Health SA Gesondheid - Volume 8, Issue 1, March 2003
Volume 8, Issue 1, March 2003
Source: Health SA Gesondheid 8 (2003)
Health behaviour and school environment among school-aged black and white South African children in the Limpopo Province : research
Source: Health SA Gesondheid 8, pp 3 –12 (2003)
The main objective of the &apos;Health Behaviour among School-Aged Children&apos; (HBSC) study was to collect information on health-related behaviour of South African youth. Another objective was to examine the association between learners&apos; perceptions of their school environment, teachers&apos; and peers&apos; support and their health behaviours. Furthermore, recommendations about the health behaviour of school-aged children are developed. The sample comprised 515 Grade 8 secondary school learners chosen at random from three urban schools in the Polokwane area, Limpopo Province. Results indicated that learners who had positive perceptions regarding their school environments were significantly more likely to engage in health promoting behaviours. The healthy food score was associated with supportive teachers but not with supportive peers and supportive parents and socioeconomic status. Regarding the different health-related behaviours, gender differences were less pronounced than racial differences. Black school-aged children had a significantly higher unhealthy food score than Whites but there were no racial differences on the healthy food score. In conclusion, therefore health promotion practitioners need to consider the impact of the school environment (particularly unrealistic scholastic expectations from teachers and parents) on health behaviours of school-aged children.
Die hoofdoelwit van die studie "Health Behaviour among School-aged Children" (Gesondheidsgedrag van skoolgaande kinders) studie is om inligting in te samel ten opsigte van gesondheidverwante gedrag van die Suid- Afrikaanse jeug . Nog &apos;n doelwit is om inligting te bekom ten opsigte van die verwantskap tussen leerders se persepsies van hul skoolomgewing, ondersteuning van hul onderwysers en portuurgroepe enersyds en hul gedrag andersyds. Verder is aanbevelings oor die gesondheidsgedrag van skoolgaande jeug gemaak. Die steekproef het bestaan uit 515 Graad 8 leerders van sekondêre skole wat ewekansig gekies is uit drie stedelike skole in die Polokwane omgewing in die Limpopo Provinsie. Resultate toon dat leerders wat positiewe persepsies het ten opsigte van hul skoolomgewing, beduidend meer geneig is om betrokke te wees in gesondheidsbevorderlike gedrag. Die gesondekos-telling is geassosieer met ondersteunende onderwysers, maar nie met ondersteunende portuurs, ondersteunende ouers en sosio-ekonomiese status nie. Ten opsigte van verskille in gesondheidsverwante gedrag, is geslagsverskille minder beduidend as rasseverskille. Swart kinders van skoolgaande ouderdom het beduidend hoër tellings op &apos;n skaal van ongesonde kos behaal in vergelyking met blankes, terwyl daar geen verskil tussen tellings vir die twee rasse was op die skaal vir gesonde kos nie. Ter samevatting : gesondheidsbevorderingpraktisyns moet die impak van die skoolomgewing (veral ten opsigte van onrealistiese skolastiese verwagtings van ouers en onderwyseres) op die gesondheidsgedrag van die jeug in berekening bring.
Adolescent mothers&apos; knowledge and perceptions of contraceptives in Tshwane, South Africa : research
Source: Health SA Gesondheid 8, pp 13 –25 (2003)
This descriptive quantitative survey attempted to identify reasons why adolescent mothers (aged 19 or younger at the birth of their babies) failed to utilise contraceptive, emergency contraceptive and / or termination of pregnancy (TOP) services. The research population comprised all adolescent mothers in the region, the accessible convenience sample consisted of all adolescent mothers who visited Tshwane&apos;s Metropolitan Council clinics from 1 January till 31 March 2000, and who were willing to complete questionnaires, designed and tested during a joint World Health Organization and Commonwealth Reproductive Health Workshop in Harare, Zimbabwe, during 1998. During pretesting, 12 questionnaires were completed by adolescent mothers who were excluded from the actual study. This report refers to data (analysed with the Epi-Info program) obtained from 61 completed questionnaires. Only a minority of these 61 adolescent mothers earned sufficient money to sustain themselves and their babies. In spite of these unfavourable financial circumstances, only 23 (37.7%) had used contraceptives prior to conception. None of them used emergency contraceptives and none accessed termination of pregnancy services. Although all these services are available free of charge in the region, these adolescent mothers did not use them. The adolescent mothers required more knowledge about contraceptives, emergency contraceptives and TOP services, and they need to perceive these services as being accessible and safe before they could utilise them effectively. Clinics providing these services should be open over weekends and during evenings so that adolescents can obtain contraceptive services without fear of meeting their mothers, aunts or teachers at these clinics. Reproductive health clinics should also strive towards providing more adolescent-friendly services.
Hierdie beskrywende kwantitatiewe opname het gepoog om redes te bepaal waarom adolessente moeders (wat 19 jaar oud of jonger was tydens die geboorte van hulle babas) nie gebruik gemaak het van kontrasepsie (voorbehoedmiddels) of noodkontrasepsie, en / of terminasie van swangerskap ("termination of pregnancy - TOP") dienste nie. Die navorsingspopulasie het bestaan uit alle adolessente moeders in die streek, die bereikbare gerieflike steekproef het bestaan uit alle adolessente moeders wat die Tshwane Metropolitaanse Raad se klinieke van 1 Januarie tot 31 Maart 2000 besoek het, en wat bereid was om vraelyste te voltooi. Die vraelyste is ontwerp en getoets tydens &apos;n gesamentlike Wêreld Gesondheids Organisasie en Statebond Voortplantingsgesondheidwerkswinkel in Harare, Zimbabwe, gedurende 1998. Tydens die voortoetsfase is 12 vraelyste voltooi deur adolessente moeders wat nie aan die werklike studie deelgeneem het nie. Hierdie verslag verwys na die data (ontleed met behulp van die Epi-Info program) wat verkry is uit 61 vraelyste wat in die Tshwaneomgewing voltooi is tussen 1 Januarie en 31 Maart 2000. Slegs enkele van hierdie 61 adolessente moeders het inkomstes gehad wat voldoende was om hulleself en hulle babas te onderhou. Ten spyte van die ongunstige finansiële omstandighede, het slegs 23 (37.7%) enige kontrasepsie gebruik voor hulle swangerskappe. Niemand het noodkontrasepsie gebruik nie en ook nie terminasie van swangerskap dienste nie. Alhoewel hierdie dienste gratis beskikbaar is in die Tshwane-omgewing, kon die respondente nie daarin slaag om die dienste te benut nie. Die adolessente moeders benodig meer kennis oor kontrasepsie, noodkontrasepsie en terminasie van swangerskap dienste, asook persepsies dat die dienste bereikbaar en veilig is, alvorens hulle die dienste kan benut. Klinieke wat sodanige dienste verskaf, behoort naweke en saans oop te wees sodat adolessente die klinieke kan bywoon sonder om te vrees dat hulle moeders, tannies of onderwyseresse ook daar sal wees. Reproduktiewe gesondheidsorgklinieke moet ook meer adolessente-vriendelike dienste daarstel.
A phenomenological investigation of experiences of pregnancy by unmarried adolescents in Maseru : research
Authors: Tjoetso V. Lehana and Lily Van Rhyn
Source: Health SA Gesondheid 8, pp 26 –38 (2003)
The transition to motherhood is accompanied by a number of social and psychological consequences that place pregnant adolescents at risk in terms of later life adjustment. The purpose of this qualitative study was to explore and describe the experiences of pregnant unmarried adolescents in the Maseru district and, if necessary, to develop guidelines for an educational and counselling program for them. Pregnant unmarried adolescents, aged 13 to 19 years, from 10 randomly selected clinics in Maseru, were allowed to give detailed descriptions of their experiences with their first pregnancy. The meanings that those experiences had for them were also explored. Sixteen individual phenomenological and two focus group interviews were conducted. Tesch&apos;s (1990) method of analysis was used to analyse the data. Results : The respondents reported to have met the confirmation of their pregnancy with a mixture of disbelief, confusion and shame. Data were grouped into four main categories namely emotions, relationships, physical problems and religion. Positive and negative experiences were described. All respondents who were still in school had to drop out. Recommendations included : every pregnant adolescent who comes to the clinic or outpatient department should receive or be referred for counselling. Prenatal education should provide anticipatory guidance related to maternal role issues.
Verskeie sosiale en sielkundige gevolge gaan gepaard met swanger adolessente se oorgang na moederskap en kan latere aanpassing by die lewe bemoeilik. &apos;n Kwalitatiewe studie is onderneem met die doel om die belewenisse van swanger ongetroude adolessente in Maseru te ondersoek en te beskryf en om, indien nodig, riglyne te ontwikkel vir &apos;n opvoedkundige- en beradingsprogram vir hierdie adolessente. Swanger, ongetroude adolessente, tussen die ouderdomme van 13-19 jaar, is uit 10 klinieke in Maseru gekies en versoek om &apos;n gedetailleerde beskrywing van die belewenis van hulle eerste swangerskap te gee. Die betekenis wat hierdie belewenis vir hulle gehad het is ook ondersoek. Sestien individuele fenomenologiese onderhoude en twee fokusgroeponderhoude het plaasgevind. Tesch (1990) se metode van analise is gebruik om die data te analiseer. Resultate : Die proefpersone het gerapporteer dat hulle die bevestiging van hulle swangerskap met &apos;n kombinasie van ongeloof, verwarring en skaamte beleef het. Die data is in vier hoofkategorieë gegroepeer naamlik emosies, verhoudings, fisieke probleme en geloof. Positiewe en negatiewe ervaringe is beskryf. Al die respondente wat nog op skool was, moes die skool verlaat. Aanbevelings sluit in : elke swanger adolessent wat na die kliniek of afdeling vir buitepasiënte kom moet berading ontvang of vir berading verwys word. Prenatale opvoeding moet voorbereidende leiding ten opsigte van die moederlike rol bied.
Factors influencing pre-eclampsia / eclampsia outcomes in high-risk patients in Zimbabwe : research
Authors: C. Mudokwenuy-Rawdon, M.C. Bezuidenhout and V.J. Ehlers
Source: Health SA Gesondheid 8, pp 39 –56 (2003)
Severe pre-eclampsia / eclampsia remains one of the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to severe pre-eclampsia / eclampsia were investigated in an effort to improve pregnancy outcomes in Zimbabwe. Cases and controls were selected from 318 obstetric records of patients with severe pre-eclampsia / eclampsia to conduct a retrospective case-control study. (Cases referred to patients who were diagnosed with severe pre-eclampsia / eclampsia and who died from these conditions while controls survived these conditions). No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia / eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. Cases apparently received better reported care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients&apos; records and changed policies for managing these conditions more effectively in Zimbabwe.
Ernstige pre-eklampsie / eklampsie bly een van die hoofoorsake van moederlike sterftes in Zimbabwe. Gebaseer op die probleem is faktore wat verband hou met moederlike sterftes as gevolg van ernstige pre-eklampsie / eklampsie ondersoek, in &apos;n poging om die swangerskapsuitkomstes in Zimbabwe te verbeter. Gevalle en kontroles is geselekteer uit 318 ernstige pre-eklampsie / eklampsie obstetriese rekords ten einde &apos;n retrospektiewe gevallekontrolestudie uit te voer. Geen beduidende faktore was identifiseerbaar wat moederlike sterftes onder vrouens met ernstige pre-eklampsie / eklampsie beïnvloed het nie. Magnesiumsulfaat was nie as roetine, teenstrydig met internasionale aanbevelings, toegedien nie. Volgens verslae het gevalle klaarblyklik beter sorg gekry as kontroles. (Gevalle is gedefinieer as pasiënte wat met pre-eklampsie / eklampsie gediagnoseer was en daaraan beswyk het terwyl kontroles die toestande oorleef het). Aanbevelings wat op die navorsingsverslag gegrond is, sluit in dat vroedvroue se onderrig en indiensopleiding verbeter moet word, pasiënte se rekords aan gereelde ouditering onderwerp moet word, en dat beleid verander moet word om die toestande in Zimbabwe meer effektief te beheer.
Illness cognitions, doctor-patient communication and prescription adherence among first diagnosed hypertensive patients from a rural teaching hospital in South Africa : research
Authors: K. Peltzer, L.B. Khoza, M.E. Lekhuleni, M. Alberts, J. Mekwa and E. Sethosa
Source: Health SA Gesondheid 8, pp 57 –68 (2003)
This study examines the relationship between illness cognitions, doctor-patient communication and the use of prescribed medication among patients first diagnosed with hypertension in the outpatient department of a rural South African teaching hospital. The sample included two men and 43 women, in the age range of 38 to 85 years, (M= 60.5 years, SD= 11.5 years); 14 (31%) were 65 years and above. Outcome measures included doctor-patient communication, recall interview, illness cognitions, and anthropometrical measurements. From the 45 patients studied 23 (51%) were not adherent with prescription medication. Major findings were that doctor-patient communication, most illness cognitions, and healthy behaviour of the patient were not associated with adherence behaviour. Perceived stress and the belief of incurability of hypertension were, however, related with adherence behaviour. Patients frequently mentioned mental and environmental stress as causative and management beliefs. On the contrary, the treating physicians did not allude to mental and environmental stress. Physicians gave little lifestyle health education. In instances where it was given, most patients seemed to practice it.
Hierdie studie ondersoek die verwantskap tussen siekte-kognisies, dokter-pasiënt kommunikasie en die gebruik van voorskrifmedisyne onder pasiënte wat die eerste keer met hipertensie gediagnoseer is, in die buitepasiëntafdeling van &apos;n landelike Suid-Afrikaanse opleidingshospitaal. Die steekproef het twee mans en 43 vroue, binne die ouderdomsgroep 38-85 jaar ingesluit (M=60.5 jaar, S=11.5 jaar); 14 (31%) was 65 jaar en ouer. Uitkomsmetings het dokter-pasiënt-kommunikasie, herbesoek-onderhoude, siekte-kognisies, en antropometriese metings ingesluit. Van die 45 pasiënte wat bestudeer is, het 23 nie gehoor gegee aan hul voorskrifmedikasie nie. Die belangrikste bevindinge was dat dokter-pasiënt-kommunikasie, die meeste siekte-kognisies en gesonde gedragswyses van die pasiënt, nie geassosieer was met gehoorsaming van voorskrifte nie. Stres wat waargeneem is en die oortuiging van dat hipertensie ongeneesbaar is, hou egter verband met die gehoorsaming van voorskrifmedisyne. Sielkundige en omgewingstres is dikwels deur pasiënte genoem as oorsaaklike en beheerbare oortuigings, maar nooit deur die geneeshere wat hierdie pasiënte behandel het nie. Die geneeshere het min riglyne ten opsigte van gesonde lewenswyses verskaf. Indien dit wel verskaf is, het dit geblyk dat die meeste pasiënte dit nagevolg het.
Perceptions on physiopathology and preferred treatment of epilepsy and asthma in the Limpopo Province, South Africa : research
Author Supa Promtussananon
Source: Health SA Gesondheid 8, pp 69 –77 (2003)
The objectives of this study were to analyse perceptions of epilepsy and asthma, due to attribution of cause, suggested means of risk reduction and preferred treatment. The sample included 100 participants selected on the basis of quota sampling (10 males and 10 females from each of the five age groups : 5-10 years, 11-19, 20-34, 35-49 and 50 years and above) in a semi-urban area in the Limpopo Province, South Africa. Data were collected by a semi-structured interview in a household survey. Results show that 34% of all participants perceived the standard cause of epilepsy and 29% the suggested standard means of risk reduction, while 67% perceived the standard cause of asthma and 78% the suggested means for risk reduction. The majority of samples preferred medical treatment for both epilepsy and asthma. Concerning asthma, more men than women would consult traditional healers and other treatment, while more women than men would go for medical treatment and behaviour modification. Age group differences were only found for epilepsy : the elderly group perceived the standard cause more often than the younger group. Low levels of knowledge and misconceptions about epilepsy and to a lesser extent about asthma, call for health education.
Die doelwitte van hierdie studie was om persepsies van epilepsie en asma te analiseer na aanleiding van die toeskrywing van oorsaak, voorgestelde metodes van risikovermindering en verkose behandeling. Die steekproef het 100 deelnemers ingesluit, geselekteer op grond van kwota-steekproeftrekking (10 manlik en 10 vroulik vanuit elk van die vyf ouderdomsgroepe : 5-10 jaar, 11-19, 20-34, 35-49 en 50 jaar en ouer) in &apos;n semi-stedelike gebied in die Limpopo Provinsie, Suid-Afrika. Data is deur middel van &apos;n semi-gestruktueerde onderhoud, in &apos;n opname in huishoudings ingesamel. Resultate toon dat 34% van alle deelnemers die standaardoorsaak van epilepsie waargeneem het en 29% die voorgestelde standaardmetodes van risikovermindering, terwyl 67% die standaardoorsaak van asma waargeneem het en 78% die voorgestelde metodes van risikovermindering. Die oorgrote meerderheid van die steekproef het mediese behandeling vir beide epilepsie en asma verkies. Meer mans as vroue sal met tradisionele genesers konsulteer ten opsigte van asma en ander behandeling, terwyl meer vroue as mans hul vir mediese behandeling en gedragsmodifikasie sal aanmeld. Slegs vir epilepsie is daar ouderdomgroepsverskille gevind. Die ouer groep het die standaardoorsaak meer dikwels waargeneem as die jonger groep. Lae vlakke van kennis en wanopvattings ten opsigte van epilepsie en, tot &apos;n mindere mate ten opsigte van asma, noodsaak gesondheidsopvoeding.
The accompaniment needs of the family with a loved one in the critical care unit : research
Authors: Charnell Quinton, Dalena Van Rooyen and Johanita Strumpher
Source: Health SA Gesondheid 8, pp 78 –88 (2003)
Nurses have unique opportunities to create environments where patient and family needs can be met. Critical care nurses face the challenge of assisting anxious families to cope with the critical illness of their loved one. There is a great need to humanise the Critical Care Unit and create a warm and caring environment. Caring for a patient&apos;s loved ones is challenging, as the family&apos;s experience of the patient&apos;s admission to the Critical Care Unit is individual and unique. Ensuring the accompaniment of the family with a loved one in the Critical Care Unit provides an excellent standard of professional practice. Concern for the quality of service is a professional responsibility. This research study was divided into three phases. The first phase explores and describes the family experience when a loved one is a patient in the Critical Care Unit. Phase two explores and describes how nurses perceive and interpret the family experience of the Critical Care Unit. These experiences and perspectives were analysed and recurring themes were identified. Finally, in the third phase of the study, guidelines to assist the nurse in the accompaniment of the family in the Critical Care Unit are described.
Verpleegkundiges het &apos;n unieke geleentheid om &apos;n omgewing te skep waar daar aan die behoeftes van beide die pasiënte en hul gesinslede voldoen word. Verpleegkundiges wat in intensiewe sorgeenhede werk, het die uitdaging om angstige gesinslede te help om die ernstige siekte van &apos;n geliefde te verwerk en te aanvaar. Daar is &apos;n groot behoefte by die publiek om die omgewing in &apos;n intensiewe eenheid te vermenslik sodat hulle warmte en aanvaarding kan ervaar wanneer hulle &apos;n siek geliefde besoek. Elke gesinslid ervaar &apos;n geliefde se ernstige siekte en opname in &apos;n intensiewe eenheid op &apos;n unieke en individuele wyse. Dit is die verpleegkundige se professionele taak om te verseker dat hierdie ervaring positief is en dat daar in gesinslede se emosionele behoeftes voorsien word. Die studie was in drie fases verdeel. In fase een is die ervarings van gesinslede van &apos;n geliefde wat in &apos;n intensiewe eenheid opgeneem is, bepaal. In fase twee is die perspektiewe van verpleegkundiges wat in intensiewe eenhede werk en wat kontak met gesinslede het, bepaal. Hierdie ervarings en perspektiewe is geanaliseer en herhalende temas is geïdentifiseer. In fase drie van die studie word riglyne gegee van hoe verpleegkundiges te werk kan gaan om gesinslede te ondersteun.
Promoting a motivational workforce in nursing practice : research
Author Karien Jooste
Source: Health SA Gesondheid 8, pp 89 –98 (2003)
The motivation of nurses is a crucial contributing factor to effective health care organisations in South Africa. Major changes are taking place due to the transformation of health services and the migration of nurses in this field. Within this changing environment, nurses might find themselves unfamiliar with their surroundings. This could lead to a lack of involvement and a lack of motivation to participate in the delivery of quality health care. As it was unclear to the author as to what the opinions of nurses were regarding their role, and those of nurse managers in addressing nurses&apos; motivational needs in the work situation, this study on motivation was conducted. This study aimed at highlighting the role of the nurse supervisor&apos;s and the nurse&apos;s role in establishing a motivated nursing corps. An explorative, descriptive, quantitative research project was embarked upon. A purposive, convenience and voluntary sample of 112 nurses attending a second year university course in Health Services Management, was selected to participate in this study. The findings indicate the motivational needs important to nurses. Guidelines were formulated according to which these motivational needs of nurses could be satisfied in future. The purpose of this article is to sensitise nurses and supervisors at all levels of the hierarchy to become more aware of their role in motivating themselves and others in their working environment.
Die motivering van verpleegkundiges is &apos;n kritiese aangeleentheid wat as bydraend tot effektiewe gesondheidsorgorganisasies in Suid-Afrika gesien kan word. Groot veranderinge is besig om plaas te vind weens transformasie van gesondheidsdienste en die migrasie van verpleegkundiges in hierdie veld. Hierdie veranderende omgewing kan daartoe aanleiding gee dat verpleegkundiges, wat nie meer met hul werksomstandighede vertroud is nie, &apos;n gebrek aan deelname en &apos;n gebrek aan motivering kan openbaar om gehaltesorg aan die gemeenskap te lewer. Aangesien dit nie vir die outeur duidelik was watter menings verpleegkundiges huldig aangaande die rol van die verpleegbestuurder en hulle eie rol in die aanspreek van hulle motiveringsbehoeftes in die werksituasie nie, was hierdie studie oor motivering onderneem. Die doel van hierdie studie was om die rol van die verpleegbestuurder en die verpleegkundige se eie rol te beklemtoon in die vasstelling van &apos;n gemotiveerde verpleegkorps. &apos;n Verkennende, beskrywende, kwantitatiewe navorsingsprojek is onderneem. &apos;n Doelgerigte gerieflike en vrywillige steekproef van 112 verpleegkundiges, wat &apos;n universiteitskursus in die tweede jaar in Gesondheidsdiensbestuur bygewoon het, was geselekteer om in hierdie studie deel te neem. Die bevindinge dui die belangrike motiveringsbehoeftes van verpleegkundiges aan. Riglyne is geformuleer waarvolgens hierdie motiveringsbehoeftes van verpleegkundiges in die toekoms vervul kan word. Die doel van hierdie artikel is om verpleegkundiges en toesighouers op alle vlakke van die hiërargie te sensibiliseer om meer bewus te word van hul rol in die motivering van hulself en ander in hul werksomgewing.