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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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    Exploring communication as a means to deliver patient education for musculoskeletal care by chiropractors in the eThekwini Municipality
    (2023-05-31) Chapman, Frances Cowley; Orton, Penelope; Prince, Cleo Kirsty
    Background: Communication is a fundamental tool used by all healthcare practitioners, as well as chiropractors, in delivering care. Practitioners use communication to connect with their patients to form trusting relationships and obtain clinically relevant information to reach a diagnosis. It is also used to deliver important healthcare information to the patient regarding their condition, relevant lifestyle changes, interventions and outcomes. The way a practitioner has utilized communication, their ability to deliver succinct patient education that is empathetic and relevant to the patients’ life, and preferences are important factors in the success of the treatment and management delivered. Despite this, communication is still considered a complex phenomenon with little concordance on its success experienced by both the patient and the practitioner. Patient education has been identified as a key factor in delivering optimal management and care of musculoskeletal disease, which is a central component of chiropractic scope of practice. It has also been identified as an important component of chronic care management and encouraging self-management, which is a fundamental part of managing risk factors for both musculoskeletal disease and chronic disease. The eThekwini Municipality, the study location, is a socioeconomically diverse region, which historically suffers from language and social disparities, which affect the delivery and success of healthcare. This research adds a unique insight into how chiropractors in eThekwini utilize communication to deliver patient education to their patients. Methodology: A qualitative research methodology was utilized to collect data through semi-structured interviews. The data were analyzed using thematic analysis to extract the meaning and understanding of the interviews. Eight interviews were conducted before data saturation was reached. Results: Three main themes, namely communication skills, communication barriers and communication techniques, emerged from the data with a number of sub-themes. Conclusion: The results revealed that all the participants thought communication skills and patient education were fundamental to how they delivered care. Their perception on the acquisition of these skills were varied and ranged from passive time in practice, foundational at a university level, and necessitating further studies. When exploring the barriers, it was thought that although patient perception was an important factor, this could be as a result of a consumeristic medical system, poor communication on the practitioners part and a lack of a unified profession identity of chiropractic. Socioeconomic, language and cultural issues still affect the delivery of care and adequate patient education, even though South Africa has been a democracy for 29 years. Communication techniques have evolved, including the utilization of communication technologies, which can contribute to patient-centeredness. Paternalistic and diseasecentered communication techniques still underpin manual therapy but patient-centered techniques are emerging.
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    Framework to mitigate disruptive behaviours involving radiographers at central hospitals in Harare Metropolitan Province, Zimbabwe
    (2022-09-29) Chinene, Bornface; Nkosi, Pauline Busisiwe; Sibiya, Maureen Nokuthula
    Background Disruptive behaviours in healthcare have become an unprecedented global problem, transcending borders, work settings and professional groups. Concerns about their impact on patient safety has led many international medical organisations and other healthcare professions to escalate the urgency of knowing the prevalence, causes and consequences of these unprofessional behaviours in different healthcare settings. Evidence shows that assessing and mitigating disruptive behaviours is critical to empowering health workers to focus on delivering high-quality, cost-effective and safe patient care. However, there is a paucity of literature exploring disruptive behaviours involving radiographers in Zimbabwe. Additionally, there is no written policy to monitor and mitigate disruptive behaviours in the Zimbabwean radiography workforce. The challenge of disruptive behaviours is of significant concern for radiographers because they use radiation that has hazardous effects on living organism cells. Aim The aim of the research was to explore disruptive behaviours involving radiographers and the consequences thereof at central hospitals in Harare Metropolitan Province in order to develop a framework to mitigate these behaviours so that healthy radiography work environments are promoted. Methodology A mixed-methods convergent parallel approach using the parallel databases variant was employed. Disruptive behaviours from 100 randomly sampled radiographers were evaluated using a semi-structured questionnaire. In addition, in-depth interviews were conducted with 11 radiography managers selected by criterion purposive sampling, in order to explore factors and strategies to mitigate these behaviours. Findings Disruptive behaviours involving radiographers in HMP are rampant and create an unhealthy work environment that can lead to compromised patient radiation protection by negatively affecting the implementation of radiation protection protocols or procedures. Cultural and environmental factors relating to disruptive behaviours in Harare Metropolitan Province include a power hierarchy, the work environment and the absence of a reporting framework. Nevertheless, the strategies to mitigate these behaviours may include awareness, willingness to address the behaviours and conflict resolution.
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    Patient satisfaction at the Durban University of Technology Chiropractic Day Clinic using a prevalidated survey
    (2021-12-01) Ruthnam, Mary Ann; Varatharajullu, Desiree
    AIM: The aim of this study was to determine the level of patient satisfaction at the Durban University of Technology Chiropractic Day Clinic and to establish if there is any association between patient demographics (age, gender, ethnicity, income) and patient satisfaction. SUBJECTS: Patients attending the Durban University of Technology Chiropractic Day Clinic were approached to participate in the study. METHODOLOGY: Patients who attended the Durban University of Technology Chiropractic Day Clinic between June and September 2020 were informed about the research study at the reception desk by the reception staff. The patients who were interested agreed to participate, and those who were within the inclusion criteria, were handed a letter of information and an informed consent by the reception staff. Each potential participant was required to read and understand the letter of information, as well as read, understand and sign the consent form. Each patient was then handed a questionnaire, and the patient was given time after their consult to complete the questionnaire. The consent forms and questionnaires were placed into separate boxes and a code was allocated to each questionnaire before the data were captured. RESULTS: A total of 150 questionnaires were analysed and it was revealed that the patients attending the Durban University of Technology Chiropractic Day Clinic are satisfied with all aspects of the clinic, except finance. It was also shown that there was no association between patient demographics (age, gender, ethnicity and income) and satisfaction. CONCLUSION: The findings of this study correlated with some studies on the association of patient demographics and satisfaction but was not in line with all those findings.
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    The current role of the chiropractor in the patient-centered approach to stress management
    (2009) Deonarain, Jitesh; Young, Karin
    Objectives: The aim of this study was to determine the current role of the Chiropractor in the Patient-Centred Approach to Stress Management. Methods: Chiropractors were contacted telephonically in order to discuss a convenient time in which they are free to receive the questionnaire at their practice. The questionnaire was developed specifically for this particular research project and verified through the use of a focus group and pilot testing. The researcher waited outside the room whilst the Chiropractor completed the questionnaire. The questionnaire was then collected after completion prior the researcher leaving the practice, in order to improve the return of the questionnaires. Results: Seventy-five percent of chiropractors, in the study indicated that they took a psychosocial history which may indicate that they utilised the fundamental biopsychosocial theme of ‘patient-centeredness’. 68.9% of chiropractors who took a psychosocial history indicated that they are equipped with the necessary skills to evaluate psychosocial stressors in patients and 55.6% indicated that their patients responded ‘Very Positively’ to their stress management protocols. All the Chiropractors in the study indicated that they had consulted patients who had associated their main complaint with stress related issues. 38.3% of Chiropractors felt that their patients ‘Often’ associated their main complaint with stress-related issues whilst 35% felt that their patients ‘Very Often’ relate their main complaint with stress-related issues. Muscle spasm (85%) was the most common symptom or sign found or elicited in a patient suffering with chronic stress. Referral was the most common primary method of treatment with 36% of Chiropractors utilising this method in the clinical setting when dealing with a stressed patient. iii Conclusion: Chiropractors in the study indicated that they took a psychosocial history therefore they utilised the fundamental biopsychosocial theme of ‘patientcenteredness’ and that the majority indicated that they are equipped with the necessary skills to evaluate psychosocial stressors in patients and that patients responded positively to their stress management protocols.
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    Patient satisfaction at the Durban Institute of Technology chiropractic day clinic
    (2006) Thoresen, Bruce
    Patient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.