Theses and dissertations (Health Sciences)
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Item Perception of chiropractic students in their preparedness in the diagnoses and management of headache disorders at a selected University of Technology(2024) Abrahams, Tamia; Abdul-Rasheed, AshuraA headache is defined as “pain found in the head above the orbito-meatal line and or nuchal ridge” and widely affects both males and females globally. Chiropractic treatment and the management of headaches is substantial, with one in five new patients’ chief complaint being a headache and, thus, the use of chiropractic care in the management and treatment of headaches is popular. The term “self-perceived preparedness” refers to how people view themselves in terms of confidence and competency with regard to certain skills. Self-perceived preparedness is essential as it relates to one’s confidence and the ability to accurately diagnose and manage headache disorders. There is a definite scarcity in South African literature as to the self-perceived preparedness of students in the diagnosis and management of headache disorders. In a South African chiropractic context, the literature, with regard to students’ confidence, awareness and self-assessment of skills is lacking. There are a number of advantages that can come from exploring the concept of self-perceived preparedness. The benefits include, but are not limited to, the assessment of whether or not the curricula goals have been achieved, the readiness of chiropractic students to confidently and correctly diagnose and manage patients sufficiently, and the different aspects that can lead to one feeling unprepared. Aim The aim of this study was to explore and describe the self-perceived preparedness of the chiropractic students’ in the diagnosis and management of headache disorders. Methodology This study design employed a qualitative, explorative and descriptive design. Purposeful sampling was utilised and individual, semi-structured interviews were conducted with 13 Master’s degree students in the chiropractic programme. These interviews took place “in person” and an interview guide was utilised in each interview. The interviews were conducted over a week from the 18th to the 23rd of September 2023. The questions surrounded the topics of self-perceived preparedness, confidence, challenges (whether educational or personal) and the effect of clinical exposure on one’s confidence and skills. The interviews were analysed and themes were extracted utilising Tesch’s eight-step approach of data analysis. Results The chief themes that emerged from the data collection included the level of preparedness, educational and environmental challenges, as well as the positive role that clinical exposure had on students’ views of their self-perceived preparedness. The participants felt largely unprepared to deal clinically with headache disorders. This stemmed from the feeling of isolation within academia, lack of support from staff and clinicians, lack of practical aspects within the curriculum and the COVID-19 pandemic, which resulted in a lack of in-person interaction. Conclusion The findings of this study highlighted the lack of confidence and feeling of under-preparedness to deal with headache disorders within a clinic setting by chiropractic Master’s students. This was mainly attributed to educational and environmental challenges. However, the exposure students gained within a clinical environment greatly improved their feeling of overall self-perceived preparednessItem The perceptions and knowledge of environmental health practitioners in ensuring health and safety in communities in the King Cetshwayo District, KwaZulu-Natal(2023-05) Sibiya, Mayenziwe Sanele; Ghuman, Shanaz; Naidoo, V.Background The role of Environmental Health Practitioners (EHPs) is essential in public health as it focuses on preventing harm to the communities through promoting health and well-being in populations. The EHPs must be within the reach of communities and available to serve and protect against health threats. Research has shown that there is a link between the availability of resources, support from communities and the success of the EHPs in their role. EHPs are under pressure to cover all areas allocated to them, however, the downfall is the insufficient numbers of EHPs to cover all these large areas. This has led to poor reporting back to communities and EHPs sometimes being labelled as unknown. Aim of the study The aim of the study was to explore the knowledge of the EHPs related to their working environment in public health facilities in King Cetshwayo District. Methodology An exploratory descriptive design, utilising a qualitative approach was used to guide the study. Data was collected through one-on-one interviews from nine (9) EHPs based in King Cetshwayo District in Kwazulu-Natal. Data was analysed using Tesch’s eight-step open coding. Findings Exploring this topic provided a better understanding of the shortcomings and achievements of the EHPs in their roles when ensuring health and safety in the public health sector. Understanding the gaps and challenges allowed for the suggestion of strategies to better equip and support the EHPs in fulfilling their roles in the community effectively Conclusion The results of the study showed that health education is the mainstay of the role of the EHP in ensuring health and safety. Equipping the community with knowledge of health and safety assists in achieving the duties of an EHP. The EHPs have a duty to protect the community against any physical, chemical, or biological hazards. Their role is somehow underrated as they must work with insufficient resources and sometimes little support. This has led to demotivation and job dissatisfaction.Item Leadership practices of nurse unit managers at a selected private hospital group in eThekwini District, KwaZulu-Natal(2022-05-13) Ngcobo, Thobani Patrick; Sibiya, Maureen Nokuthula; Naidoo, VasanthrieLeadership has become an important aspect of management practice in the changing health care environment. As health care organisations restructure to meet the demands for accessible, efficient, safe and affordable health care, nurses in management roles are under constant pressure to develop new skills and strategies to meet the challenges that accompany system change. Research has shown links between leadership styles in nursing and nurses’ job satisfaction, job retention, quality of care, and hospital costs. Nurse Unit Managers (NUMs) as first-line leaders have a responsibility to induce changes in the clinical or work environment, calling for their active participation in the development of healthcare policies and strategies. Aim of the study The aim of the study was to explore the leadership practices of NUMs that allow them to achieve success in their leadership roles. Methodology A qualitative design guided the study and data was gathered through one-on-one, in-depth interviews from NUMs based at a private hospital group in the eThekwini District in KwaZulu-Natal. Findings Exploring this topic provided an understanding of the current gaps in leadership in the nursing sector; in particular, to the private healthcare industry. The understanding of the challenges makes it possible for the suggestion of strategies to assist and meet the needs of future NUMs with regard to leadership roles. Conclusion Research findings showed links between leadership styles in nursing and nurses’ job satisfaction, job retention, quality of care, and hospital costs. Whilst, NUMs as first-line leaders have a responsibility to induce changes in the clinical or work environment, their roles and functions have been somewhat stifled as they have had to function with limited resources and constraints. This has led to decreased levels of job satisfaction, further limiting growth or enhanced professional roles.Item Perceptions and management of paediatric allergies amongst registered homoeopathic practitioners in the greater eThekwini area(2021-12-01) Pillay, Suvanya; Hall, Cornelia MariaPaediatric allergies in South Africa are of significant concern in respect to the recent increase in prevalence, aetiologies, clinical presentation, diagnosis, treatment, and management thereof. The perceptions and management of paediatric allergies amongst registered Homoeopathic practitioners in the greater eThekwini area were of significance in understanding and improving the current knowledge of these from a Homoeopathic perspective. Furthermore, the study provided reliable data in support of the prescription and usage of Homoeopathic treatment. No study on the Homoeopathic treatment and management of paediatric allergies in eThekwini had been conducted. In conducting such study, it expanded the literature of paediatric allergies from a Homoeopathic perspective for the benefit of the researcher, Homoeopathic bodies, parents and caregivers, and the general public. Furthermore, it intended to advocate the use of Homoeopathy as the primary healthcare intervention and first line of treatment for paediatric allergies and associated conditions. The study aimed to explore the perceptions and management of paediatric allergies amongst registered Homoeopathic practitioners in the greater eThekwini area with regards to aetiologies and clinical presentation as these presented in practice, and the diagnostic approaches, and treatment and management protocols that they followed. METHODOLOGY An explorative, qualitative design was employed to conduct the research study amongst a minimum of 12 Homoeopathic practitioners who fulfilled an inclusion criteria, or until saturation of data via questioning was achieved. Interviews were conducted at the respective participants’ consultation rooms located in the greater eThekwini area and captured via audio-recordings. Data was analysed under the supervisor’s guidance, and Tesch’s 8-step procedure of data analysis was applied, from which themes and sub-themes were formed. RESULTS Following data analysis, 4 main themes and their sub-themes were formed, namely knowledge of paediatric allergies with regards to aetiologies, types, and signs and symptoms; diagnosis with regards to clinical presentation and blood tests; multidisciplinary care with regards to referrals and approach to conventional treatment; and treatment and management protocols from a Homoeopathic, nutraceutical, dietary, and educational approach. CONCLUSION Homoeopathic practitioners share mutual perceptions and general knowledge of paediatric allergies in spite of limited professional training of allergies that is available to them. Their expertise and knowledge within their capacity was nevertheless trusted by concerned parents or caregivers to accurately identify, diagnose, treat, and manage a suspected allergy as per their patient’s totality of symptoms. Furthermore, to flatten an allergic tendency with indicated Homoeopathic treatment and appropriate adjuncts so as to prevent any possibility of a subsequent allergy. However, practitioners ought to consider the possible impact of elimination diets on their patients and families, as nutritional deficiencies, malnutrition, emotional stress, and financial expense are all causes of concern. Further clinical evidence is required to advocate them, for which practitioners may consider in their diagnostic, treatment, and management protocol. While Homoeopathy was not the primary option of treatment for their patients’ allergic conditions and concerns, it nevertheless remains a successful modality of CAM for the treatment thereof.Item An investigative documentation of the homoeopathic management of diabetes mellitus type 2 in KwaZulu-Natal(2020-11-30) Moodley, Nivania; Maharaj, M.; Alwar, VanishreeDiabetes mellitus, or commonly known as diabetes, is a chronic condition that manifests when the pancreas can no longer produce insulin or when the body is unable to utilise the insulin that the pancreas produces. In diabetes mellitus type 2, patients commonly affected are middle aged adults. Prior to diagnosis there is an asymptomatic stage classified as prediabetes. During this stage there is mild hyperglycaemia, insulin resistance and an early decrease in insulin secretion. Diabetes mellitus type 2 is a growing concern among the Black and Asian community in South Africa, more so affecting the high density of the abovementioned race groups in the KwaZulu-Natal Province. According to a recent investigation conducted (Brown et al, October 2015) in 2014 it was recorded that the KwaZulu-Natal Province had 1,288,973 diabetic patients registered in governmental health schemes. According to an article published on the National Health portal of India, Homoeopathy has had a positive role in the treatment and management of early diagnosed diabetes mellitus cases (Das 2016). Although at present there is no standard protocol for the Homoeopathic treatment and management of diabetes mellitus Type 2, Yoga, Naturopathy and homoeopathic remedies are among the many holistic methods utilized by homoeopaths. The main priority is to first control the elevated blood sugar levels to save the patient from life threatening complications. This is often done by prescribing homoeopathic remedies that could reduce the blood sugar levels. Aim The aim of this qualitative study is to determine the homoeopathic management of diabetes mellitus type 2 in the KwaZulu-Natal Province Methodology A study paradigm of qualitative, descriptive and exploratory design was employed in this study. Qualitative methods were selected for this study to gain an in-depth view of the methods homoeopathic practitioners use to manage type 2 diabetes in their patients. The population for this study included a minimum of 10 homoeopathic practitioners all of whom were registered with the Allied Health professions Council of South Africa (AHPCSA) and were practicing in KwaZulu-Natal for a minimum of 5 years (in private practice), selected through purposive sampling. The data collected was analysed using Tesch and Creswell’s methods of analysis. Results The results showed that the homeopathic management of diabetes mellitus type 2 involved indepth case taking and analysis with individualization of each case. Practitioners were involved in the health and well-being of their patients and put emphasis on patient education. Some of the ways in which practitioners managed diabetes mellitus type 2 in their practices included prescription of a constitutional remedy attained through thorough case taking, phytotherapeutic modalities, nutrition advice and referrals to specialist practitioners when necessary Conclusion In light of the results and discussion shared in Chapters 4 and 5, the main aspects of the homoeopathic management of Diabetes mellitus type 2 consist of full case taking and analysis by the practitioner, leading to a constitutional prescription for the patient. The findings in this study reveal that, unlike in allopathic treatment, there is no one specific remedy or group of remedies that are the first point of treatment for a patient seeking homoeopathic care. The management process is a very tailored and individualized method of treatment that considers the patient in their entiretyItem The management of non-musculoskeletal disorders by chiropractors in the eThekwini District(2020-06-10) Pillay, Janice; Van der Meulen, AnthonyBACKGROUND: The management of non-musculoskeletal disorders (NMSDs) by chiropractors is gaining more popularity among patients who are leaning towards complementary and alternative medicine (CAM) to optimise their health. Patients are made aware that chiropractors offer care holistically, rather than solely treating musculoskeletal disorders (MSDs). However, due to the paucity of evidence-based research in the chiropractic management of NMSDs, it is unclear whether chiropractors are actually treating the source of a NMSD or merely providing symptomatic relief of NMSDs. The study’s objectives was to determine the types of NMSDs presenting to chiropractors in the eThekwini District; the management protocols of chiropractors for NMSDs and the association between selected demographic characteristics of chiropractors (e.g. age, gender, qualification, institute of study, number of years in practice, philosophical orientation) and the management of NMSDs. AIM: To determine the nature and extent of the management of NMSDs by chiropractors in the eThekwini District. METHODOLOGY: The study was designed as a cross-sectional survey-based study with a quantitative paradigm. Information was obtained through questionnaires completed by registered chiropractors practicing full-time and part-time in the eThekwini District. A prevalidated questionnaire was adapted for this study. Outcome measures included the frequency of NMSDs being treated by chiropractors as a primary and as a secondary complaint; patient demographics of those who presented to the chiropractor with NMSDs, the chiropractor’s management protocols utilised to manage NMSDs and the association between the chiropractors’ demographic characteristics and the choice of management methods of NMSDs. A focus group was held, followed by a pilot study to determine the validity of the questionnaire. A total of 73 chiropractors returned completed questionnaires with a response rate of 82%. The data was then coded on a Microsoft Excel spreadsheet and transferred to SPSS for statistical analysis. RESULTS: Seventy-three of 89 chiropractors responded. The primary NMSDs garnering the greatest positive ratings include headache of NMSK origin (89%), infantile colic (80.8%), dizziness (67.1%), vertigo (61.6%), sinus-related disorders (58.9%) and tinnitus (54.8%). Of the secondary NMSK complaints, headache (82.2%), dizziness (72.6%), constipation (68.5%), sleep disorders (64.4%), fatigue (63%), sinus-related disorders (61.6%), vertigo (57.5%), bowel disorders (56.2%), infantile colic (52.1%) and tinnitus (52.1%) were the most frequent NMSDs with symptomatic improvement, following treatment of MSK conditions seen by participants. For the management of primary and secondary NMSDs, the most common treatment modalities reported were auxiliary therapies, patient education and manipulative therapy. The majority of participants used a variety of treatment methods (no single treatment method was exclusive to a particular disorder) to manage NMSDs. A significant positive association (p < 0.001) was found between female chiropractors and the more frequent use of auxiliary therapy to manage NMSDS than their male counterparts. No other associations (for age, qualification, institute of study, number of years in practice and philosophical orientation) were observed between the chiropractors’ demographic characteristics and the management of NMSDS. CONCLUSION: The majority of chiropractors in the eThekwini District report managing some NMSDs in clinical practice. When the results of NMSDs treated collectively (as primary and secondary complaints) were combined, it was found that the most common NMSDs - garnering the greatest positive ratings - were headache of NMSK origin (most commonly migraine), infantile colic, dizziness, vertigo, sinus-related disorders and tinnitus. Future studies should use stringent criteria to investigate a larger representation of chiropractors across the country for the management of NMSDs.Item An investigation into the risk factors and management of rugby injuries in the greater Durban area(2010) Tuck, Andrew Murray; Haswell, GarrickObjective: Majority of studies to date have focused on injury profiles and types of injuries in rugby, without looking at the risk factors associated and the management of these injuries. It was thus the aim of this study to determine the risk factors and management of rugby injuries in the greater Durban area. Methods: This was a prospective, cross-sectional based study, using a self-administered questionnaire, developed specifically for this research utilizing a focus group and pilot study. The questionnaire details a patient injury history, rugby history, resources, management, coaching and training parameters. Letters of informed consent and the questionnaire were distributed to 300 players / coaches for completion and data was analysed using Pearson’s correlation and t-tests. Results: A response rate of 70% (n=210) was achieved. Selected risk factors were found to be significantly related to current and / or previous injury. New risk factors which did significantly impact injury, were also determined. Conclusion: It is advised that coaches and players take note of significant injury risk factors and management protocols in order to improve player health and decrease injury risk. Further research may look into the factors identified in order to set up better structures in order to prevent further injuries.