Faculty of Health Sciences

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Factors predisposing emergency medical technicians to workplace violence: a cross sectional study
(SAGE Publications, 2024) Khoza, Tshikani Lewis; Sibiya, Maureen Nokuthula; Mshunqane, Nombeko
Emergency medical technicians (EMT) are at high risk of workplace violence as they often care for patients in uncontrolled and often hostile emergency settings. Gauteng Province, the most populous province in South Africa, caters for 75% of the total population which is dependant on state funded health care. Public sector EMTs' have been robbed with aggravated circumstances, assaulted with intent to do grievous bodily harm, raped and even murdered whilst on duty. Despite this, comprehensive studies investigating the factors that predispose public sector EMTs' to workplace violence in Gauteng Province are lacking. Thus, the aim of this study was to investigate the factors that predispose public service EMTs' to workplace violence in Gauteng Province. Data were collected using questionnaires. A total of 413 questionnaires were returned by community members of Gauteng who met the inclusion criteria. Descriptive statistics and binomial tests were used to analyze data. The results of this study revealed that workplace violence toward public service EMTs' in Gauteng is attributed to the high rates of crime, the widening gap of inequality, economic deprivation of basic rights to previously disadvantaged communities by government, vulnerability of EMTs' when responding to the ill and injured within low- and middle-income communities and a lack of consequence for disorderly behavior within the communities. An understanding of the community factors that predispose EMTs' to workplace violence may improve the understanding of the phenomenon of workplace violence and developing prevention programs within the communities.
A model for the prevention of work-place violence towards public service emergency care providers in Gauteng province
(2021-12-01) Khoza, Tshikani Lewis; Sibiya, M. N.; Mshunqane, N.
Background Workplace violence is an alarming world-wide phenomenon that also affects healthcare providers. However, among healthcare providers, Prehospital Emergency Care Providers (PECPs) are particularly at risk of workplace violence as they provide direct patient care in often hostile and undefined public areas whilst interacting with the patient, their family members and bystanders. Gauteng Province is South Africa’s economic hub and the most populous province. In Gauteng Province, workplace violence towards public service PECPs persists, producing a negative impact on the effectiveness of the public healthcare system, despite the measures that have been put in place. Aim The aim of this study was to develop a model to prevent of workplace violence against public service PECPs in Gauteng Province. Methodology The study was conducted using a non-experimental, cross sectional and mixed methods design guided by a social constructivism/ interpretivism paradigm with an interpretative framework founded on pragmatism. Overall, 413 questionnaires were administered in the quantitative subphase. The qualitative subphase the study included seven (7) face to face semi-structured interviews from the management cohort and focus group discussions comprised of 35 PECPs. Parallel mixed methods analysis was used to analyze the data. Findings The findings of this study revealed that even with the current preventative measures in place, there is a high incidence of workplace violence towards public sector emergency care providers within low and middle income communities of Gauteng who rely on state funded healthcare. The risk factors to workplace violence included service delivery frustrations and protests, high crime rates, a lack of reliable backup and emergency care providers being perceived as easy targets. Workplace violence results in a lack of job satisfaction and a poor perception of workplace safety culture amongst PECPs and a decreased quality of and limited access to emergency medical care amongst the low and middle income communities in Gauteng. The findings and meta-inferences generated by the mixed results informed the development of a proposed model for the prevention of workplace violence towards public service PECPs in Gauteng Province.
Exploring lived experiences of Gauteng based military pre-hospital emergency care providers during external deployment
(2018) Khoza, Tshikani Lewis; Mshunqane, Nombeko; Du Plessis, Herman; Sobuwa, Simpiwe
Introduction The South African Military Health Service (SAMHS) provides multi-disciplinary health care, including emergency medical care (EMC), to the South African National Defence Force (SANDF). Post 1994, the SAMHS pre-hospital emergency care providers (PECPs), in support of SANDF, have been deployed in various external operations and have gained a wealth of combat EMC experience. The challenges experienced during deployment are reported using formal military reports which often do not address the in-depth experiences of individual PECPs during service delivery. Aim of the study This study aimed to explore and describe the lived experiences of Gauteng based military PECPs when providing EMC during external deployment. Objectives The study’s objective was to describe the experiences of PECPs working at SAMHS in Gauteng during external deployment. Methodology The study was conducted using a qualitative, exploratory and descriptive research design guided by a phenomenological approach. Eighteen (18) participants, who had been deployed, were recruited from a study population consisting of 276 military PECPs based at four SAMHS units in Gauteng using a purposive random sampling method. Semi-structured, in-depth individual interviews were conducted and subsequently analysed using thematic analysis. Results Five themes emerged from the study, namely, the organisational culture of the SAMHS; political situation during external deployment; resources; human resources and safety. The sub-themes that emerged included the challenges reported in formal military reports, tactical decisions that may affect healthcare, harsh environments, political will of the host country, civilian hostility, gaps in what the mandate authorises, prolonged casualty evacuation times, limited resources, unique casualty transportation, mental stress, lack of trauma care experience, task overload, training expectations and inadequate guarantee of safety. Conclusion The findings of this study indicated that the Gauteng based military PECPs interact well and receive a high degree of group support from their co-workers. This decreases the morbidity and mortality of their patients during external deployment. However, they also reported feelings of anger and frustration because of unresolved challenges arising from previous deployments, inappropriate casualty transportation and inadequate leadership. They further reported that the limited transportation and the political situation in the host country during deployment contributed to both stress and feeling unsafe. The findings also indicated a low rate of service delivery by military PECPs which negatively affects the maintenance of human resources and which may, thereafter, adversely affect the success rates of external missions conducted by the SAMHS and the SANDF

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