneel en verbaal mishandel word. Hulle beleef ook vrees en woede. Riglyne vir leerders en onderwysers is uit hierdie bevindinge afgelei. GEVOLGTREKKINGS: Hierdie navorsing het bevind dat leerders aggressie in hul skoolomgewing beleef en ondersteuning benodig om hul geestesgesondheid te fasiliteer. <![CDATA[<b>British doctors' experiences of working in rural South Africa: The London GP Out of Programme Experience</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100024&lng=pt&nrm=iso&tlng=pt BACKGROUND: A paucity of research exists that has examined temporary placements of foreign health professionals in South Africa (SA) as a possible strategy for addressing health worker shortages. The Out of Programme Experience (OOPE) initiative, run by the London GP Deanery, aims to provide a sustainable inflow of British, trainee GP doctors into rural public health facilities in SA. OBJECTIVES: The present study explored the experiences of these British doctors working in rural hospitals in SA as part of their OOPE. The reasons and motivations underlying their decision to come to SA were also examined. METHODS: In-depth interviews were conducted with fifteen British doctors who were currently working, or had worked in the past, as part of OOPE in rural health facilities in SA. Interviewswere transcribed and analysed using thematic analysis. RESULTS: The first theme that surfaced from the interviews was that the most common reasons underlying these doctors' motivations for coming to SA related to: the type of diseases and advanced pathologies that they would encounter; the challenge and opportunity for professional growth; and the difference in work environment that would confer on them I greater responsibility and autonomy, compared to working in similar positions in the British National Health Service. The second theme, central to the participants' narratives, was the accelerated period of learning that they experienced whilst in SA. Exposure to new and unfamiliar medical cases, a greater level of autonomy and decision-making authority, and resource shortages forced greater reliance on their clinical skills and judgment, whichcontributed to their professional development. CONCLUSION: The doctors' believed the OOPE enhanced their clinical skills and competencies. The findings provide some evidence that attests to the OOPE's potential to benefit both host facilities and the participating foreign doctors. The findings of the study have practicalimplications for the further development of programmes to fill vacant posts for health workers in rural South African hospitals.<hr/>AGTERGROND: Daar bly 'n gebrek aan navorsing met betrekking tot tydelike posisies vir buitelandse professionele gesondheidswerkers in Suid-Afrika (SA) as 'n moontlike strategiese oplossing vir die tekort aan gesondheidswerkers in die land. Die 'Out of Programme Experience' (OOPE) inisiatief, wat deur die 'London GP Deanery' georganiseer word, se doel is om 'n volhoubare invloei van Britse dokters-in-opleiding aan plattelandse openbare gesondheidsfasiliteite te voorsien. DOELWITTE: Hierdie studie het die ervarings van hierdie Britse dokters, wat as deel van die OOPE-program in plattelandse Suid-Afrikaanse hospitale gewerk het, verken. Die onderliggende redes en motivering vir hul besluite om na Suid-Afrika toe te kom, is ook ondersoek. METODES: In-diepte onderhoude is met 15 Britse dokters gevoer wat huidiglik, of in die verlede, in plattelandse gesondheidsfasiliteite in SA gewerk het as deel van die OOPE-program. Die onderhoude is getranskribeer en tematiese analise is gebruik om dit te analiseer. RESULTATE: Die eerste tema wat uit die onderhoude geïdentifiseer is, is dat die mees algemene redes hoekom hierdie dokters na SA gekom het verband hou met die tipe siektes en gevorderde patologie wat hulle in SA sou teëkom. Die tweede tema wat geïdentifieer is, is die versnelde leerkurwe wat hulle ervaar het in SA. GEVOLGTREKKINGS: Die dokters het geglo dat die OOPE-program hul kliniese vaardighede verbeter het. Hierdie studie getuig van die OOPE se potensiaal om beide die plaaslike gesondheidsfasiliteite sowel as die deelnemende buitelandse dokters te bevoordeel. Die gevolgtrekkings van die studie het praktiese implikasies vir die verdere ontwikkeling van programme om vakante poste vir gesondheidspersoneel in plattelandse hospitale in SA te vul. <![CDATA[<b>A qualitative study of the factors influencing the global migration of anatomical pathologists in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100025&lng=pt&nrm=iso&tlng=pt BACKGROUND: The aim of the present study was to identify the factors that influence the globalmigration of South African anatomical pathologists working in the province of KwaZulu- Natal. OBJECTIVE: The present study answered the question 'what factors influence Kwazulu-Natal-based histopathologists to emigrate out of South Africa?', thus providing insight into an under-researched medical specialisation. METHODS: A qualitative approach and purposive sampling were used. Data included 11in-depth interviews with histopathologists working in KwaZulu-Natal (KZN), and one interview with a former KZN-based histopathologist now working in the United States. The interviews were recorded and transcribed. The data were coded for patterns, and these patterns generated themes. The processes of coding and thematic generation were iterative. RESULTS: Six themes were discovered from the data. Of these, five themes suggested reasonsfor the potential emigration of histopathologists. : lack of recognition by clinical doctors, lack of career-pathing opportunities, the deterrent of compulsory service in the public sector upon qualifying, socio-economic and political instability in South Africa, and endemic levels of crime. A sixth theme revealed that remuneration was not a deciding factor as to whether histopathologists choose to emigrate. CONCLUSIONS: Remuneration was not revealed to be a reason for emigration, as these specialists' salaries are commensurate with global salaries. The findings, whilst not generalisable, suggest that more work needs to be done on the human relations aspects of retention for these medical specialists. This has implications for human resources for health policy.<hr/>AGTERGROND: Die doel van hierdie artikel is om die faktore te identifiseer wat die globale migrasie van Suid-Afrikaanse anatomiese patoloë wat in die provinsie van KwaZulu-Natal werk, beïnvloed. DOELWIT: Hierdie artikel beantwoord die vraag: 'Watter faktore beïnvloed histopatoloë wat in KwaZulu-Natal gebaseer is om uit Suid-Afrika te migreer?', en verskaf sodoende insig in 'n ondernagevorste mediese spesialisasie. METODES: 'n Kwalitatiewe benadering en doelgerigte steekproefneming is gebruik. Die data het 11 diepgaande onderhoude met histopatoloë wat in KwaZulu-Natal (KZN) werk en een onderhoud met 'n voormalige KZN-gebaseerde histopatoloog wat nou in die Verenigde State werk, ingesluit. Die onderhoude is opgeneem en getranskribeer. Die data is vir patrone gekodeer en hierdie patrone het temas gegenereer. Die koderingsproses en tematiese generering was herhalend. RESULTATE: Ses temas is in hierdie data ontdek. Hiervan het vyf temas redes vir die moontlike migrasie van histopatoloë voorgestel. Dit sluit in gebrek aan erkenning deur kliniese dokters, gebrek aan loopbaangeleenthede, die afskrikmiddel van verpligte diens in die openbare sektor na kwalifisering, sosio-ekonomiese en politieke onstabiliteit in Suid-Afrika, en endemiese misdaadvlakke. 'n Sesde tema het aan die lig gebring dat vergoeding nie 'n beslissende faktor is in histopatoloë se keuse om te migreer nie. GEVOLGTREKKINGS: Vergoeding blyk nie 'n rede vir migrasie te wees nie, aangesien die salarisse van hierdie spesialiste in ooreenstemming met globale salarisse is. Hoewel dit nie veralgemeenbaar is nie, stel die bevindings voor dat meer werk aan die menseverhouding-aspekte gedoen moet word om hierdie mediese spesialiste te behou. Dit het implikasies vir menslike hulpbronne in gesondheidsbeleid. <![CDATA[<b>Perceptions of menopause and aging in rural villages of Limpopo Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100026&lng=pt&nrm=iso&tlng=pt BACKGROUND: The term 'menopause' is derived from the Greek words men (month) and pausis (a cessation, a pause). It is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman's life when she has experienced her last menstrual bleed. Menopause is not a disease per se but a condition associated with hormonal changes where oestrogen diminishes to a low level, causing agingrelated health problems. OBJECTIVES:The purpose of this study was to explore perceptions of menopause and aging amongst women in rural villages of Vhembe District in Limpopo Province, South Africa. METHOD:The study was qualitative and explorative, using phenomenological approach. Purposive sampling was used to select the four villages and to select the focus groups. Sample size was determined by data saturation. RESULTS: The study findings were that participants in the villages associated cessation of I menstruation to aging rather than menopause. Once menstruation stopped, one was regarded I as old. CONCLUSION: The conclusions of the study were that (1) menopausal issues should be emphasised and receive priority from puberty at the girls initiation schools, high schools, churches, other community resources and health care services so that when women reach menopause, (2) they should accept and be able to effectively cope with menopause and aging. (3) Emphasis should also be placed on menopause as the aspect of human aging.<hr/>AGTERGROND:Die term 'menopouse' is afgelei van die Griekse woorde menos (maand) en pausis (onderbreking/pouse, einde) en is 'n direkte beskrywing van die psigologiese en fisiese gebeure in vroue waar menstruasie ophou voorkom. Dit is die tyd in 'n vrou se lewe wanneer die laaste menstruele bloeding ervaar word. Menopouse is nie 'n siekte per se nie, maar 'n toestand wat geassosieer word met hormonale veranderings waar estrogen afneem tot 'n vlak wat gesondheidsverwante probleme veroorsaak. DOELSTELLING: Die doel van die studie was om persepsies ten opsigte van menopause en veroudering onder landelike vroue in die Vhembe-distrik in Limpopo Provinsie, Suid-Afrika, te verken. METODE: Die studie was kwalitatief en verkennend, met ’n fenomenologiese benadering. Doelgerigte steekproefneming is gebruik om die vier dorpies en deelnemers van die fokusgroepe te selekteer. Die steekproefgrootte is bepaal deur dataversadiging. Resultate: Die bevindings was dat die deelnemers die einde van menstruasie aan ouderdom, en nie aan menopause nie, toeskryf. Wanneer menstruasie stop, word ’n vrou dus as oud beskou. GEVOLGTREKKINGS:Aanbevelings was dat (1) menopausale onderwerpe reeds beklemtoon behoort te word vanaf puberteit in inisiasieskole, hoërskole, kerke en gemeenskappe en gesondheidsdienste sodat, wanneer menopouse bereik word, (2) vroue dit kan aanvaar en positief ervaar. (3) Klem behoort ook op menopause as 'n menslike aspek van veroudering gelê te word. <![CDATA[<b>The effectiveness of a pregnancy leaflet to promote health in Tshwane, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100027&lng=pt&nrm=iso&tlng=pt BACKGROUND: Pregnancy-related health education conveys basic information regardinghealthy lifestyle choices and preventive healthcare in order to promote the health of the mother and foetus. Verbal education is supplemented frequently by means of health- promotion leaflets. A pregnancy-related leaflet used in primary care clinics in Tshwane, South Africa titled: 'Are you pregnant or planning to have a baby?' was the focus of this research. OBJECTIVES: The study had two objectives, the first of which was to explore whether the English pregnancy leaflet improved the knowledge of young female adults with regard to maintaining their health and preventing complications during pregnancy. The second objective was to explore whether the literacy level of the young adult female had an effect on the efficacy of the English pregnancy leaflet. METHOD: The research design used was a pre-test post-test design. Two samples of 30 participants each, namely, a post-secondary and a tertiary sample, participated in the study. Self-report data were gathered with a questionnaire based on the leaflet. The quantitative data were analysed using descriptive statistics and a Pearson's chi-square test. FINDINGS: The findings indicated both samples' prior knowledge regarding health maintenance, showing that prevention of complications during pregnancy was almost nonexistent and that the pregnancy leaflet did not improve their knowledge to an extent where I they would be informed and knowledgeable about their health during pregnancy. CONCLUSION: An evidence base must be developed in order to support the development of behaviour changing material.<hr/>AGTERGROND: Swangerskapsverwante gesondheidsopvoeding dra basiese inligting oor aangaande gesonde leefstylkeuses en voorkomende sorg om die gesondheid van moeder en fetus tydens swangerskap te bevorder. Verbale gesondheidsonderrig word dikwels versterk deur gedrukte inligtingstukke. 'n Swangerskapsverwante inligtingstuk tans in gebruik in primêre gesondheidsorgklinieke in Tshwane met die titel: 'Are you pregnant or planning to have a baby?' was die fokus van die studie. DOELWITTE: Die studie het twee doelwitte gehad, naamlik (1) om uit te vind of die Engelse inligtingstuk die kennis van jong volwasse vroue to so 'n mate kon verbeter dat hulle in staat was om gesond te bly tydens hul swangerskap en komplikasies te voorkom, asook (2) om te bepaal of die geletterdheidsvlak van die jong volwasse vroue 'n invloed gehad het op die vermoë van die inligtingstuk om hul kennisvlakke te verhoog. METODE: Die navorsingsontwerp was 'n voor-toets/na-toets ontwerp. Twee groepe van 30 deelnemers elk, 'n na-sekondêre onderrig en 'n tersiêre groep, het aan die studie deelgeneem. Data is deur self-rapportering ingesamel waar die deelnemers 'n vraelys gebaseer op die pamflet voltooi het, voor en na blootstelling aan die inligtingstuk. Die data is met behulp van beskrywende statistiek en 'n Pearson's chi-kwadraat ontleed. RESULTATE: Die bevindings dui daarop dat beide groepe baie min voorkennis aangaande gesondheid tydens swangerskap gehad het en dat die swangerskapsverwante inligtingstuk nie hul kennis tot so 'n mate verbeter dat hulle ingelig en in staat sou wees om gesond te bly tydens hul swangerskap nie. GEVOLGTREKKING: Dit is belangrik dat navorsingsbewyse gebruik word in die ontwikkeling van gedragsveranderingsmateriaal. <![CDATA[<b>Interventions to promote psychiatric patients' compliance to mental health treatment: A systematic review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100028&lng=pt&nrm=iso&tlng=pt BACKGROUND: Non-compliance to treatment remains one of the greatest challenges in mental healthcare services, and how to improve this remains a problem. AIM: The aim of this study was to critically synthesise the best available evidence from literature regarding interventions to promote psychiatric patients' compliance to mental health treatment. The interventions can be made available for mental health professionals to use in clinical practice. METHOD: A systematic review was chosen as a design to identify primary studies that answeredthe following research question: What is the current evidence on interventions to promote psychiatric patients' compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were critically appraised and identified as answeringthe research questions. Evidence extraction, analysis and synthesis were then conducted by means of evidence class rating and grading of strength prescribed in the American Dietetic Association's manual. RESULTS: The systematic review identified several interventions that can improve patients' compliance in mental health treatment, for example adherence therapy and motivational interviewing techniques during in-hospital stay. CONCLUSIONS: Conclusions were drawn and recommendations formulated for nursingpractice, education and research.<hr/>AGTERGROND: Geen-samewerking met behandeling bly steeds een van die grootste uitdagings in geestesgesondheidsorgdienste, en genoegsame kennis oor hoe om dit te verbeter, is steeds 'n probleem. DOELWIT: Die doel van hierdie studie was om die beskikbare bewyse vanuit literatuur aangaande intervensies ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling krities te sintetiseer. Hierdie intervensies kan aan professionele gesondheidsorgpersoneel beskikbaar gestel word ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling. METODE: 'n Sistematiese literatuuroorsig is gekies as die ontwerp om primêre studies te identifiseer wat die volgende navorsingsvraag beantwoord: Wat is die huidige kennis ten opsigte van intervensies wat psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling bevorder?. RESULTATE: Studies is ingesluit vir kritiese gehalte-beoordeling ten opsigte van metodologie, en is uiteindelik geïdentifiseer as bronne van bewyse wat die literatuuroorsigvraag toepaslik beantwoord. Bewysonttrekking, -analise en -sintese is gedoen deur middel van die beoordeling van bewysklas en -gradering van bewyssterkte, soos voorgeskryf in die American Dietetic Association se handleiding. Die sistemiese literatuuroorsig het aangedui dat daar heelparty intervensies is wat psigiatriese pasiënte se samewerking met behandeling kan verbeter, byvoorbeeld samewerkingsterapie en motiveringsonderhoudstegnieke. GEVOLGTREKKING: Gevolgtrekkings is gemaak en aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing in verpleging. <![CDATA[<b>Mammographer personality traits - elements of the optimal mammogram experience</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100029&lng=pt&nrm=iso&tlng=pt BACKGROUND: Mammography is not supported optimally by patients as a screening and diagnostic tool for breast cancer, often as result of negative perceptions amongst patients which originate from a range of factors OBJECTIVES: The objective of the wider study was to probe some of the factors impacting on patient perceptions. This article reports findings regarding patients' preferences and perceptions concerning mammographer personality traits METHOD: Descriptive, exploratory research employed a non-probability, convenience sampling method to collect data by means of a questionnaire from 274 mammogram patients in four clinical training centres in Gauteng. Respondents had to rate 24 personality traits in mammographers in terms of importance. Validity, credibility, reliability and ethical considerations were addressed RESULTS: A questionnaire return rate of 91% was achieved. Descriptive statistics and factor analysis facilitated interpretation of the data and four factors emerged from the personality trait scale CONCLUSION: Patients seem to rate mammographers in terms of the trust they instil, the care that they emanate, how safe they make patients feel and how well they communicate. As mammographer-patient interaction plays an integral role in the way patients perceive mammogram experiences, these factors are conceptualised as also being fundamental elements of an optimal mammogram experience<hr/>AGTERGROND: Mammografie word nie optimaal deur pasiënte as diagnostiese en siftingsmetode vir borskanker ondersteun nie, deels as gevolg van pasiënte se negatiewe perspepsies daarvan, wat aan 'n veskeidenheid faktore toegeskryf kan word DOELSTELLINGS: Die doel van hierdie studie was om van die faktore wat pasiënte se persepsies beïnvloed, te ondersoek. Pasiënte se persepsies en voorkeure ten opsigte van mammograwe se persoonlikheidseienskappe word in hierdie artikel bespreek METODE: In dié beskrywende, verkennende studie is 'n nie-waarskynlikheid-gerieflikheidsteekproef-metode gebruik om data van 274 mammogram-pasiënte in vier kliniese opleidingsentrums in Gauteng met behulp van 'n vraelys in te win. Die respondente moes die belangrikheid van 24 persoonlikheidseienskappe van mammograwe beoordeel. Geldigheid, betroubaarheid, geloofwaardigheid en etiese oorwegings is in ag geneem RESULTATE: Van al die vraelyste is 91% ingehandig. Die data is met behulp van beskrywende statistiek en faktoranalise geïnterpreteer, en vier faktore is uit die persoonlikheidskaal geïdentifiseer GEVOLGTREKKING: Dit blyk dat pasiënte mammograwe beoordeel volgens die vertroue wat hulle inboesem, die sorg wat hulle verleen, hoe veilig hulle pasiënte laat voel, asook hoe goed hulle kommunikeer. Aangesien die mammograaf-pasiënt-verhouding pasiënte se indrukke van mammogramme sterk beïnvloed, kan hierdie vier faktore as fundamentele elemente van 'n optimale mammogram-ondersoek beskou word <![CDATA[<b>A critical synthesis of interventions to reduce stigma attached to mental illness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100030&lng=pt&nrm=iso&tlng=pt BACKGROUND: Interventions have been developed and implemented to reduce the stigma attached to mental illness. However, mental healthcare users are still stigmatised OBJECTIVE: The objective of this study was to critically synthesise the best available evidence regarding interventions to reduce stigma attached to mental illness METHOD: An exploratory and descriptive research design was followed to identify primary studies; systematic review identified primary studies answering this research question: What best evidence is available regarding interventions to reduce the stigma attached to mental illness? A search was done on selected electronic databases. Seventeen studies (n = 17) were identified as providing evidence that answered the research question. The following instruments were used: Critical Appraisal Skills Programme, John Hopkins Nursing Evidence-Based Practice research evidence appraisal tool and the Academy of Nutrition and Dietetics Evidence Analysis Manual. The study was submitted to the Post-graduate Education and Research Committee of the School of Nursing Science at Potchefstroom Campus of North-West University for approval RESULTS: Results indicated some interventions that reduce the stigma attached to mental illness, such as web-based approaches, printed educational materials, documentary and anti-stigma films, as well as live and video performances CONCLUSIONS: Humanising interventions seems to have a positive effect on reducing stigma attached to mental illness. From the results and conclusions recommendations were formulated for nursing practice, nursing education and research<hr/>AGTERGROND: Ingrypings is ontwikkel en geïmplementeer om die stigma verbonde aan geestesongesteldhede te verminder. Die persone wat aan geestesongesteldhede ly, ondervind egter steeds dat daar 'n stigma aan hulle kleef DOELSTELLINGS: Die doel van die studie was om die beste beskikbare voorbeelde van intervensies om stigmatisering van geestesongesteldhede te verminder, krities saam te vat METODE: 'n Verkennende en beskrywende navorsingsontwerp is gevolg om primêre studies te identifiseer. 'n Sistematiese oorsig is gekies as metode om primêre studies te identifiseer om die volgende navorsingsvraag te beantwoord: Wat is die beste beskikbare voorbeelde van ingrypings om die stigma verbonde aan geestesongesteldhede te verminder? 'n Ondersoek is gedoen op 'n uitgesoekte elektroniese databasis RESULTATE: Tydens die keuring van studies is 17 studies geïdentifiseer (n = 17) as bewyslewering en wat die navorsingsvraag beantwoord. Die volgende instrumente is gebruik: 'Critical Appraisal Skills Programme', 'John Hopkins Nursing Evidence-Based Practice', 'Research Evidence Appraisal Tool and Evidence Analysis Manual', en 'Academy of Nutrition and Dietetics' GEVOLGTREKKING: Die studie is aan die Nagraadse Onderrig- en Navorsingskomitee van die Skool van Verpleegkunde van die Potchefstroomkampus, Noordwes-Universiteit, voorgelê vir goedkeuring. Aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing <![CDATA[<b>Nurses' knowledge of chronic disease management</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100031&lng=pt&nrm=iso&tlng=pt BACKGROUND: Chronic diseases of lifestyle are detrimentally affecting South Africans. National Health Insurance, which is intended to improve care, requires capacity building for nurses at primary care clinics to ensure appropriate service provision OBJECTIVE: This study's objective was to evaluate the impact of the 'Primary Care 101' chronic disease management guideline and training on nurses' knowledge of chronic diseases management METHOD: A population-based, unblinded, stratified cluster randomised controlled trial with intervention (n = 20) and control clinics (n = 10) in three South African districts was conducted over six months in 2012. Nurses in the clinics participated in surveying knowledge on management of tuberculosis, human immunodeficiency virus infection, mental health, epilepsy, diabetes, hypertension and asthma and chronic obstructive pulmonary disease (COPD). All nurses were surveyed at baseline and six months later. Intervention clinic nurses were also surveyed immediately after training and three months post-training. Data were analysed using SPSS version 19 (SPSS Inc., Chicago, IL).Total mean knowledge percentage scores were calculated for each chronic disease. Mean knowledge percentage score changes between baseline and six months amongst all nurses and between intervention and control clinic nurses were compared using the paired samples t-test and independent samples t-test respectively RESULTS: There were significant improvements in nurses' knowledge of hypertension and diabetes management over six months. Knowledge about asthma and COPD management decreased in all districts and nurse categories CONCLUSION: The improvements in nurses' knowledge can ensure improved patient management, but attention to asthma and COPD management is required<hr/>AGTERGROND: Chroniese lewenstylsiektes beïnvloed Suid-Afrikaners nadelig. Die nasionale gesondheidsversekering, wat ten doel het om sorg te verbeter, vereis kapasiteitsbou vir verpleegsters by primêre-sorg-klinieke om sodoende toepaslike dienslewering te verseker DOELWITTE: Hierdie studie se doel was te evalueer wat die impak van die 'Primary Care 101' chroniese siekte bestuursriglyn, asook opleiding is op verpleegsters se kennis van hoe om chroniese siektes te bestuur METODE: 'n Bevolkingsgebaseerde, onverblinde, ewekansige gekontroleerde trossteekproef met ingrypings- (n = 20) en kontrole-klinieke (n = 10) is oor 'n tydperk van ses maande in 2012 in drie Suid-Afrikaanse distrikte uitgevoer. Verpleegsters in hierdie klinieke het deelgeneem aan 'n opname oor hul kennis oor die bestuur van tuberkulose, menslike immuniteitsgebreksvirus-infeksie, geestesgesondheid, epilepsie, diabetes, hoë bloeddruk, asook asma en chroniese obstruktiewe longsiekte (COPD). Alle verpleegsters is by die basislyn ondervra en ses maande later. Intervensie kliniekverpleegsters is ook ondervra onmiddellik na die opleiding en drie maande post-opleiding. Data is ontleed met behulp van SPSS, weergawe 19 (SPSS Inc, Chicago, IL). Totale gemiddelde kennis persentasietellings is vir elke chroniese siekte bereken. Veranderinge in die gemiddelde kennis persentasietellings tussen die basislyn en ses maande later is onder alle verpleegsters, asook tussen ingrypings- en kontrole-kliniekverpleegsters vergelyk met behulp van die gepaarde steekproef t-toets en die onafhanklike steekproef t-toets onderskeidelik RESULTATE: Daar was 'n aansienlike verbetering in verpleegsters se kennis oor die bestuur van hoë bloeddruk en diabetes na ses maande. Kennis oor die bestuur van asma en COPD het in alle distrikte en verpleegster-kategorieë afgeneem GEVOLTREKKING: Die verbetering in die verpleegsters se kennis kan verbeterde pasiëntbestuur verseker, maar die bestuur van asma en COPD vereis verdere aandag <![CDATA[<b>Health workers' perspectives on implementation of an integrated medical male circumcision strategy in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362014000100032&lng=pt&nrm=iso&tlng=pt BACKGROUND: KwaZulu-Natal province began implementation of voluntary medical male circumcision (VMMC) as an integral part of its HIV infection prevention strategy that includes other programmes such as HIV counselling and testing (HCT), screening and treatment of sexually transmitted infections and tuberculosis, and other sexual and reproductive health services. This followed randomised controlled trials that showed up to 60% HIV infection risk reduction amongst circumcised men. Implementation of the strategy occurred despite absence of knowledge of operational barriers and its acceptability to health care workers (HCWs OBJECTIVES: The study aimed to explore HCWs' perspectives of and barriers to strategy implementation at public sector health facilities to inform implementation policy METHOD: A purposive quota sampling method was used to select HCWs for focus group discussions at three study sites. Participants were asked open-ended questions using an interview schedule based on a literature review to explore acceptability of and perceptions regarding provision of the strategy. Thematic analysis was conducted RESULTS: Acceptability of the strategy was high amongst the participants; however, there was limited knowledge of some key concepts of the strategy, personnel role confusion, missed opportunities for client recruitment, and infrastructural constraints. Negative perceptions included beliefs that VMMC would discourage condom use and cause stigma associated with non-circumcision of HIV-positive males, with perceptions of sexual behavioural disinhibition in circumcised men CONCLUSION: There is a need to engage further with stakeholders if implementation of VMMC is to be successful. More training and support needs to be provided to HCWs at public sector facilities<hr/>AGTERGROND: Die implementering van vrywillige mediese manlike besnyding (VMMC) is 'n integrale deel van KwaZulu-Natal provinsie se MIV-voorkomingstrategie, wat ander programme soos MIV-berading, siftingstoetse (HCT) en die behandeling van seksuele oordraagbare siektes (STI), asook ander seksuele en reproduksie-gesondheidsdienste (geïntegreerde VMMC) insluit. Dit volg op die resultate van ewekansige gekontroleerde steekproewe wat 'n doeltreffendheid getoon het van tot 60% vermindering in HIV-risiko onder mans wat besny is. Die implementering van die strategie het plaasgevind ten spyte van die afwesigheid van kennis van operasionele struikelblokke of aanvaarding deur gesondheidswerkers (HCWs DOELWITTE: Die studie is daarop gerig om HCW se perspektiewe en hindernisse vir die implementering van die VMMC program by die openbare sektor se gesondheidsfasiliteite te verken, ten einde die uitvoering van die beleid vas te stel METODE: Die doelgerigte kwotasteekproefmetode is gebruik om HCW deelnemers vir fokusgroepbesprekings (FGDs) op drie studieterreine te kies. Deelnemers is oop vrae gevra met behulp van 'n onderhoudskedule gebaseer op 'n literatuuroorsig van die aanvaarbaarheid en persepsies aangaande die voorsiening van die strategie. Tematiese analise is in ooreenstemming met die doelwitte van die studie gedoen RESULTATE: Die aanvaarbaarheid van VMMC was hoog onder die deelnemers, maar 'n paar probleemareas is geïdentifiseer: beperkte kennis van belangrike begrippe van die strategie, personeelrolverwarring, geleenthede vir kliëntwerwing en infrastruktuurbeperkings. Negatiewe persepsies het ingesluit: oortuigings dat VMMC die gebruik van kondome sou voorkom, die stigma wat verband hou met onbesnede HIV-positiewe mans en die persepsie van onderdrukte seksuele gedrag by mans wat besny is