Theses and dissertations (Health Sciences)
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Item Investigating the perceptions and experiences of parents and guardians regarding paediatric Homoeopathic care received from Homoeopaths in the eThekwini Municipality(2022-09-29) Strauss, Tylah; Hall, Cornelia Maria; Erwin, KiraBackground: Homoeopathy is a Complementary and Alternative Medicine (CAM) therapy that is based on the law of similars – “Let Likes be Cured by Likes" – whereby substances that are capable of causing diseases in healthy people can be used in an infinitesimal dose as remedies to treat the similar disorder in someone who is ill. Globally homoeopathy is receiving greater recognition nowadays, particularly for its use in children. This is a result of parents seeking out treatments which they believe to be more tailored and "natural". However, this same trend is not mirrored in a South African setting. Despite there being a greater recognition of homoeopathy, the research on homoeopathy in South Africa (especially paediatric homoeopathy) is scarce and overseas trends cannot be extrapolated to a South African population. Therefore, this study aimed to fill a gap in the literature by exploring and describing the perceptions and experiences of parents and legal guardians regarding paediatric homoeopathy care received from homoeopaths in the eThekwini Municipality. Objectives: The aim of the study was to investigate the perceptions and experiences of parents and legal guardians regarding paediatric homoeopathic care received from homoeopaths in the eThekwini Municipality. Methods: A qualitative study was conducted using semi-structured interviews. This study was conducted on 12 parents regarding paediatric homoeopathy care received from one of the homoeopaths in the eThekwini Municipality. The interviews began with a 'grand tour' question followed by other approved questions to gauge these perceptions and experiences. The interviews were conducted in English and later transcribed verbatim. The transcripts were analysed using Tesch's 8-step approach to qualitative research, whereby specific recurring themes are extracted from the data. Results: A total of 12 participants were interviewed. Four major themes emerged from the data: perceptions of homoeopathy, experiences of homoeopathy, challenges to homoeopathy and their possible solutions, homoeopathy versus allopathy, and an unplanned emergent theme of motherhood. The participants had varying levels of knowledge of homoeopathy depending on their level of connection (i.e. those with a close friend/relative who was in the profession had a better understanding). There were uniform perceptions of homoeopathy being "natural", "gentle", allusions to the law of similars and principle of the minimum dose, individualistic treatment and the stimulation of the vital force in order to allow the body to heal itself. Homoeopathic medication had perceptions of having no side-effects, having the ability to treat a wide array of conditions, and difficult dosages to adhere to. The overall experiences of homoeopathy were exceedingly positive. The participants commented on the thoroughness of the consult, the need for the practitioner to delve deep to find out the cause for the disease, the availability of the practitioner and the empathy and care felt. Awareness and education to the public, public access of OTC homoeopathic remedies, multi-disciplinary approach to paediatric management and integration into public healthcare proved to be the most beneficial solutions. When comparing homoeopathy to allopathy, we see that the homoeopathic holistic approach (whereby all symptoms are considered and there is an attempt to treat on more than just the physical plane) is preferred, there is a great mistrust with the pharmaceutical industry and participants wanted to be active participants in selecting which form of healthcare they chose. Mothers proved to be a valuable source in gaining awareness and mouth-to-mouth referral; their role in paediatric healthcare is paramount. Conclusion: Overall there were positive perceptions and experiences of homoeopathy, however, greater effort needs to be placed on education of the public, building relationships with other professionals and integration into public health care. Future studies should assess a wider catchment area, include quantitative research to get statistical evidence of efficacy, conduct in-person interviews to assure the quality of the data and include the role of mothers in future paediatric healthcare. Recommendations for the homoeopathic community include making information accessible to patients, increasing awareness of homoeopathy to the public and building inter-professional relationships and integrating into public healthcare.Item An epidemiological investigation of musculoskeletal injuries among rhythmic gymnasts in the eThekwini Municipality(2018) Strauss, Tylah; Van der Meulen, Anthony G.Background: Rhythmic Gymnastics is a sporting discipline involving the use of an apparatus (hoop, ball, clubs, ribbon or rope) to a choreographed routine with music. It requires agility, grace, co-ordination and most of all flexibility. Safety in Rhythmic Gymnastics is questionable when one takes training hours and the extreme flexibility required into consideration. An awareness and understanding of the prevalence and risk factors in Rhythmic Gymnastics will allow event organisers, medical personnel, managers, and coaches to adapt training approaches that will minimize the development of injuries. This information will also aid in developing monitoring systems to prevent adaptation injuries, which will lead to safer training and better management of gymnasts Objectives: This study aimed to investigate the prevalence of musculoskeletal injuries in rhythmic gymnasts within the eThekwini municipality and to identify selected factors associated with an increased risk of injury, in order to improve the management of gymnasts. Methods: A quantitative, descriptive questionnaire-based survey with a Beighton Score assessment was conducted on 67 Rhythmic gymnasts in the eThekwini municipality. Statistical analysis was performed on the results obtained from the questionnaire and the Beighton Score using IBM SSS version 23.0. The Chi-squared test was used (Fisher’s Exact Test was used when the Chi-squared test was violated); A p value of less than 0.05 was considered as statistically significant. Graphical representation of scores by groups was done using various types of tables and graphs. Risk factors for injuries were assessed using logistic regression. Factors were entered individually into the model to determine the co- efficients and odds ratios. Trend tests were computed in order to better assess associations between specific factors and injury. Results: A 100% response rate was achieved in this study. The average age of the participants was 12.3 years (95% CI= 11.7-12.8), average height was 148.5 centimetres (95% CI= 145.1-151.9), average weight was 41.0 kilograms (95% CI= 38.3-43.7), the average level of performance was 4.9 (95% CI= 4.1-5.8) and the average Beighton Score was 5.8 (95% CI= 5.3-6.3). The most commonly previously injured areas were the ankle (n=25) (14.0%), hip and knee (each n=19) (each 10.6%) and the low back (n=18) (10.1%). When considering the two most severe previous injuries the results stay similar, with the ankle being most commonly injured (n=15) (28.0%), followed by the hip (n=9) (17.0%) and the knee (n=6) (11.0%). When considering current injuries, the most commonly injured area is the knee and low back (each n=11) (each 14.5%), and the hip and ankle (each n=9) (each 11.8%). From the above it can be deduced that RG results in more injuries to the lower limb than the upper limb, or core/abdomen or the spine. The most common types of RG injury were muscle strains (n=16) (23.9%), followed by unsure (n=9) (13.4%) and joint sprains (n=8) (11.9%). The most common cause of injury for both previous and current RG injuries were overstretching and overuse ((n=23) (34.3%) for previous injuries; (n=15) (22.4%) for current injuries). Risk factors for injury were significant for the following: training hours per week (36.5 times for 5-8 hours of training per week; 15.7 times for under five hours of training per week; both when compared to more than 8 hours) and lack of balance skills included in RG training (4.5 times more likely than not). When considering treatment option used to keep the body in a good condition, a participant was 4.3 times more likely to utilize home remedies than any other treatment option. Trend tests noted that there is an increase in the mean of injuries as one goes up in age, up until a certain age (13-14 years of age for current injuries; 15-16 years of age for previous injuries), thereafter, there is a decease. Trend tests were also constructed for training hours per week; there was a directly proportional relationship between training hours per week and injury. Conclusion: When considering risk of injury in RG, many of the risk factors cannot be modified (such as age). Those risk factors that can be modified (such as training amount and components of training) should be considered by gymnasts and their coaches in order to implement strategies that could prevent injury.