Theses and dissertations (Health Sciences)
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Item Practice-related hygiene behaviours utilized by Chiropractors pre, during and post the COVID-19 pandemic in South Africa.(2024) Enslin, Jan-Frederik; Krishna, Suresh Babu Naidu; O’Connor, LauraBackground: The COVID-19 pandemic had an impact on the delivery of healthcare services worldwide. The Allied Health Professions Council of South Africa implemented regulations to control the spread of the virus, including social distancing, face masks/shields, hand sanitisation, surface disinfection, and protective shields. Chiropractors had to incorporate new hygiene measures to ensure the safety of their patients and themselves. Without adherence to proper hygiene protocols, manual therapy poses a substantial risk of transmission for both the practitioner and the patient. There is limited information available regarding the changes made by chiropractors to their practices in response to the pandemic and if these changed behaviours are still being implemented. Exploring and understanding changes in behaviour can help identify areas where chiropractors may need additional support or resources to adapt to new circumstances and can provide valuable information on how the pandemic has impacted the field of chiropractic care. Additionally, by studying how chiropractors adapted during the pandemic can help gain insight into best practices for future challenges or crises that may arise, as well as can help improve patient care and outcomes in the future. Aim: To determine the practice-related hygiene behaviours of chiropractors before, during and post the COVID-19 pandemic in South Africa. Methodology: An anonymous online survey was completed by registered Chiropractors in South Africa (n=119) registered with the Allied Health Professions Council of South Africa, having provided informed consent. The survey consisted of questions related to practice hygiene behaviours pre, during and post the COVID-19 pandemic and distributed via a link on QuestionPro®. The survey closed on 02/02/2024. Results: The study examined the distribution of hand and equipment disinfection in a healthcare setting, before and after the COVID-19 pandemic. The response rate for the survey was 22.45%. A total of 36% of chiropractors had been practicing for seven years and 60% lived in urban or major cities. Most practitioners returned to their work in level 4 of lockdown and practiced as a sole practitioner. The study found a significant statistical difference that sanitiser availability and the use of personal protective equipment were less prevalent before and after the pandemic than during the pandemic. Most chiropractors (78%) felt that the COVID-19 hygiene protocols made them more aware about practice hygiene behaviours. However, 30% of chiropractors believed they were likely to contract COVID-19 if they did not adhere to proper hygiene practices. Barriers to implementing hygiene practices during COVID-19 included patient reluctance, lack of time, resources and difficulty in adhering to hygiene practices. Half of the chiropractors agreed to continue with good hygiene practices post COVID-19. Conclusion: The COVID-19 pandemic resulted in increased adherence to practice related hygiene behaviours with the implementation of safety precautions such as protective screens and face masks. Many of the chiropractors continued to utilise these behaviours after the pandemic.Item 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.Item The effects of the Covid-19 pandemic on the mental health of the chiropractic students in South Africa(2024) Strydom, Danica; Varatharajullu, Desiree; Van Heerden, KirstenBackground: The SARS-CoV-2 pandemic has had an impact on tertiary education, especially the practical courses, such as Chiropractics. Learning platforms were moved online and exposure to practice, such as clinic interactions, was limited. Aim: To determine the effect of SARS-CoV-2 on the mental health of Chiropractic students in South Africa Methodology: A QuestionPro® survey link was sent to Chiropractic students registered at Durban University of Technology and the University of Johannesburg. A total of 187 students completed the survey and the data were captured for statistical analysis. Statistical analysis was performed using Microsoft Excel Spreadsheet Software. Result: Of the 187 who responded, 60.10% expressed discomfort if individuals did not wear masks and 73.4% reported they experienced conflicts due to prolonged time spent with household members in limited personal space. The pandemic also had personal effects, such as 69% reported having reduced productivity, 42% increased financial difficulties, 50% decreased physical activity, and 80.85% spending more time on social media. They reported these challenges had detrimental effects on mental health, including increased anxiety (92.02%), difficulties in thought control (75.5%), withdrawal from social interactions (80.32%), decreased motivation (90.96%), and concentration issues (89.89%). A portion of the students (43.62%) experienced a decline in academic marks. Conclusion: The SARS-CoV-2 pandemic lockdown had a negative effect on the majority of Chiropractic students, especially in terms of their academic progress, mental health, social and personal functioning.Item Operationalisation and implementation experiences of the coronavirus disease 2019 (COVID-2019) response guidelines by nurse managers at selected private hospitals in KwaZulu-Natal, South Africa(2023-05) Raghunath, Shamintha; Naidoo, Vasanthrieackground The Coronavirus 2019 (COVID-19) pandemic is a complex global public health crisis presenting clinical, organisational and system challenges. In any healthcare organisation, management and leadership are key components and enablers of change for the delivery of health services. The uncertainty of the pandemic, emotional turmoil in the face of death and dying together with unfamiliar directives and the adoption of unaccustomed work practices has posed challenges in the work environment. The challenges of responding to COVID-19 national imperatives, such as response guideline adherence and preparation of vaccination rollouts has demanded meticulous coordination and control by all Nurse Managers. Furthermore, the role and functioning of the Nurse Manager as a change agent, during the pandemic, has undoubtedly determined the effectiveness of the COVID19 risk mitigation strategies at an operational level. Aim of the study The aim of the study was to explore the experiences of Nurse Managers regarding the operationalisation and implementation of the COVID-19 Response Guidelines. Methodology The study was guided by a qualitative research design, using an exploratory, descriptive approach. This approach enabled the researcher to explore the experiences of Nurse Managers regarding the operationalisation and implementation of the COVID-19 Response Guidelines. Data was gathered through individual interviews from the study population based at two hospitals of different private hospital groups in KwaZulu-Natal, South Africa. Data saturation was achieved after interviewing 13 participants. The study was guided by Carl May’s Normalisation Process Theory and Creswell’s six steps of data analysis was utilised for content analysis and themes in this study. Findings Findings revealed three (3) major themes and associated sub-themes. Whilst management and leadership of Nurse Managers were constantly challenged, they appeared to lead by example, often placing themselves at the frontline. This study has revealed that leadership, during the pandemic in the health care sector, moved beyond just the recognition of the leader as a change agent. Their behaviors and approaches led these nurse leaders to effectively improvise and respond to the crises in the field of health care service delivery during disaster management. Furthermore, their shared vision, commitment and resilience ensured effective navigation during the COVID-19 pandemic.Item Experiences of non-critical care trained professional nurses deployed to work in the intensive care units during the Coronavirus 2019 (COVID-19) pandemic(2023-05) Sivnarain, Rena; Naidoo, V.; Zikalala, Nomusa PeniccaBackground South Africa has been greatly affected by the Coronavirus Disease 2019 (COVID19) pandemic causing a crippling effect on the country’s healthcare system as it was not adequately prepared in terms of staffing, equipment and disaster planning. Due to the nature of the COVID-19 outbreak and subsequent mitigation plans, nonspecialist nurses were deployed to the intensive care units (ICUs) to assist with patient care, control sophisticated therapeutic assist devices and assume multiple roles that were beyond their scope of practice. Aim of the study The aim of the study was to describe the experiences of non-critical care trained nurses, deployed to work in the ICUs during the COVID-19 pandemic, at a private hospital in the KwaZulu-Natal region. Methodology A qualitative, descriptive design guided the study. Fifteen non-critical care trained nurses were purposively sampled and interviewed using a semi-structured interview guide. Audio-recordings were transcribed verbatim and analysed using Braun and Clarke’s (2006) thematic analysis framework. Findings The experiences of non-critical care trained nurses deployed to work in the ICUs during the COVID-19 pandemic yielded four main themes, namely, deployed nurses working in an unfamiliar environment; nurses lack of ICU experience, skills and knowledge; the lack of supervision, mentorship and leadership for the deployed nurses and the psychosocial impact of the deployment of nurses to the ICUs during the COVID-19 pandemic. Conclusion Nurses deployed to work during the COVID-19 pandemic endured overwhelming responsibilities while they provided care to the critically ill and infected patients in the ICU. These roles were executed without proper intensive care training, qualification, skills and leadership. Thus, there is a dire need for disaster management training for all staff, especially nurses in the healthcare setting. Supervision, peer-mentorship and support systems such as counselling should be readily available during disaster management.