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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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Start date: 2022Subject: search.filters.subject.Alternative medicine

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    An exploration of the adoption of personal nonpharmaceutical intervention measures by students at a university of technology in response to the COVID-19 pandemic
    (2024) Kell, Colette Melissa; Haffejee, Firoza; Jinabhai, Champaklal C.
    Background In March 2020 the World Health Organisation (WHO) declared coronavirus disease (COVID-19) to be a global pandemic. Due to the novel nature of the virus, there was no effective vaccine or established treatment methods, and public health officials turned to the personal non-pharmaceutical protective intervention (NPI) measures of physical distancing, hand sanitisation and the wearing of masks to interrupt disease transmission and ‘flatten’ the pandemic curve. Despite the WHO recommendation that NPIs should be included as part of any pandemic response, prior to the COVID-19 pandemic, little behavioural science research had been conducted on how to improve NPI adoption. During the COVID-19 pandemic, many Knowledge, Attitude and Practice (KAP) surveys investigated NPI compliance, but there is a dearth of qualitative literature to provide insight into the barriers and facilitators to adoption in specific populations. Over the past two decades, the South African Higher education sector has largely been transformed to accommodate students from poor and rural backgrounds. As a result, students requiring accommodation in the urban centres where universities are often based, has dramatically increased. During the COVID-19 pandemic these students effectively became mobile members of their households, returning home at various times and lockdown levels, potentially spreading the disease to relatively isolated areas. In addition, studies have consistently found that young people were more likely to be considered non adopters of the COVID-19 NPIs, partly due to the increase in risk taking behaviour associated with adolescence. In South Africa, the risk behaviour of young people is also of significant public health concern in the context of HIV/AIDS, teenage pregnancy, substance abuse and violence, this is compounded by the limited success of large research interventions. Yet, despite the acknowledgement of the need for specificity in designing youth targeted interventions, there has been little exploration of how and why South African adolescents adopt positive behaviours. Knowledge of which would be useful to better understand behaviour motivation and inform strategies for positive behaviour change. Aim This study aimed to gain an understanding of the factors influencing the adoption of the personal NPIs in response to the COVID-19 pandemic, among students at a University of Technology (UOT). Insight into these factors was used to develop guidelines to inform the design of targeted interventions to promote positive behaviour change by South African adolescents. Methodology This exploratory, qualitative study sought to understand behaviour change using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Eighteen student participants at a UOT were selected using purposive, maximum variability sampling. Each participant was interviewed individually via Microsoft Teams. Data was transcribed verbatim and analysed both deductively and inductively. Deductive analysis was guided by Theoretical Domains Framework which was developed to integrate with the COM-B model. Where possible, participant statements were coded to the appropriate domain, statements relevant to the aim of the study but did not align with the TDF domains which were inductively analysed using the Tesch approach to qualitative analysis and Braun and Clarke (2006) thematic approach. Findings This study found that NPI adoption among students evolved over time, closely aligned to the available published literature regarding NPI efficacy and WHO recommendations, but not necessarily aligned to or in compliance with government regulations. A notable exception was the reduced compliance when interacting with loved ones. In these circumstances, despite high levels of both the psychological and physical capability to perform the protective behaviours, the participants lacked the social opportunity and emotional motivation to do so. Notable factors that facilitated NPI adoption included trust in international health organisations, personal experience of COVID-19 and an altruistic desire to protect others. Factors that acted as barriers to NPI adoption included in-group trust, government distrust and social disapproval for adoption. The major themes that emerged included the need for autonomy in adolescent health decision making, the importance of social connection, the influence of social media, and the need to include young people in the development of targeted behaviour change interventions (BCIs). Conclusion This study contributes to the limited body of knowledge regarding the factors that served as barriers and facilitators to the adoption of positive health behaviours by South African adolescents in the context of the COVID-19 pandemic. These factors contributed to the development of guidelines which can be utilised by the relevant stakeholders when designing BCIs targeting this group.
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    A qualitative study on the treatment practices of complementary and alternative medicine practitioners in the treatment and management of Gastro Oesophageal reflux disease
    (2024) Naidoo, Ashadré; Couchman, Ingrid Marcelline Stephanie; Ducray, J. F.
    Background Gastro Oesophageal Reflux Disease is a digestive disorder that occurs when stomach acid frequently flows up into the oesophagus and irritates the oesophageal cell lining and damages the lower oesophageal sphincter. This condition is commonly known as Acid Reflux or Regurgitation, encompassing a range of different disorders such as dyspepsia and pyrosis and in some cases may cause difficulty swallowing. There may be a sour or bitter taste at the back of the mouth due to reflux of acid. Gastro Oesophageal Reflux Disease is difficult to treat successfully. Prolonged Gastro Oesophageal Reflux Disease leads to injury and inflammation of the oesophageal lining resulting in a condition known as Barrett’s Oesophagus, with complications such as oesophageal cancer, ulceration and stricture of the oesophagus. Gastro Oesophageal Reflux Disease is commonly seen in pregnant women and individuals with hiatal hernias that suffer from dyspepsia and pyrosis, it is also commonly seen as a side effect of medication and, more commonly, stress and anxiety related effects. Gastro Oesophageal Reflux Disease and other gastrointestinal disorders are caused due to stress related inflammation which occurs in patients with stressful lifestyles. Aim of study This study aimed to identify the possible therapeutic practices and management of Gastro Oesophageal Reflux Disease from diagnosis to treatment plans by various Complementary and Alternative Medicine protocols within the context of their philosophical backgrounds. Furthermore, this research study would document valuable information of six different Complementary and Alternative Medicine modalities. These modalities are Traditional Chinese Medicine, Ayurveda, UnaniTibb, Homoeopathy and Reflexology. Methodology The research methodology has utilized a qualitative design incorporating semistructured interviews of twelve Complementary and Alternate Medicine practitioners in the eThekwini area on their treatment of Gastro Oesophageal Reflux Disease. Interviews were done with each Complementary and Alternative Medicine practitioner at a place that was convenient to each practitioner. The interviews were recorded on a Dictaphone and a mobile audio recorder. Each interview was 30 minutes long and was guided by research questions. A stratified purposive sampling was implemented in order to select practitioners according to their modality in the provinces of South Africa exclusively. A pilot study was conducted to ensure trustworthiness and Ethics approval was sort from the Durban University of Technology Institutional Research Ethics Committee (IREC) Analysis of data utilized qualitative design methods that would produce themes and concepts from the information collected. Results The findings of this study showed that Gastro-oesophageal Reflux Disease can be interpreted by many Complementary and Alternative Medicine modalities according to different philosophies such as Miasms, Temperaments, Systemic Meridians and Doshas. Each Complementary and Alternative Medicine philosophy is governed by a set of factors that requires homeostasis to produce optimal health. Despite the various philosophical theories, all modalities were underpinned by the same principle that Gastro Oesophageal Reflux Disease is caused by a constitutional imbalance. This is characterized, in modern times, by inflammation, acidic build up, emotional and mental health and physical conditions, being understood as contributing factors of Gastro Oesophageal Reflux Disease, thus the theme of individualization was the key understanding in the treatment and management protocols. Each Complementary and Alternative Medicine modality prescribed well indicated herbal medicine in conjunction with lifestyle modification best suited for each patient individually. Management included therapies such as acupuncture, yoga, cupping and calming exercises. Furthermore, each modality “borrowed” medicines or therapies from other modalities in order to enhance the efficacy of the treatment and management of Gastro Oesophageal Reflux Disease. Conclusion It was concluded that Gastro Oesophageal Reflux Disease needs a multidimensional approach of treatment and management. Lifestyle changes, medication (herbs and remedies), stress management and dietary changes are needed to correct and manage Gastro Oesophageal Reflux Disease along with reducing or preventing the risk of complications that can manifest. Overall, the treatment and management through Complementary and Alternative Medicine modalities can improve the quality of life of patients with Gastro Oesophageal Reflux Disease. 7
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    A repertorial analysis of the homoeopathic remedies indicated in pica in pregnancy
    (2022-09-29) Kaneza, Nadia; Maharaj, M
    Introduction Pica refers to the consumption of non-food items or items with no nutritional value. This phenomenon is often seen among children, individuals with developmental disabilities and pregnant women. Pica has been extensively studied in children, but is understudied in pregnant women. This study focused on pica occurring during pregnancy, seeking to determine homoeopathic remedies that can be used in treating pica occurring during pregnancy. Aim of the study The aim of this study was to determine by repertorial analysis and explore the homoeopathic remedies indicated for treating pica during pregnancy. Methodology The study design of this study was two-fold: a qualitative investigation on pica experiences during pregnancy was carried out through interviews with 12 women who have experienced pica in their pregnancy. These women were sampled using the purposive sampling method. The analysis of this qualitative aspect followed Tesch’s eight step qualitative data analysis method. The experiences described by the participants were then subjected to a repertorial analysis using a homoeopathic repertory book called “Synthesis” of Dr. Frederick Schroyens. Remedies emerging from this repertorisation were then reviewed by use of materia medicas. Results Findings showed that for the majority of the participants, cravings for non-food items started in their first trimester and worsened in their third trimester as labour got closer. The results also revealed that geophagia was the most common form of pica practiced during pregnancy, followed by pagophagia. It was also revealed that iron deficiency or anaemia of some sort, as well as the smell, taste, texture and appearance of the craved substances, were highly linked to pica habits during pregnancy. The study also revealed that pica during pregnancy occurred with other pregnancy symptoms such as nausea, vomiting, headache, backache, etc, and that apart from non-food items, participants also craved food items, mostly sweet, sour and spicy food. Findings also showed that constipation (especially for those consuming geophagic items) and a sense of satisfaction, were the most common physical and emotional effects associated with pica practice during pregnancy. Still on the emotional plane, findings were that the most common emotional response that participants had with regards to the experience of pica during pregnancy was guilt and worry over their health and of their unborn children. The study also revealed that the majority of participants responded with anger to their loved ones who advised them against their pica habits. Finally, the repertorisation of the above experiences as described by the participants and the review of the emerging remedies revealed that Nux vomica and Alumina were the most suited remedies for pica occurring in pregnancy, followed by Sepia officinalis, Natrum muriaticum and Pulsatilla pratensis. Conium maculatum and Silicea terra were also shown to be good differential remedies for pica during pregnancy. Conclusion Of the homoeopathic remedies already in use for treating pica, some remedies such as Alumina, Nux vomica and Silicea terra, may also be used to treat pica specifically occurring in pregnancy. The study showed that there is a need to educate pregnant women about pica practice and raise awareness among pregnant women and their families regarding the harmful consequences that pica practice might have on both mother and baby.
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    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, Kira
    Background: 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.
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    Exploring the knowledge, attitudes and perceptions of Homoeopathy and the Ukuba Nesibindi Homoeopathic Community Centre (UNHCC) in the Warwick Junction community
    (2022-09-29) Gama, Khulu Khwezi Kwazi; Hall, Cornelia Maria; Ngobese, Brian
    Introduction The South African public healthcare system is maintained as an under-resourced and overburdened area of the economy. This has been further exacerbated by the COVID-19 pandemic which continues to be a source of concern. CAM usage has increased exponentially, with homoeopathy being the second- fastest growing medicinal modality globally. With that said, the assumption would be that homoeopathy is growing in acceptance and understanding. However, research indicates a moderate knowledge of homoeopathy in South African communities, particularly in African communities, which make up 80% of the total South African population. Aim of the study The aim of this study was to explore the knowledge, attitudes and perceptions held by the Warwick Junction community members towards homoeopathy and the Ukuba Nesibindi Homoeopathic Community Centre (UNHCC). This was to understand the notable lack of knowledge about homoeopathy and the UNHCC, which is the pioneering satellite clinic under the auspices of the Durban University of Technology, as well as factors influencing this lack of progress in knowledge, despite the increasing need for healthcare. Methodology A qualitative, explorative and phenomenological design was employed in this study. Qualitative research was considered the most appropriate method to collect primary data to ensure an in-depth understanding of the participants’ knowledge, attitudes and perceptions of homoeopathy and the Ukuba Nesibindi Homoeopathic Community Centre (UNHCC). This design also fostered freedom of expression without the hinderance created by a selection of responses as with a survey. Thirteen participants from the Warwick junction community were interviewed. Results It was discovered that 23% of the participants were familiar with homoeopathy and 45% understood the functioning of the UNHCC. Of the 23% that were familiar with homoeopathy, it was viewed as a natural but foreign medicinal modality and not well understood. Of the 45% that understood the purpose of the UNHCC facility, there was an understanding that the facility was reserved for HIV testing and counselling. The lack of knowledge regarding homoeopathy and the UNHCC can be ascribed to the lack of effective marketing of the facility, linked to commercial advertising legislations; the ambiguous nomenclature ’Ukuba Nesibindi’ and the physical location of the facility. The generally poor growth in knowledge of homoeopathy can also be attributed to the increase in conventional medicine through mass production of pharmaceutical drugs and polypharmacy for financial gain, with no parallel strategy evident in the distribution of CAM.
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    The knowledge, attitude and practices of registered complementary medicine professionals on the use of Complementary Medicine (CM) modalities for the treatment of autism
    (2022-05-13) Rasool, Tasfiyah; Couchman, Ingrid; Young, A.C.J.
    INTRODUCTION Complementary medicine (CM) practitioners are professionals who practice natural medicinal therapies. Complimentary medicine has been in existence from the 1700s. In recent times healthcare has shifted more towards natural medicinal therapies due to their known limited side-effects. Autism is a major neurodevelopmental disorder which is on the rise globally and the effects thereof are impairing to an individual’s everyday functioning. In South Africa and the world in general there is a lack of research in the field of autism and complementary medicine. Research specifically on autism is very scarce in South Africa (Pillay et al. 2020). Due to this lack of information, disorders such as autism are largely ignored, and the community then treat children who are autistic with disrespect and prejudice these children are often marginalised in the education sectors (Baraza 2019). The availability of information or education regarding the uses of complementary medicine for autism and other impairing neurodevelopmental disorders should be improved. This will be of great advantage to the autistic community and the healthcare professionals in the field. OBJECTIVE The first objective was to determine the extent of knowledge in the usage of complementary medicine for autism amongst practitioners registered with the Allied Health Professions Council of South Africa (AHPCSA). Another main objective was to establish the attitudes and practices related to usage of CM for autism. METHODOLOGY A quantitative descriptive survey was conducted in the form of a web-based questionnaire via GoogleDocs® to determine the knowledge, attitudes, and practices of registered complementary medicine professionals regarding the use of complementary medicine modalities for treatment of autism symptoms. The sample was obtained from the (AHPCSA) website and through organisations for the respective professions who are registered with AHPCSA namely: Aromatherapy Association of South Africa (AromaSA), Homeopathic Association of South Africa (HSA), South African Association of Chinese Medicine and Acupuncture (SAACMA) and South African Naturopathy Association (SANA). Complementary medicine professionals included were aromatherapists, homoeopaths, acupuncturists, and naturopaths. The data was analysed using frequency tables and bar charts in relation to categorical variables. Fishers exact test was used to analyse certain data. RESULTS One hundred and thirty-two online surveys were completed and used for analysis out of the expected 282 (a response rate of 46.8%). CONCLUSION This study concluded that complementary medicine professionals are very uncertain when it comes to their knowledge of complementary medicine for autism. However, Complementary medicine professionals’ attitude towards complementary medicine for autism seems to be positive. that Complementary Medicine could benefit autistic people and the practices of these Complementary Medicine Professionals seem to be showing good outcomes in the field of autism. The uncertainty in the knowledge of complementary medicine professionals shows a lack of information in the related field and the dire need to create more research and education in this field to create more usage of CM for autism.