bluuebunny/crossref_metadata_2025 huggingface dataset:
Health education as education of the oppressed
Authors: Van Wyk NC
Published: November 2012

Paolo Freire’s theory of critical thinking shows remarkable similarities to the principles supported by health education. In his capacity as Brazilian educationalist, Freire emphasized man’s active participation in his own development. Without this active involvement, growth and development become quite impossible to attain.
Improving eye care in the primary health care setting
Authors: De Wet M , Ackermann L
Published: November 2012

One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.
The composition of old age homes in South Africa in relation to the residents and nursing personnel
Authors: Perold A.
Published: November 2012

This research project is the first phase of a larger study aimed at describing and exploring the cost-effective utilisation of nursing personnel in old age homes in South Africa. The aim in the first phase was to describe the composition of the residents and nursing personnel of old age homes in South Africa. An exploratory and descriptive survey was conducted and the data was collected by means of a questionnaire. The questionnaire also included data on the financial implications of utilising professional nursing personnel to manage the care of the frail residents/older persons in old age homes in South Africa. The questionnaires were mailed to 612 old age homes published in the Hospital and Nursing Yearbook of 1997 (100% sample). A total of 145 (23.69%) questionnaires were returned and included in the descriptive data analysis. The residents are mainly female (77%), older than 85 years of age, belong to the white race group (83,74%) and are highly dependent on nursing care and supervision (69,7%). Old age homes are mainly managed/ controlled by welfare organisations and lay health care workers are utilised to a large extent (42,22% of the nursing workforce) to render nursing care to the frail residents. The cost-effective utilisation of nursing personnel (registered and enrolled), as well as the utilisation of lay health workers in old age homes, needs to be critically examined.
Problems experienced by role players within the managed healthcare context in Gauteng
Authors: Mahlo S , Muller M
Published: November 2012

Role players within the context of managed healthcare in Gauteng experience problems in the delivery of healthcare, which negatively affect their working relationships. This in turn, affects the quality of care provided to patients. The purpose of this study is to explore and describe the problem experienced by different role players within the context of managed healthcare in Gauteng, as well as the suggested solutions to counteract these problems. These results will be utilised as the basis of a conceptual framework to formulate a strategy to enhance the working relationships amongst these role players. The strategy will not be discussed in this article as the focus is on the problems experienced by the role players in the delivery of healthcare, as well as suggested solutions in the counteraction thereof. A qualitative, exploratory, descriptive and contextual study was followed to explore and describe the problems, as well as the suggested solutions to counteract these problems. Focus group interviews were conducted to collect data from three private hospitals, three managed care organisations and four general medical practitioners in Gauteng. The participants were purposively and conveniently selected. Content analysis as described by Tesch (1990) was followed to analyse the data. The main problems experienced were related to inadequate communication, inadequate staff competence, cost saving versus quality care, procedural complexity, perceived loss of power by doctors and patients and the system of accounts payment. The suggested solutions focused mainly on empowerment and standardisation of procedures. It is recommended that replication studies of this nature be conducted in other provinces and that ethical standards are formulated within the managed healthcare context.
Online teaching and learning in a graduate course In nursing education
Authors: Gwele NS
Published: November 2012

Information technology has a potential to be the answer to one of Africa’s most pressing problems- providing education to a number of geographically dispersed learners, who currently have to leave their countries for a number of years in order to pursue their studies elsewhere. The School of Nursing at the University of Natal launched an online graduate course in nursing education at the beginning of the year 2000 for the first time as part of a masters degree programme. A number of lessons have been learned from this experience. Firstly, it took too long to arrive at ‘closure’ on discussion of any one particular theme. There seemed to be a perpetual feeling of never “completing” teaching/learning tasks. Ordinarily, in a face-to-face (f2f) classroom, a particular theme or topic is scheduled for a particular lecture period. More often than not, whether clarity and/or resolution has been attained, the discussion moves on to the next theme, or topic. This has not been easy to do in computer mediated communication (CMC). The students’ contributions, however, seemed more thought out and more focused than had been the case in the f2f classes. Secondly, the essentiality/importance of structure became apparent very early. After an initial tentative and slow start, once the students felt comfortable with the computer “classroom” , the bulletin board was flooded with messages, necessitating re-thinking the original structure.
Critical thinking by nurses on ethical issues like the termination of pregnancies
Authors: Botes A.
Published: November 2012

This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decisionmaking. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these findings the researcher concluded that nurses are not thinking critically when making ethical decisions concerning the termination of pregnancies. Recommendations are made as a possible solution for this problem.
The experience of mothers caring for their teenage daughters' young children
Authors: Modungwa N , Poggenpoel M , Gmeiner A
Published: November 2012

The purpose of this study was firstly to explore and describe the experiences of mothers who are looking after their teenage daughters’ young children. Secondly, to formulate guidelines (based on the results obtained) for psychiatric nurses in assisting these mothers to mobilise resources in order to promote, maintain and restore their mental health as an integral part of health. An exploratory, descriptive, contextual and qualitative design was used and Guba’s model for ensuring trustworthiness in qualitative research was applied. The phenomenological approach was used to collect and analyse data from a sample of seven respondents who were purposively selected. Three independent themes emerged from the analysis of results: Meaning of the parenting role, life-style changes and support systems. The results further show that for these mothers the problem of teenage pregnancy and parenthood ends up being their problem. Their experiences in looking after these babies, although sometimes fulfilling and meaningful, are most of the time stressful. This has implications on their mental health. Guidelines are recommended in order to facilitate these mothers to mobilise their resources for mental health.
Adapting to and implementing a problem-and communitybased approach to nursing education
Authors: Fichardt AE , Viljoen MJ , Botma Y , Du Rand PP
Published: November 2012

The process of change, implemented by the School of Nursing at the University of the Orange Free State so that a paradigm shift in approaches to nursing education at undergraduate level could be achieved, is outlined. The necessity to change, the identification of external and internal variables that impact on change, the founding of a support system, the process of overcoming resistance to change, the evaluation of the process of change and options for the future, are discussed. The rationale for the implementation of a problem-based teaching strategy and the phasing in of a community-based approach to teaching as the heart of the process of change are discussed.
Risk for traumatization among violent crime victims in an urban community sample in South Africa
Authors: Peltzer K
Published: November 2012

This study intended to investigate risk factors for the development of trauma symptoms as a consequence of violent crime in an urban South African community. The sample included 128 adult victims of violent crime chosen by snowball sampling. The adults were 36 (28.1%) males and 92 females (71.9%) in the age range of 18 to 52 years (M age 36.6 yr., SD -8.9). Results indicate that the most common violent crimes experienced among the participants were rape (attempted rape), followed by physical assault, armed robbery, attempted murder and threat in that order. The majority of the victims scored high on the Kolner Risk Index (for traumatization) - several case examples are given. Analysis of Variance indicated that almost all factors of the Kolner Risk Index seem to be significantly correlated with PTSD outcome measures (PTSS- 10, IES-R, Peritraumatic Dissociation and Trauma Belief). It is concluded that the Kolner Risk Index can be a useful tool for identifying crime victims at risk for the development of trauma symptoms, especially in (mental) health care settings.
A “ Youth Multi-function Centre” in the Free State: An alternative to clinic-based HIV/AIDS prevention and care
Authors: Heunis C
Published: November 2012

The youth are especially vulnerable to the HIV/AIDS epidemic in South Africa. In the Free State (second highest incidence of HIV/AIDS among the provinces), the Welkom-Goldfields area may for various reasons be singled out as a high risk area for HIV/AIDS which should receive priority attention in attempts to combat the disease. It is suggested that a Youth Multi-function Centre would place youth reproductive health care in the broader development and life skills arena - where it could be thought to rightfully belong. The objectives of the paper are to depict the rationale for a Youth Multi-function Centre, to broadly conceptualise a Youth Multi-function Centre, and to report on the process and methodology followed in an attempt to actually establish such a centre in Thabong/Welkom.
A model of facilitative communication for support of general hospital nurses nursing mentally ill people
Authors: Mavundla TR , Poggenpoel M , Gmeiner A
Published: November 2012

Part 1 of this article dealt with a full description of the research design and methods. This article aims at describing a model of facilitative communication to support general hospital nurses nursing the mentally-ill. In this article a model of facilitative communication applicable to any general hospital setting is proposed. Fundamental assumptions and relationship statements are highlighted and the structure and process of facilitative communication is described according to the three steps employed: 1) assisting the general hospital nurse learn the skill; 2) assisting the general hospital nurse practise the skill in order to develop confidence; and 3) using the skill in a work setting. The guidelines for operationalising this model are dealt with in the next article. The evaluation of the model is also briefly described.
The effect of type 2 Diabetes Mellitus on health-related quality of life (HRQOL)
Authors: Westaway MS , Rheeder P
Published: November 2012

Improving the quality of life of all South Africans has become a major concern to health care practitioners, organisations and politicians. However, the paucity of local information on health-related quality of life (HRQOL) does not allow us to address this public health challenge. In order to rectify this deficiency and complement international research, we undertook a study with 281 Type 2 Black diabetic patients and 437 controls, with no self-reported chronic conditions, to ascertain HRQOL. We used the SF-20 to measure functioning, general health, wellbeing and bodily pain (HRQOL). It was hypothesised that diabetes mellitus significantly affects functioning, general health and well-being. Multiple analyses of covariance controlled for age, schooling, marital status, employment status and commodity ownership (a socio-economic measure). Patients were significantly more likely to report poorer role functioning, poorer general health and more pain than controls, providing partial support for the hypothesis. Reliability (internal consistency) coefficients on the four multi-item SF-20 sub-scales ranged between 0.79 (well-being), 0.81 (general health), 0.83 (physical functioning) and 0.94 (role functioning) for patients; for controls these coefficients ranged between 0.70 (well-being), 0.78 (general health), 0.80 (physical functioning) and 0.90 (role functioning). Inter-correlations among the sub-scales were significant for patients and controls (p = 0.01). It was concluded that the SF-20 is a reliable instrument for measuring HRQOL in both patient and control samples, and diabetes mellitus has more impact on general health and level of pain than on well-being. Key words: Functioning, general health, well-being, quality of life
Exploring the critical care nurses’ experiences regarding moonlighting
Authors: Bhengu BR
Published: November 2012

While moonlighting is so prevalent amongst critical care nurses, there are no documented facts in this country about how it affects the nurses and the hospital management, considering the nature of their work that is both physically, mentally and emotionally strenuous. The aim of this study was to explore the critical care nurses’ rationale and experiences regarding holding a second job (moonlighting). A non-experimental exploratory study was done using focus groups. Many positive and less positive experiences were revealed, for example, economical, educational, and psychosocial ones. Participatory control of moonlighting activity was suggested involving both management and staff at functional level.
“Why me and not my neighbour?” HIV/AIDS care and counselling in a traditional African context.
Authors: Van Dyk AC
Published: November 2012

HIV/AIDS in Africa places a tremendous burden on the nursing profession. Hospitals are inundated with very sick and dying AIDS patients and nurses often find that their role as healers has shifted to a great extent to that of caregivers, counsellors and educators. AIDS also calls for nurses to go beyond the strict Western-based bio-medical model to be able to help and understand patients who come from a traditional African background. This article discusses relevant aspects of the traditional African worldview by explaining what health, sickness and sexuality mean in traditional Africa. Traditional African perceptions of the causes of illness (God, ancestors, witches, pollution and germs), perceptions of sexuality, the importance of having children, cultural beliefs inhibiting the usage of condoms, the importance of community life, as well as the controversial issue of confidentiality in Africa are discussed. The implications for AIDS care and counselling in Africa are explored and suggestions on how to use traditional beliefs and customs to the advantage of AIDS education, are offered.
Caring for the caregivers - a nursing management perspective
Authors: Minnaar A
Published: November 2012

The aim of the study was to explore the practice of caring for the caregivers in selected hospitals in KwaZulu-Natal. A qualitative research approach was used to ensure that the complexities of caring were reflected in the study. The qualitative analysis of the interviews with nurse managers and nurses indicated that they saw caring as an important part of their management task. The participants in the study saw caring for nurses mainly as dealing with the interpersonal aspects of nurses. Caring for nurses was further described in terms of solving the personal problems of nurses, promoting the development and growth needs of nurses with the focus, mainly, on the educational needs of the organisation itself, the welfare needs of nurses with specific reference to their family needs and responsibilities, and a major emphasis on HIV/AIDS issues arising amongst nurses themselves. Die
Enabling legislation in diagnosis and prescribing of medicine by nurses/health practitioners
Authors: Geyer N
Published: November 2012

The South African health system has undergone major changes over the last 5 - 1 0 years. These rapid changes have not only significantly increased the visibility of the nurse practitioner in South Africa, but are also posing challenges to the profession and health care services that need to be addressed. In its Health Policies the Government has indicated that the nursing/midwifery profession, as the biggest group of health care professionals, should be the practitioners to provide primary health care services to the communities. But to do this, they require enabling legislation. The “permit system” has been in place for non-pharmacists and institutions other than hospitals and pharmacies to acquire, possess, use and supply medication for a number of years. This system has been fraught with problems mainly due to a lack of clarity on exactly how the system works and the system has been abused. The purpose of this article is to explore the current situation with the aim to analyze the legal framework that exists within which the primary health care services, and specifically the diagnosing and prescribing of medication, could be performed. The conclusion is made that health legislation has not kept up with the rapid changes in service delivery and are not adequate to empower the nurse to deliver health services. Some recommendations are made for the way forward.
Standards for perinatal education Part 2
Authors: Richter M.S.
Published: November 2012

In part one of the article, the method that was followed to develop standards for perinatal education was described. In part two of the article, each standard with its required criteria will be presented completely.
Attitudes and knowledge of nurse practitioners towards traditional healing, faith healing and complementary medicine in the Northern Province of South Africa
Authors: Peltzer K. , Khoza L.B.
Published: November 2012

Objective: To investigate the attitudes and knowledge of nurses towards traditional healing, faith healing and complementary therapies in the Northern Province in South Africa. Design: Survey of nurses. Setting: Registered professional nurses at health centres and clinics. Participants: 84 registered professional nurses Results: Nurse’s perceptions were basically positive toward ethnomedical therapy (traditional healing, faith healing and complementary medicine); this also included their integration into the primary health care system. Mean ratings for referral to a faith healer was 2.7, followed by complementary medicine (2.6) and traditional healing (2.2). Although low rates of referrals to ethnomedical therapists were practised, it was done so mainly in the patient’s interest and not as a last resort for chronic or terminal illness. Most did not discuss with a patient benefits of traditional healing but 71% discussed the possible harmful effects. However, the majority discussed the benefits rather than harmful effects of faith healing. With respect to mean ratings on knowledge, faith healing was considered the most important (4.3), followed by complementary medicine (4.2), and traditional healing (4.1). Conclusion: Faith healing was considered as more important than complementary medicine and traditional healing. Implications are relevant for nursing health care and policy.
Healthy dietary practices among rural and semi-urban Blacks in the Northern Province of South Africa
Authors: Peltzer K.
Published: November 2012

The aim of the study was to investigate five healthy dietary behaviours in a sample of rural and semi-urban South Africans. The sample consisted of 200 adults, 100 from an semi-urban area (Mankweng) and 100 from a rural area (Tiberius) in the central region of the Northern Province of South Africa. The two geographically different communities were chosen by convenience and the participants in the two communities were choosen by cluster sampling. Results indicate that about a third (30% in semi-urban and 34% in rural) of the study sample are overweight and 18% are obese. A moderately high prevalence of six simple healthy dietary practices was found. However, there was a very low prevalence rate of eating fruits daily among both semi-urban (10%) and rural dwellers (9%). Semi-urban dwellers showed significantly higher healthy diet behaviour than rural dwellers in regard to avoiding fat, trying to eat fiber, limiting red meat, and limiting salt. Men reported more than women that they tried to eat fiber and they had more often breakfast everyday. Being semi-urban and female were significantly associated with the healthy dietary index, whereas age, BMI, educational level and marital status were not. The results give insight into dietary health behaviour practices and the factors that influence them, which have practical implications for dietary health promotion.
Concept analysis: Some limitations and possible solutions
Authors: Botes A.
Published: November 2012

Concepts are the basic building blocks of scientific knowledge or theoretical frameworks for any discipline. The strength of the theories that guide a discipline is dependent on the quality of the concept analysis. Thus, the utilisation of poorly understood concepts in research and theory development will result in questionable reliability and validity. Concept analysis is associated with the research design of philosophical inquiry. The purpose of philosophical inquiry is to perform research using intellectual analysis to clarify meaning. Traditionally, no empirical (qualitative or quantitative) investigations were used to clarify the meaning of concepts. The lack of empirical investigation to clarify concepts, results in certain limitations in the methodology of concept analysis.
Reflective journal writing: How it promotes reflective thinking in clinical nursing education: A students’ perspective
Authors: Kok J. , Chabeli M.M.
Published: November 2012

According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on “creating” reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing.
Keeping record of the postoperative nursing care of patients
Authors: Roets L. , Aucamp M.C. , De Beer H. , Niemand M.
Published: November 2012

The aim of this research project was to evaluate the recordkeeping of postoperative nursing care. A total of 186 randomly selected patient records were evaluated in terms of a checklist that included the most important parameters for postoperative nursing care. All the patients underwent operations under general anaesthetic in one month in a Level 3 hospital and were transferred to general wards after the operations. The data collected was analysed by means of frequencies. One finding was that the neurological status of most patients was assessed but that little attention was paid in the patient records to emotional status and physical comfort. The respiratory and circulatory status of the patients and their fluid balance were inadequately recorded. The patients were well monitored for signs of external haemorrhage, but in most cases haemorrhage was checked only once, on return from the theatre. Although the patients’ pain experience were well-monitored, follow-up actions after the administration of pharmacological agents was poor. The surgical intervention was fully described and, generally speaking, the records were complete and legible, but the signatures and ranks of the nurses were illegible. Allergies were indicated in the most important records. The researchers recommend that a comprehensive and easily usable documentation form be used in postoperative nursing care. Such a form would serve as a checklist and could ensure to a large degree that attention is given to the most important postoperative parameters. Errors and negligence could also be reduced by this means.
Perception of the health of children living and working on the streets of Sunnyside - Part 1: Literature review and methodology
Authors: Prinsloo L
Published: November 2012

The phenomenon of street children is generating increasing concern in South Africa. The number of street children has grown because of the current economic hardship in South Africa, increasing levels of violence and widespread family and community disruption.
Perception of the health of children living and working on the streets of Sunnyside - Part 2: Methodology, interpretation and recommendations
Authors: Prinsloo L
Published: November 2012

In part one of the article, a thorough literature review was done on the phenomenon of street children. Part two of the article will cover the methodology, interpretation and recommendations.
Rheumatoid arthritis: hand function, activities of daily living, grip strength and essential assistive devices.
Authors: Shipham I
Published: November 2012

Persons with rheumatoid arthritis use assistive devices to enable them, in spite of impaired hand dexterity and grip strength, to manage Activities of Daily Living (ADL).
The experience of therapy by therapists and survivors after exposure to armed robbery
Authors: Marais SJ
Published: November 2012

In this article the results of research undertaken to explore the experience of therapy by respectively the survivor of armed robbery and the therapist of the survivor of armed robbery in the case where therapy is prematurely terminated by the survivor of armed robbery are discussed. A high percentage of therapy for the survivor of armed robbery is being terminated prematurely by the survivor. This might be the reason for failing to use all possible opportunities to recover within reasonable time. The research questions that arouse are: “How do survivors of armed robbery experience therapy after being exposed to armed robbery?” and “How do therapists experience therapy for the survivor of armed robbery?” A qualitative, exploratory, descriptive and contextual research design was utilised. Phenomenological, semi-structured interviews were conducted with survivors of armed robbery and therapists of survivors of armed robbery to explore and describe their experiences.
Socio-cultural deterrents to family planning practices among Swazi women
Authors: Ziyani IS
Published: November 2012

To investigate deterrents to family planning practices among Swazi women, 205 structured interviews were conducted with conveniently selected women in the four geographical regions of Swaziland. The Statistical Package for Social Sciences (SPSS) was used to analyse data. These results revealed that cultural practices, religious beliefs, gender issues and health care practices were the main barriers to the use of contraceptives among Swazi women. Recommendations were suggested regarding the education of men, women, adolescents and the entire society about contraceptive practices.
Role-player expectations regarding the education of nursing research
Authors: Zeelie SCD
Published: November 2012

This article reports on role player expectations regarding the education of nursing research. The importance of the role player expectations are two-fold: firstly as a factor in the external environment influencing and guiding the formulation phase of the development of standards and secondly, due to the clear indications of problems regarding nursing research in the nursing profession in literature. The role player expectations were elicited using a qualitative, exploratory and contextual design. The role player population included nurse educators, nurses in managerial, clinical and research positions, students and the medical profession. The data was gathered using the naïve sketches and qualitative data analysis was done using Morse & Field’s approach (1996:103-107) in combination with Tesch’s data analysis approach as cited by Creswell (1994:154-156). Sixty initial categories were narrowed down to six final categories, which are the research learning programme, personnel, students, departmental policies, funding and support systems.
The relationship between adolescent depressive symptomology and substance abuse
Authors: Blore L.G. , Schulze S. , Lessing A.C.
Published: November 2012

The research aimed to investigate the phenomena of adolescent depressive symptomology, substance abuse and the relationship between the two phenomena in a South African context. The influence of moderator variables was also examined. Another objective was to determine risk factors for the before mentioned. This was done by using a questionnaire with a sample of 1298 conveniently selected adolescents in a South African high school. It was determined that adolescents become progressively unhappier from 13 to 17 years of age. Girls are more depressed than boys. This research also revealed that adolescent depressive symptomology is significantly and positively correlated with earlier age of onset of substance abuse as well as frequency of usage. There appear to be no gender differences in substance abuse but teenagers from different ethnic and language groups differ in their use of substances. Risk factors for depression and substance abuse included a conflict relationship with parents, the experience of major stressful events, dissatisfaction with school grades and friends’ use of substances.
Integrated reproductive health services: the perspectives of providers
Authors: Maharaj P.
Published: November 2012

With the advent of the AIDS epidemic the focus of family planning programmes has shifted from an emphasis on pregnancy prevention to include disease prevention. The move towards integration has meant a major re-orientation in the role of health providers. This article seeks to expand knowledge about the implementation of integrated services from the perspective of providers. It focuses more specifically on the provider’s perceptions and experiences of integrated services. A range of methods is used to obtain information from providers, including an inventory of health facilities, in-depth interviews and focus group discussions. The results suggest that the majority of providers expressed favourable attitudes to integrated services. Integrated services are seen as a more client centred approach. However, there is a lack of clarity about the precise form that integration should take. As a result, providers seem more comfortable with the traditional focus on family planning and maternal and child health than sexually transmitted infections.
Knowledge, beliefs and attitudes of community health workers about hypertension in the Cape Peninsula, South Africa
Authors: Sengwana M.J. , Puoane T.
Published: November 2012

This article explores the perceptions and attitudes of community health workers (CHWs) about hypertension. The level of knowledge of hypertension, as well as their personal attitude towards this is crucial in the style and quality of their interventions. CHWs, whose role in health promotion is being increasingly recognised, can help contain or reduce the prevalence of hypertension by influencing the community to adopt healthy lifestyles. Forty-three CHWs employed by Zanempilo in two study areas, Sites B and C in Khayelitsha in the Cape Peninsula, South Africa, were included in the study. Firstly, focus group discussions were conducted with 17 purposively selected CHWs to explore attitudes, beliefs and perceptions of hypertension. Secondly, interviews were conducted to assess their basic knowledge about causes, prevention and control of hypertension. The focus group discussions revealed that CHWs were uncertain about the causes of hypertension. They also found it difficult to grasp the fact that people without risk factors, such as overweight or a family history of hypertension, could be hypertensive. Many CHWs believe in traditional medicines and home-brewed beer as the best treatment for hypertension. They believe that people who take medical treatment become sicker and that their health deteriorates rapidly. Risk factors of hypertension mentioned during the structured interviews include inheritance, lack of physical activity, consuming lots of salty and fatty food. Conclusions drawn from the findings of the CHWs’ responses highlighted their insufficient knowledge about hypertension as a chronic disease of lifestyle. Meanwhile they are expected to play a role in stimulating community residents’ interest in the broad principle of preventive health maintenance and follow-up. Data obtained from this research can be used for the planning of health-promotion programmes. These should include preventing hypertension and improving primary management of individual sufferers. Because of their working relations and close link with CHWs, community nurses in primary health-care facilities need to recognise these beliefs and attitudes since these may differ from their own.
Health-service utilization by pregnant women in the greater Mafikeng- Mmabatho district
Authors: Pretorius C.F. , Greeff M.
Published: November 2012

Since the implementation of free maternity services in South Africa from 1994, more maternity services were provided (SA, 1994: 73). These services are however inaccessible to many pregnant women in the rural areas, leading to sub-optimal antenatal health service utilization. Another problem that emerged, is deterioration in antenatal health service rendering throughout the country, as well as a lack of guidelines for the mobilization of pregnant women in order to promote optimal antenatal health service utilization (ANHSU) in the North West Province. The mentioned problems were the reasons for undertaking this research.
Severe disability: Do primary health care nurses have a role to play?
Authors: Bornman J. , Alant E. , Lloyd L.L.
Published: November 2012

This article focuses on the importance of primary health care nurses’ involvement in the identification of children with severe disabilities, early and appropriate intervention that includes referral, as well as the provision of support to the children’s caregivers. The use of multiskilling as a strategy to train nurses to fulfil this role is described. The traditional roles of community nurses are explored within the disability paradigm, with specific reference to multi-skilling. Finally, research results following the implementation of the Beginning Communication Intervention Protocol (BCIP), which uses multiskilling as a training strategy, are described. Recommendations for further research are then provided.
Mortality and morbidity among traditionally circumcised Xhosa boys in the Eastern Cape Province, South Africa
Authors: Mogotlane S.M. , Ntlangulela J.T. , Ogunbanjo B.G.A.
Published: November 2012

Male circumcision is one of the oldest traditions observed by many societies. The ritual is performed at specific periods in life with the main purpose of integrating the male child into the society according to cultural norms. Recently, especially in the Eastern Cape, many initiates have died or have had to face life with mutilated genitals following this ritual.
Nutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at day hospitals in the Cape Metropole
Authors: Becker H. , Bester M. , Reyneke N. , Labadarios D. , Monyeki K.D. , Steyn N.P.
Published: November 2012

The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1 %) of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt) content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1 % of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI) < 25), 25.9% were overweight (BMI 25 - 29.9) and 61.2% were obese (BMI ≥ 30); 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88cm in women; 102cm in men) was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90mm Hg) were found in 61.2% of these patients at the hypertension clinics.
Pathways to mental health care in KwaZulu - Natal
Authors: Mkize L.P. , Uys L.R.
Published: November 2012

The understanding of popular beliefs about mental health care and the pathways clients take prior to admission to a mental health institution is vital in planning to reduce delays in seeking treatment. The objectives of this exploratory survey were to determine pathways of care the clients with mental illness take, which ultimately lead to the mental health institution, the effects of socio-cultural and economic factor on the pathways to mental health care and the satisfaction with different service providers consulted. Data was gathered through semi-structured interviews. The results indicate that African clients interpret mental illness as bewitchment. Delays in seeking appropriate mental health care are experienced because traditional and faith healers are the first port of call. The short pathways are used when the first signs of psychotic features are severe, including like aggressive or violent behaviour. Financial constraints seem to be the problem for most of the clients in accessing mental health care. Furthermore, defaulting treatment was also observed due to the fact that mental illnesses are stigmatised in African communities.
Health beliefs and prescription medication compliance among diagnosed hypertension clinic attenders in a rural South African hospital
Authors: Peltzer K.
Published: November 2012

This study examines the relationship between health beliefs and the use of both prescribed medication and alternative healing agents among at least one year diagnosed hypertensives attending an hypertension out-patient clinic in a rural South African hospital. The sample included 33 men and 67 women, in the age range of 31 to 81 years, (M=60.7 years, SD=9.8 years). Main outcome measures included causative beliefs, health beliefs, and quality of the health care provider patient interaction. From the 100 patients studied 35% were not compliant with prescription medication. Most patients (almost 80%) had taken something else for their high blood pressure apart from prescription medication, especially those who had been non-compliant with prescription medication. Most popular were the use of home remedies and faith healing, followed by traditional healing and over-the-counter drugs. Non-compliant behaviour was associated with the use of alternative healing agents, the belief of curability of hypertension by traditional and faith healers, perceived benefits and barriers of antihypertensive medication and some items of the quality of the practitioner-patient relationship such as not explaining medical problems. Results are discussed in view of improving culturally sensitive compliance behaviour among hypertensive patients.
Organ donation and transplantation within the Zulu culture
Authors: Bhengu B.R. , Uys H.H.M.
Published: November 2012

Greater knowledge and technological advancement in the field of transplantation has increased the demand for organ donation beyond the supply of organs, especially among the black communities. This imbalance arises from the few sources of organs, limitations on the techniques of organ retrieval, disparities in the allocation of organs and socio-cultural factors. The aim of this study was to investigate the extent to which Zulu cultural norms and social structures influence an individual’s decision to donate an organ or to undergo transplantation. A qualitative approach using an ethno-nursing method was selected. Semi-structured interviews were conducted with a transplant co-ordinator representing the professional sector, with traditional healers and religious leaders representing the folk sector, and with the general public representing the popular sector of the health care system. Both urban and rural settings were used. Conclusions arrived at showed that knowledge was lacking among Zulu speaking people about organ donation and transplantation and misconceptions about the topic were related to Zulu life patterns, beliefs about death, burial and life hereafter, and values and social structures. Recommendations with regard to the promotion of organ donation and transplantation among Zulu speaking people were made based on culture-sensitive and culture-congruent principles.
South African nurse managers’ perceptions regarding cost containment in public hospitals
Authors: Ntlabezo E.T. , Ehlers V.J. , Booyens S.W.
Published: November 2012

The perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape were investigated. Results indicated that nurse managers required better preparation for their cost control responsibilities. Although the majority of the nurse managers realised that staffing issues affected cost containment efforts, they were reportedly unable to prevent nurses from leaving their points of duty without due authorisation, curb the rate of absenteeism or reduce the number of resignations. Nurse managers suggested that cost containment efforts would benefit from effective security checks to curb losses of stock and equipment, including wheelchairs, and that more public telephones should be installed in hospitals. Rationalisation of staff and specialised services among the four major hospitals could further enhance cost containment efforts.
A pilot study of death competency amongst health workers in the Uthukela District in KwaZulu-Natal
Authors: Brysiewicz P. , Mclnerney P.A.
Published: November 2012

The aim of this study was to investigate the registered nurses abilities to cope with the death of their clients and to determine if there was any improvement after attending a workshop designed to address this issue.
A strategy for the management of HIV/ AIDS in the health sector of the city of Johannesburg
Authors: Barnard A. , Muller M.
Published: November 2012

The HIV/AIDS pandemic is posing major challenges to all sectors in South Africa, including the health sector of the city of Johannesburg. The health sector of the city of Johannesburg, as a result of the pandemic, is faced with increasing demands on its scarce resources at a time of major reform at local government level including transformation of the health sector. The overall objective of the study is to explore and describe a strategy for the management of HIV/AIDS by the health sector of the city of Johannesburg. An exploratory, descriptive and quantitative research design was utilized and the UNAIDS “Guide to the strategic planning process for a national response to HIV/AIDS” (1998), was employed to formulate the strategy. The content validity of the strategy was determined according to the process originally described by Lynn (1986) and adopted by Muller (in Booyens, 1998:607-609). The research was conducted in two phases. The first phase, the developmental phase, involved the exploration and description of the theoretical framework and the response to the pandemic, and formulation of a draft strategy. The second phase, the quantification phase, involved the assertion of the content of the strategy by a group of experts and determination of the content validity index (CV1). The final strategy focused on the following: to lead and facilitate intersectoral collaboration; to strengthen primary health care services to provide comprehensive community-based care; prevention of new infections; community mobilization towards prevention, non-discrimination and non stigmatization and empowerment of the health sector to deal with the AIDS .pandemic. The CVI results showed that the average content validity index determined during this study was adequate: full score (1.0) for acceptability and technical soundness, and 0.89 for feasibility and perceived affordability. The strategy formulated for the management of HI V/A1DS by the health sector of the city of Johannesburg is therefore acceptable, technically sound and feasible and perceived as affordable. It was finally recommended that the strategy be adopted for implementation within the health sector of the city of Johannesburg.