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 Radiation therapists’ experiences of disruptions in radiotherapy service delivery during the Covid-19 pandemic at public oncology hospitals in KwaZulu-Natal, South Africa(2024) Tshoke, Lesego; Nkosi, Pauline BusisiweBackground The novel coronavirus (COVID-19) rapidly impacted all human life following its escalation to a pandemic status in early March 2020. This viral pandemic severely affected the world’s developed and developing countries, resulting in disruptions within healthcare delivery systems, including radiotherapy. Although the government guidelines and restrictions to mitigate the risk of viral transmission were implemented, radiotherapy departments were amongst multiple departments forced to promptly adjust in order to encourage continuous clinical care. However, to provide this service, radiation therapists work closely together and in close proximity to their patients. These inherent working conditions resulted in changes in the number of treatments for some patients, clinical working patterns and conventional radiotherapy practice during the pandemic era. This challenge was faced by numerous radiotherapy departments globally, hence there is a need to explore how radiation therapists in South Africa coped to ensure continuous clinical service delivery. Aim The aim of this study was to explore radiation therapists’ lived experiences of the COVID-19 pandemic disruptions on their radiotherapy service delivery at public oncology hospitals in the KwaZulu-Natal (KZN) province, and ultimately recommend strategies to support them to cope with the changes due to the pandemic. Methodology To conduct this research, the researcher employed a constructivist paradigm and a qualitative phenomenological approach. Criterion purposive sampling was used to select two public oncology hospitals, whereby the critical case sampling selected a radiotherapy manager as well as simulator, planning and treatment machine radiation therapists from each to constitute a minimum sample size of ten. Findings The study interview data was analysed using Colaizzi’s Seven-step Method of data analysis to identify themes which were then presented as findings. This resulted in four major themes that revealed the radiation therapists’ common narrative during the COVID-19 pandemic as: Changes in hospital settings, working conditions, radiation therapists’ practices and wellbeing; barriers to radiotherapy service delivery; facilitators to radiotherapy service; and support needed. Conclusion and recommendations In exploring radiation therapists’ lived experiences of disruptions in radiotherapy service delivery in a developing country such as South Africa, there can be strategies that aid in supporting radiation therapists to continue providing clinical service delivery. As part of the recommendations to attain this, the study brought forth managerial training, similar study conduction to validate study, interviewing of patients, psychological support to employees concerned, educational programmes for both patients and employees, remote treatment planning for radiation therapists, as well as routine screening for concerned employees.Item The prevalence, selected risk factors and burden of primary headaches in lecturers at a University of Technology (UoT) in KwaZulu-Natal during the COVID-19 pandemic(2024) Chetty, Deidre; Orton, Penelope Margaret; O’Connor, LauraBackground: Headaches are a common disabling condition that affect many people worldwide. Headaches have been under-studied in developing countries and there is a paucity of literature documenting headaches in lecturers. The COVID-19 pandemic has forced lecturers to adapt to online teaching, which may have resulted in headaches. It is envisaged that this research will be beneficial to chiropractors, other healthcare providers and lecturers. Aim of Study: The aim of this study was to determine the prevalence, selected risk factors and burden of primary headaches in lecturers at a university of technology (UoT) in KwaZulu Natal during the COVID-19 pandemic. Methodology: A quantitative, descriptive cross-sectional design, where 685 lecturers employed at the Durban University of Technology, through self-selection, were selected to participate, using consecutive sampling. A minimum sample size of 247 was calculated, using a confidence level of 95% and confidence interval of 5%. Lecturers from all six faculties were invited to participate. The headache-attributed restriction, disability, social handicap and impaired participation (HARDSHIP) questionnaire was administered electronically via QUESTIONPRO®. Each participant was required to initial a consent form prior to answering the questionnaire. The diagnostic algorithm was utilised to diagnose headaches according to the diagnostic questions in the HARDSHIP questionnaire. All data were captured on an Excel spreadsheet and subsequently analysed using SPSS version 28. Results: There was a total of 255 completed questionnaires. The mean age of respondents was 45.66 years old. Of the total sample (n=255), 51.8% were headache sufferers. Most respondents suffered from probable tension-type headache (41.9%; n=54), followed by migraine-type headache (27.9%, n=36). Social risk factors revealed a significant relationship between alcohol and headaches, and sleep deprivation and headaches. Medial risk factors revealed a significant relationship between a head injury and headache and sinusitis and headache. Although there was a relationship between psychological risk factors and headache, it was not significant. Many work-related risk factors were significantly related to headache. There was a greater number of headache sufferers who tested positive for COVID-19. Many respondents experienced loneliness and their workload increased during the pandemic. Most of the respondents’ headaches interfered with work, and they usually took medication to treat their headache. Conclusion: Headaches are common in lecturing staff with, tension type headaches being most prevalent. There are many risk factors which are strongly associated with headaches and its impact caused an interference with work and negatively affected the suffers mental health. Family, social or leisure activities are also neglected when a headache occurred. This study adds to the current literature on headache prevalence in the lecturer population and increases awareness.Item Experiences of healthcare workers as patients during the Covid-19 pandemic at a private health facility in the uMgungundlovu District, KwaZulu-Natal(2023-05) Beekrum, Reshnee; Ghuman, Shanaz; Naidoo, VasanthrieBackground By understanding patient experiences of healthcare workers during the COVID-19 pandemic, can help the healthcare delivery system prepare and educate healthcare workers on the needs of patients both physical and psychological. Also how to deal with the stresses and reactions to a global pandemic. The effectiveness of care is dependent on the quality of the care delivered by the care providers. Healthcare workers influence the outcome of the treatment not only through their technical expertise, but also the psychosocial support. A patients’ experience during the COVID-19 pandemic has a lasting impact on the patient as well as their family. Being a COVID survivor post hospitalization, patients often experienced a “new lease on life”. Healthcare workers since the start of the pandemic tried to “dodge the bullet” by taking all precautions not to get infected by the virus. A change in attitude and approach is evident following COVID infection. Feelings are charged with gratitude; which shapes the patients’ beliefs. The researcher aims to illustrate that the patients’ experiences of healthcare workers will shape the delivery of healthcare and their practices on return to work. Specific measures can be implemented to support patients and their families during the pandemic. Also the researcher hopes that this study will improve the delivery of care and mould the organisations’ culture by being proactive agents of change. Aim of the study The aim of the study was to explore the experiences of healthcare workers as patients during the COVID-19 pandemic at a private healthcare facility in the UMgungundlovu district, KwaZulu-Natal. Methodology The research study employed a qualitative design, which used and exploratory descriptive approach. This allowed the researcher to explore the patient perceptions and experiences of healthcare workers during the COVID-19 pandemic at a private health institution. The explorative descriptive studies are studies that are conducted with the purpose of detailed exploration and describing the topic of inquiry, and addresses the problem that is in need of a solution. Qualitative research design is an investigation phenomenon. This rich data is obtained through a flexible research design. The study population included fourteen (14) participants who were admitted at the healthcare facility and who worked at the private hospital. The study participants ranged from clinical to non-clinical staff. It is noted that a descriptive research approach is used to develop a multi dimensional picture of the problem, which involves reporting from multiple perspectives. Data saturation was achieved after interviewing twelve (12) participants. The method used drew on the theories of Maslow’s hierarchy of needs model. Findings This study investigated the experiences of healthcare workers, as patients during the COVID-19 pandemic, at a private health facility in the UMgungundlovu District, in KwaZulu-Natal. The study drew on the theoretical framework of Maslow’s hierarchy of needs. This motivation theory related to the basic human needs of man during the wellness continuum. Following the participant interviews the data analysis revealed three (3) major themes and sub-themes for the healthcare workers who were patients. The study revealed the basic need for physiological and safety needs; and psychological needs for belonging and social security. While some participants fully recovered from the virus, others still experience long COVID and post-traumatic stress. Conclusion A lack of understanding of patient’s experiences, influences patient’s safety, patient engagement and patient outcomes. Despite the barriers during the COVID pandemic; it appears that going back to basics of care was vital. By understanding patient experience, a key step in moving toward patient-centred care is possible. By evaluating patient experience along with other components such as effectiveness and safety of care is essential to providing a complete picture of health care quality and delivery.Item Reconstructing wellness among Australian families transitioning through the COVID-19 pandemic(2023-05-31) Dorasamy, Jirushlan; Bhagwan, RaisuyahThere is a general understanding that wellness is a holistic, multidimensional concept, encompassing various aspects of human life, which complement one another. Studies have found different key dimensions that make up wellness. However, this study limited itself to the following eight dimensions - occupational, emotional, spiritual, environmental, financial, physical, social, and intellectual at the interface of Australian families transitioning through the COVID-19 pandemic. These eight usually surface in many other studies. Given the lack of empirical research related to family well-being, the study sought to explore how family wellness was affected in a multidimensional way within the COVID-19 pandemic and tried to understand how family life may be reconstructed in light of the stressors relating to the wellness dimensions that have been brought to bear upon these families. Hence, a qualitative approach was deployed as the study became inquiry grounded. Thus, it was conducted through semi-structured interviews in which the researcher interrogated the lived experiences and perspectives of families based in Melbourne, Australia. A non-probability/convenience sampling approach was used to recruit 12 families until saturation was reached. The collected data was analysed by classifying the identical narratives through thematic analysis and the results showed that COVID-19 negatively impacted all eight wellness dimensions used to assess family wellness during the pandemic. The key findings show that some of families suffered job losses and business shutdown, while many families experienced heightened psychological and mental effects. Equally, the closure of religious centres contributed to feelings of hopelessness and loss of direction, while household domestic waste increased due to families working and schooling from home. Families experienced financial instability; and physical activities were disrupted which contributed to weight gain. In addition, the families experienced social isolation, while their intellectual wellness was compromised due to limited access to learning materials. Nevertheless, the families managed to create pathways to circumvent the constraints imposed by the lockdown among which included maintaining connections with family friends and colleagues; working from home; controlling expenditure; managing work-life balance; engaging in indoor exercises and outdoor activities within the social isolation mandates; observing conservation practices, showing altruistic behaviour, and playing games/online reading and viewing. The pathways of wellness pursued by families illustrated the connectivity between the wellness dimensions and the moderating influence of wellness support programmes. The critical finding of this study revealed that the support structure provided by families has a major effect on how the families reconstructed and maintained their wellness during the pandemic, and thus the family-centric support system was recommended in this study. Based on the analysed information, the study put forth a wellness framework for consideration. This study will contribute to the growing research on the COVID-19 pandemic, by exploring its influence (COVID-19) on family wellness, as well as contribute to the awareness and understanding of pandemics and their effect on family wellness. The study is also expected to contribute both locally and globally in shaping strategies and policies to mitigate the negative effects of the pandemic in relation to wellness and ensure that family life is restored and preserved immediately afterwards. Furthermore, the research highlighted diverse holistic approaches as alternative methodologies in preserving and reconstructing family life regarding wellness across the eight dimensions. These were considered in a recommended wellness frameworkItem Upper body musculoskeletal pain associated with remote working of academics at the Durban University of Technology during the COVID-19 pandemic(2022-09-29) Narainsamy, NeviniaBACKGROUND The world-wide pandemic COVID-19, which initiated international lockdowns and varied degrees of work considerations, enforced remote working to reduce the spread of infection. Ergonomic support for effective remote working during this rapid transition received little consideration. Musculoskeletal disorders (MSDs) associated with musculoskeletal pain (MSP) are frequently linked to poor ergonomic support at the workplace and compromises the quality of life of those affected. MSP may be aggravated by prolonged, repetitive, and awkward movements, poor posture and ergonomics, or a fast-paced workload. Additionally, the onset of upper body MSP contributes to workrelated MSDs, resulting in decreased work productivity. It is believed that the current shift to remote working may result in an increase in MSP. This study, therefore, aims to determine the prevalence and effects of upper body musculoskeletal pain (head, neck, shoulder and back) associated with the ergonomic changes of remote working during the current COVID-19 pandemic. OBJECTIVES 1. To determine the prevalence of musculoskeletal pain among those working remotely during the COVID-19 pandemic. 2. To determine the selected risk factors predisposing to upper body musculoskeletal pain as an ergonomic effect of remote working. 3. To identify the extent to which remote working has impacted the occurrence of musculoskeletal pain with particular reference to ergonomic aspects. 4. To determine the effects of musculoskeletal pain and its impact on work performance/productivity. 5. To provide guidelines/recommendations and future considerations to support the prevention of MSP during remote working. METHOD A quantitative, descriptive cross-sectional study was conducted on all Durban University of Technology (DUT) academic staff members, to obtain relevant data regarding the onset of musculoskeletal pain and ergonomical factors, whilst working remotely during the COVID19 pandemic. Data were collected through the use of an online questionnaire, administered through DUT’s electronic platform. The Dutch Musculoskeletal Questionnaire was adapted to focus more on ergonomics and working remotely. Descriptive statistics were used to provide summarised questionnaire data. All data were analyzed using the IBM SPSS version 25 software package. Bivariate analyses, such as the Pearson’s chisquared test, ANOVA, and T-tests, where appropriate, were done. A p<0.05 was considered statistically significant. Findings of similar studies, both locally and internationally, provided generalised and more contextualised recommendations related to the ergonomic effects of working remotely. RESULTS In summary, 87.2% of participants reported to having musculoskeletal pain (MSP) prior to COVID-19. However, there was a massive increase in MSP while remote working, with 81.8% of participants reporting MSP during COVID-19. A great number of academic staff members (52.7%) reported to have worked remotely and having suitable equipment (59.1%) to facilitate remote work. With a reported increase in workload (89.1%), there was also an increase in productivity (53.6%). The most severe location of pain while remote working was the back (25.5%). Ergonomic factors that were noteworthy were that 64.5% participants sat without their back supported; shoulders were not relaxed in neutral (68.2%); wrists were not in a neutral position (51.8%) and the neck was not in a neutral position while remote working (63.6%). These factors remained consistent before and during COVID-19, indicating a minute change in the statistical significance of ergonomic factors. The p-value was less than 0.001. Regarding the emotional states of the respondents, it has been revealed that there was an association between the emotional status before and during COVID-19. All corresponding p-values were less than 0.001, indicating a statistically significant relationship. CONCLUSION The COVID-19 pandemic has placed unprecedented pressures on governments, economies, and families, posing what many observers consider the largest global peacetime challenge since the Great Depression a century ago. In South Africa, the government moved swiftly after the first confirmed case of COVID-19 on 5 March 2020, which subsequently led to a national lockdown by 27 March 2020. This placed huge challenges on the population, especially for the poor and those working from home. The exponential rise in COVID-19 infections rapidly transformed how and if people would return to the traditional way of working. Working from home during the nationwide lockdown led to poor quality of work and a lack of efficiency, which ultimately led to poor work productivity. Many employers worldwide chose to protect both the health and job security of their employees by implementing remote working. The average household lack the components of a functional office setup such as a simple desk and good quality chair. This consequently predisposed many to work hunched over coffee tables or on kitchen stools without proper neck and back support. It is possible that many working individuals will emerge with increased incidence of MSP after the coronavirus crisis. Ergonomic support for effective remote working may have been ignored amidst the more disastrous effects of the pandemic, but the crisis becoming a major contributor to an increased onset of MSP. This is likely to remain as the norm, even after the shifting of lockdowns, for millions of workers. The adverse effects of the pandemic thus appear to extend beyond its direct consequences into an increased onset of ergonomical concerns that warrants some investigation. This study therefore aimed to determine the prevalence and effects of upper body (head, neck, shoulder and back) musculoskeletal pain associated with ergonomic changes experienced with remote working during the COVID-19 pandemic. It is hoped that the results of this study will inform interventions to redress such effects in remote working climates.