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    Primary caregiver experiences and perspectives on caring for a child with chronic kidney disease within a South African context
    (2024) Govender, Shamanie; Adam, Jamila Kathoon
    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 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.
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    Knowledge, attitude and practices of caregivers regarding Vitamin A supplementation in children below five years old in Ugu District
    (2024) Mazeka, Sithabile Noxolo Perseverance; Sokhela, Dudu Gloria
    Background: Vitamin A is an essential micronutrient for the health and well-being of infants and children, and is mainly responsible for good vision growth and development. Vitamin A deficiency (VAD) occurs due to a diet that lacks sufficient amount of vitamin A, and is common in developing countries where there is food insecurity. Vitamin A deficiency can result in night blindness, xeropthalmia, increased morbidity and mortality of children under five years old. The World Health Organisation (WHO) recommends supplementation with a high dose of vitamin A supplementation (VAS) oral drops to children from 6 to 59 months, in countries where deficiency is a concern. However, the programme is not reaching all targeted children, leaving them at risk of suffering from preventable illnesses. Methods: A quantitative, descriptive cross-sectional survey design was used to determine the knowledge, attitude and practices of caregivers regarding VAS for children below five years old, in selected primary health care (PHC) facilities in Ugu District. Primary health care facilities were stratified according to different municipalities, and then those with the highest headcount of children under five years old were purposively sampled. Respondents from those PHCs were sampled using systematic random sampling. Data were collected through the use of a questionnaire and checklist and analysed using SPSS version 26. Results: Respondents’ level of knowledge was limited and they lacked vital information regarding VAS. Respondents indicated a positive attitude towards VAS as they perceived it to be an important and effective strategy for their children. Overcrowding and long queues of health facilities were noted as a challenge that could contribute towards low coverage of VAS. Conclusion: Based on the results of this study, there is a need for effective and comprehensive health education on VAS. Use of mass media to accentuate critical aspects of VAS as it reaches large audience at a faster rate, and is commonly used by young mothers. One of the recommendations is for task shifting from professional nurses to integrated management of childhood illnesses by using Integrated Management of Childhood Illnesses trained enrolled nurses to relieve the heavy load from professional nurses and reduce the long queues so that mothers do not forego this service.