Research Publications (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/216
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Item Exploring the interrelationships between physical function, functional exercise capacity, and exercise self-efficacy in persons living with HIV(SAGE Publications, 2024) Nokes, Kathleen M.; Sokhela, Dudu G.; Orton, Penelope Margaret; Samuels, William Ellery; Phillips, J. Craig; Tufts, Kimberly Adams; Perazzo, Joseph D.; Chaiphibalsarisdi, Puangtip; Portillo, Carmen; Schnall, Rebecca; Hamilton, Mary Jane; Dawson-Rose, Carol; Webel, Allison R.While physical activity can mitigate the metabolic effects of HIV disease and HIV medications, many HIV-infected persons report low levels of physical activity. Purpose: To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. Setting/sample: A total of 810 participants across eight sites located in three countries. Measures: Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. Analysis: Both univariate and multivariant analyses were used. Results: Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = −1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84–31.98, p < .001), hip–waist ratio (β = −2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = −0.10, p = .120). Among the covariates, age (β = −0.16, p < .001), gender (β = −0.43, p < .001), education (β = 0.08, p = .026), and hip–waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity ( r = 0.27). Conclusions: Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.Item Exploring intersectionality and HIV stigma in persons receiving HIV care in nurse-led public clinics in Durban, South Africa(Elsevier BV, 2023) Sokhela, Dudu Gloria; Orton, Penelope Margaret; Nokes, Kathleen M.; Samuels, William E.Background: Although stigma associated with South African people living with HIV has declined since the 1980s when HIV/AIDS was first identified, it still persists. Stigma is associated with poor health outcomes and avoidance of interactions with healthcare systems. The HIV stigma framework distinguishes three HIV-related self-stigma mechanisms. Aims: The aims of this study were to explore intersectionality between HIV-stigma mechanisms and selected sociodemographic as well as HIV factors, and interrelationships between three HIV-related self-stigma mechanisms. Setting and method: This study was a secondary analysis of data collected from a cross-sectional sample of people receiving HIV-related primary health care at different municipal clinics in Durban, South Africa (N = 100). Results: The average participant was Black African, female, unemployed, with a monthly income below R2 500, most had completed primary school. No sociodemographic or HIV-related factors were significantly related to total or subscale HIV stigma scores. Respondents reported experiencing (enacted) no stigmatization, did not expect to experience (anticipated) much stigmatization from their social interactions with family, community, healthcareworkers, and reported no strong stigmatizing beliefs about themselves (internalized). Conclusion: Intersectionality did not identify any particular socio-demographic or HIV-related factor associated with greater HIV stigma. Participants reported low HIV stigma arising from interactions with healthcare and social service providers or families. Although no socio-demographic or HIV-related factors were significantly associated with HIV stigma mechanisms in this relatively homogeneous sample, being marginalized can nevertheless result from living with other differences compared to societal norms and result in particular vulnerability when living with HIV/AIDS.Item Factors related to functional exercise capacity amongst people with HIV in Durban, South Africa(AOSIS, 2021-04-29) Orton, Penelope Margaret; Sokhela, Dudu Gloria; Nokes, Kathleen M.; Perazzo, Joseph D.; Webel, Allison R.BackgroundPeople with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.Aim
To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.Setting
Respondents (N = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.Methods
Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent's medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m2); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).Results
On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.Conclusion
South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.Item Creating an instrument to measure perceptions about access to health-related higher education programmes in South Africa(Stellenbosch University, 2020-12-04) Orton, Penelope Margaret; Essack, Sabhia; Nokes, Kathleen M.; Brysiewicz, PetraBackground: The South African government has created countless policies that support the need to admit and graduate students who had been excluded from health-science programmes in higher education settings during the apartheid era. Objective: to develop a questionnaire that could be used by various stakeholders to obtain their perceptions about access to health sciences education in higher education settings. Method: A mixed methods design was used; the qualitative stage allowed for the identification of themes while the quantitative stage used measurement theory, to develop an instrument based on those themes. Results: The overarching theme was Achieving equity of access for success is multi-factorial and has diverse & complex challenges and eight sub-themes emerged which were used to create a 17-item questionnaire that has good content validity and reliability (Cronbach alpha=.767). Conclusion: Further psychometric testing with larger, more diverse samples will result in a refined instrument that can be administered to various stakeholder groups, such as current and potential health sciences students and faculties, and used in programme evaluation. Health science programmes can use the instrument to measure access within different disciplines and possible changes over time as innovations are piloted. Different health sciences programmes can be compared and contrasted and objective data can be used to make systematic organizational changes.