Faculty of Health Sciences
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Item Primary caregiver experiences and perspectives on caring for a child with chronic kidney disease within a South African context(2024) Govender, Shamanie; Adam, Jamila KathoonBackground: Informal and unpaid caregivers play an important role in the management of paediatric patients who have chronic kidney disease (CKD). The burdens that the caregivers experience during their caregiving roles and responsibilities have not been extensively researched, particularly within this patient population. The high physical, psychosocial and economic burdens experienced by the caregiver can in turn lead to negative impact on the child’s health outcomes and medical treatment. This study ascertained the burdens that caregivers experienced, in their care of paediatric CKD patients, who were receiving haemodialysis, in the renal unit of a large public hospital in KwaZulu Natal, South Africa. Methods of communication and types of information provided by the renal healthcare team and the support needs of caregivers to reduce burden, anxiety and social dysfunction was elicited. Methods: Two standardized instruments, namely, the General Health Questionnaire - 12 and the Paediatric Renal-Care Burden Scale were used to ascertain burden, anxiety, and social dysfunction experienced among caregivers of CKD paediatric patients on haemodialysis. Two semi-structured questionnaires were administered. In the first instance, caregivers were asked to provide information on areas that could assist them to alleviate the burden of caregiving and the second questionnaire was used to ascertain from renal staff, the methods they used to communicate with, and the information they provided to caregivers. Results: Twenty-one caregivers participated in the study, with females providing most of the caregiving duties (76.2%). Using the PR-CBS, financial burden emerged as the highest burden experienced (mean = 4,86 and SD = 0,77). The use of the GHQ – 12, revealed that anxiety and distress were significantly high in caregivers (mean = 0.95 and 0.85) respectively. Overall, 18 caregivers had moderate to high burden. The total mean burden score for the PR-CBS for females was significantly higher than that for males (11.30; SD = 6.11 vs 7.83; SD = 4.70). This is confirmed by the total mean burden score declared by females for GHQ – 12, which was also significantly higher than that declared by males (6.58; SD = 2.83 vs 3.75; SD = 1.80). There was significant positive correlation between GHQ-12 anxiety score (p= 0.003) and PR-CBS burden score (p = 0.005). Conclusion: The prevalence of burdens, anxiety and social dysfunction was significantly high among caregivers of CKD paediatric patients and is often overlooked by the renal Background: Informal and unpaid caregivers play an important role in the management of paediatric patients who have chronic kidney disease (CKD). The burdens that the caregivers experience during their caregiving roles and responsibilities have not been extensively researched, particularly within this patient population. The high physical, psychosocial and economic burdens experienced by the caregiver can in turn lead to negative impact on the child’s health outcomes and medical treatment. This study ascertained the burdens that caregivers experienced, in their care of paediatric CKD patients, who were receiving haemodialysis, in the renal unit of a large public hospital in KwaZulu Natal, South Africa. Methods of communication and types of information provided by the renal healthcare team and the support needs of caregivers to reduce burden, anxiety and social dysfunction was elicited. Methods: Two standardized instruments, namely, the General Health Questionnaire - 12 and the Paediatric Renal-Care Burden Scale were used to ascertain burden, anxiety, and social dysfunction experienced among caregivers of CKD paediatric patients on haemodialysis. Two semi-structured questionnaires were administered. In the first instance, caregivers were asked to provide information on areas that could assist them to alleviate the burden of caregiving and the second questionnaire was used to ascertain from renal staff, the methods they used to communicate with, and the information they provided to caregivers. Results: Twenty-one caregivers participated in the study, with females providing most of the caregiving duties (76.2%). Using the PR-CBS, financial burden emerged as the highest burden experienced (mean = 4,86 and SD = 0,77). The use of the GHQ – 12, revealed that anxiety and distress were significantly high in caregivers (mean = 0.95 and 0.85) respectively. Overall, 18 caregivers had moderate to high burden. The total mean burden score for the PR-CBS for females was significantly higher than that for males (11.30; SD = 6.11 vs 7.83; SD = 4.70). This is confirmed by the total mean burden score declared by females for GHQ – 12, which was also significantly higher than that declared by males (6.58; SD = 2.83 vs 3.75; SD = 1.80). There was significant positive correlation between GHQ-12 anxiety score (p= 0.003) and PR-CBS burden score (p = 0.005). Conclusion: The prevalence of burdens, anxiety and social dysfunction was significantly high among caregivers of CKD paediatric patients and is often overlooked by the renal healthcare team. The experiences of this unique population of caregivers are complex and multifaceted, but despite the various challenges they encounter, they continue to provide care and support for their young patients. Renal healthcare practitioners may use the findings to develop and provide suitable supportive interventions and resources for these caregivers. It is essential that these be included in treatment guidelines for the ill child, not only to reduce caregiver burdens but also to improve the overall CKD paediatric patient outcomes.Item Caregivers experiences of living with an adolescent who abuses drugs in the Sol Plaatjie Municipal area in the Northern Cape(2024) Ditshetelo, Nomonde Patience; Hillerman, L. A.; Sokhela, Dudu GloriaAim Drug abuse by adolescents has devastating effects on the ability of their families and caregivers to function. The aim of the study was to explore and describe the caregiver’s lived experiences of living with an adolescent who was abusing drugs and receiving treatment in selected drug rehabilitation institutions. Research Design and Approach A qualitative, descriptive, and contextual with a phenomenological approach. was adopted to explore caregivers’ lived experiences living with adolescents who abuse drugs. Research setting The study was conducted at four purposively chosen Non-Governmental Organizations (NGOs) rehabilitation institutions situated in the Sol Plaatjie Municipality in Kimberly in the Northern Cape Province. Participants were recruited from selected rehabilitation government institutions and NGOs in the Sol Plaatjie Municipal area after full ethics approval was obtained from the DUT Institutional Research Ethics Committee (IREC). A non-probability purposive sampling, also known as the judgment sampling method, was used in this study. to interviews with 15 purposively selected caregivers whose adolescents were abusing drugs. Interviews were recorded and then simultaneously translated and transcribed. Thematic analysis was used to identify themes related to the experiences of caregivers of adolescents with a drug abuse problem. Results Results show that the behaviour of these adolescents created an environment that led to feelings of shame and embarrassment, family disintegration, conflicts, and communication breakdown, suicidal feelings, and stress related ailments of these caregivers. Participants experienced personal challenges which included psychological and emotional effects of fear, stress, pain, and self-blame. Participants also highlighted family disruptions and financial drain as adverse experiences as a result of their adolescents’ behaviour. Conclusion The study results highlighted the psychosocial challenges experienced by those caregivers of adolescents who abuse drugs. These findings underscore the need for efforts to be directed at the development of formal support interventions for caregivers of adolescents who are affected by this public health scourge.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.Item System, cognitive and emotional support of students during clinical placement : exploring the experiences of students from a college of nursing in KwaZulu-Natal, South Africa(2022-05-13) Makhetha, Thembeka Dorothy; Ngxongo, Thembelihle Sylvia PatienceIntroduction and background: Nursing education was introduced to improve the quality of nursing, and includes theory and clinical components of the curriculum which should be integrated to ensure that the course content that is taught covers the needs of the community, and that the graduate nurse is competent enough to care for the health care users. Clinical training is an essential component in the provision of nursing education and training that ensures the production of competent nurse cadres with the necessary competencies to respond to current and ever-changing healthcare needs of a diverse population. The South African Nursing Council (SANC) mandates that students should be supported throughout their training programme during clinical placement. Nevertheless, research highlights that support is one of the many challenges that are faced by students in the clinical learning environment. AIM OF THE STUDY The aim of the study was to explore and describe the experiences of students from a college of nursing in KwaZulu-Natal (KZN) regarding system, cognitive and emotional support received by the students during clinical training. OBJECTIVES OF THE STUDY The objectives of the study were to 1) Describe the experiences of students from a college of nursing in KZN with regards to system, cognitive and emotional support during clinical placement, 2) Determine if system, cognitive and emotional support was given to students during clinical training, and 3) Identify strategies that could be implemented to facilitate system, cognitive and emotional support to students during clinical placement. Method: A quantitative, non-experimental descriptive study design was undertaken using Schlossberg’s Transition Theory as a theoretical framework to guide the study. Ethics approval to conduct the study was received from the institutional Ethics Committee (IREC 151/20). Data was collected using a selfadministered questionnaire between February and March 2021 from 214 3rd and 4 thyear nursing students who were registered for a four-year basic nursing programme in KZNCN, and analysed using version 21 of SPSS. Findings: The findings of the study confirmed that although all forms of support (system, cognitive and emotional) were given to students, several gaps prevailed, for example, negotiating student workloads with clinical staff. A significant difference was noted in the response regarding cognitive support between the 3rd and the 4 th year students. Conclusion The findings from the current study confirmed that in a college of nursing in KZN, South Africa, system, cognitive and emotional support of students during clinical placement was evident but there were several gaps that still needed to be addressed. These findings confirmed the anecdotal evidence by the researcher which, together with research evidence, raised concerns regarding availability of system, cognitive and emotional support to nursing students during clinical placement. Recommendations: Recommendations to address gaps identified are made with regards to policy formulation, review and implementation, service delivery, nursing education. Further research is recommended regarding adherence to policies and guideline by nursing education and health care institutions involved in student clinical training in the matter of student support. Some recommendations are directed to the students who should acknowledge that to groom them into responsible professional support offered to them is informed by several factors including the level of training as support needs differ from level to level. Students should also acknowledge that at selected levels of training support made available to them students is adjusted to allow them to grow into independent practitioners as they exit the training programme to assume the duties and responsibilities of being professional nurses.Item The relationship between work stress and years of experience amongst male mental health care practitioners within tertiary psychiatric hospitals in the uMgungundlovu Health District(2020-11-30) Smith, Mark Albert; Orton, Penelope; Adams, CarolPsychiatric nursing is a speciality within the nursing profession in which the nurse directs his or her efforts to the early identification of and intervention in emotional problems and work towards the promotion of mental health. In addition, effort is placed on the prevention of mental disturbances, and follow - up care to minimize long - term effects of mental disturbance (Uys and Middleton, 2014:18-20). According to the South African Depression and Anxiety Group (SADAG) (2015), 16.5% of South Africans suffer from common mental disorders like depression and anxiety. Even more concerning is the fact that 17% of children and adolescents suffer from mental disorders. Mental illness adversely affects the person’s brain and at times requires long-term treatment. In this study a total of 158 male mental health care nurse practitioners’ were questioned and a quantitative non- experimental cross sectional descriptive survey was conducted to describe male mental health care nurse’s practitioners’ years of experience in psychiatric nursing and the levels of stress of these nurses was identified. The researcher also determined whether there was any relationship between the stress reported and the years of experience amongst male mental health care nursing practitioners in tertiary psychiatric hospitals in Pietermaritzburg.Item Patients experience of their first homeopathic consultation at Cato Ridge homeopathic community health centre, KwaZulu-Natal, South Africa(2021-05-27) Nyawose, Mzwandile Enerst; Couchman, IngridCato Ridge Homoeopathic Community Health Centre (CRHCHC) is situated at Cato Ridge, under the uMgungundlovu District-Mkhambathini municipality (Mkhizwana village). It is a multidisciplinary health care center consisting of specialties from the Durban University of Technology-Faculty of Health Sciences, namely: Nursing, Chiropractic, and Homoeopathy. These specialties provide comprehensive primary health care services which include screening tests for HIV, Diabetes, and Pregnancy, etc. They also offer referral letters to clinics/hospitals for all conditions beyond their scope of practice, management of minor/acute conditions, prescription of chronic medication, comprehensive homoeopathy and chiropractic treatment as well as patient management. The centre operates only on Wednesdays from 9h00 to 15h00 . CRHCHC was established in 2016 by Durban University of Technology (DUT), to help the Mkhizwana village community with a nearby community health centre where they will receive medical attention. This community centre is unique in that it is in a rural area and there are no nearby healthcare facilities. The closest healthcare facility is RK Khan, located 60 Km away from Mkhizwana village. Since this centre was recently opened, a survey on patient experience is important to assess the centre from the community’s perspective. Aim of the study The study aimed to determine the experiences of patients after their first Homoeopathic consultation and their satisfaction with service delivery at CRHCHC. Methodology A quantitative, descriptive, cross-sectional study design was used to guide the study. 100 consenting patients were selected randomly and given a questionnaire. The Data was analysed using Microsoft office Excel 2019 and SPSS version 25 software. Results The result showed a high degree of satisfaction on homoeopathic consultation. The majority of the participants were satisfied with the homoeopathic consultation which includes medication, information and advice, length of consultation, love and care shown by the homoeopathy students. Furthermore, the majority of the participants were satisfied with the manner in which the homoeopathic students conduct themselves as well as their professionalism. However, the majority of the participants highlighted that there is a need for a proper clinic and for the centre to operate every day rather than just one day a week.Item Clinical instructor's experiences of clinical education at a chiropractic teaching clinic in KwaZulu-Natal(2018) Vogl, Enya Elizabeth; Orton, Penelope MargaretINTRODUCTION: This dissertation provides insight into the status of the clinical instructor’s experience of clinical education at a chiropractic teaching clinic in KwaZulu-Natal and aims to equip the profession to understand better how clinical instructors perceive their role in the clinical education of chiropractic students. AIMS AND OBJECTIVES: The primary objective of this study was to explore and describe the experiences of the clinical instructors at the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) as perceived by themselves. This study contributes to knowledge of the clinical education experience of clinical instructors at the DUT CDC. This information can assist the institution to better equip the clinical instructors for clinical learning, thus improving the educational experience of the students, and accomplishing the departmental and institutional vision and mission. RESEARCH DESIGN: This study was conducted within a constructivist paradigm using a qualitative, exploratory, descriptive design to explore the experiences of clinical instructors at the DUT CDC with regards to the clinical education setting. The constructivist paradigm as an epistemological position takes the view that knowledge of how things are is a product of how we come to understand them. This design concentrates on understanding and exploring meaning and the way people make meaning rather than proving a theory. RESEARCH METHODOLOGY: Semi-structured interviews were conducted with chiropractic clinical instructors so as to explore their clinical education experience within the DUT CDC, until saturation was met. A total of 14 interviews were conducted and analysed. The data was transcribed and coded by the researcher as well as the research supervisor. Content was analysed using the Graneheim and Lundman (2004) framework. RESULTS: The research question was answered and three primary themes that encompassed the experience of the chiropractic clinical instructors were identified. These were: clinical instruction and the role of the clinical instructor; interpersonal relationships in the clinical education setting; and the clinical education environment experience.