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Health SA Gesondheid : interdisciplinary research journal

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Volume 8, Issue 2, June 2003
ABSTRACTS

Health care-seeking behaviour for child illnesses among rural mothers in South Africa: a pilot study

Promtussananon, Supa; Peltzer, Karl

Abstract: The aim of this study was to examine the health care-seeking behaviour of mothers when their children under five years suffer from common childhood illnesses such as diarrhoea, fever, cough and worms. The study was conducted in a rural community in the Limpopo Province of South Africa. The sample consisted of 100 rural mothers attending a clinic. The results indicated that the complaint most commonly reported was fever (95%), followed by diarrhoea (91%); worms were reported by only 25% of the mothers. The most common health care-seeking behaviour was a visit to the clinic: 79% of the mothers took their children to the clinic for coughing, 68% for fever, 50% for diarrhoea and 11% for worms. The second most common form of health care-seeking behaviour was self-care: for diarrhoea (20%) and for fever (13%); a private doctor was consulted for coughing (11%) and drug vendors were used for the treatment of worms (8%). Most mothers (76%) used home remedies for the treatment of diarrhoea and modern drugs for the treatment of fever (91%), for coughing (98%), and for worms (22%). Among mothers in the age group 31 to 49 years, 52.9% had experienced the death of a child, followed by 13.3% in the age group 15 to 19 years, and 9.8% in the age group 20 to 30 years.

Die doel van die navorsing was om moeders met siek kinders se gesondheidsgedrag na te vors. Die fokus was op die moeders se pogings om mediese hulp vir hul kinders te bekom. Die kinders in die steekproef was onder die ouderdom van vyf jaar en van 'n plattelandse gemeenskap in die Limpopo Provinsie van Suid-Afrika. Die kinders het simptome van algemene kindersiektes soos diarree, koors, hoes en wurms getoon. Die steekproef het bestaan uit 100 moeders wat van die kliniekdienste gebruik maak. Die resultate dui aan dat die simptome wat meestal gerapporteer word diarree (91%), koors (95%) en wurms (25 %) is. Die oorgrote meerderheid van die moeders het hul kinders na die klinieke geneem vir koors (68%), hoes (79%), wurms (11%) en diarree (50%). Die tweede keuse vir gesondheidsorg was selfversorging: vir diarree (20%), en koors (13%). 'n Privaatpraktisyn is geraadpleeg vir hoes (11%), en vir wurms (8%) is medikasie by die apteek verkry. Die meeste moeders (76%) het tuismedisyne gebruik vir die behandeling van diarree en die meeste het moderne medisyne gebruik vir die behandeling van koors (91%), hoes (98%) en wurms (22%). Van die moeders in die ouderdomsgroep van 31-49 jaar het 52.9 % kinders aan die dood afgestaan gevolg deur die groep van 15 -19 jaar (13.3 %) en die groep van 20-30 jaar (9.8 %).

Key words: Health care-seeking behaviour, Common childhood illness, Dead child, Rural community, South Africa

 

 

The social construction of HIV / Aids

Goldstein, Natalie; Pretorius, H.G.; Stuart, A.D.

Abstract: An in-depth look is taken at the specific discourses surrounding the debilitating HIV / AIDS epidemic sweeping South Africa and the world. Not only is the statistics daunting, the incidence of the HIV infection worldwide is staggering. This article provides a concise definition of what a discourse entails as well as its impact on the perceptions concerning the epidemic and its treatment. It looks at the cultural meanings contributed to the infection, its etiology and progress. The role of cultural schemas and means of explanation are examined as well as the gender roles that are used to organise ideas around sexuality and the individual expression of that sexuality. The article securely situates the HIV / AIDS debate within the larger political structures forming today's world. It clearly implicates historic discourses in the modern day perceptions regarding the disease. In the final instance it becomes clear that any interpretation of the experience of HIV / AIDS has to incorporate the effects of culture, gender and broader political structures on individuals' responses to and understanding of the disease.

Hierdie artikel poog om 'n indiepte ondersoek te loods na die spesifieke diskoerse rondom die MIV / VIGS epidemie in Suid-Afrika en die wêreld. Wêreldwyd is die statistiek rondom die epidemie oorweldigend en die groeiende voorkoms daarvan onrusbarend. Dié artikel bied eerstens 'n omvattende definisie van wat diskoerse behels asook die impak daarvan op die persepsies van die infeksie en die behandeling daarvan. Kulturele skemas en verduidelikings van MIV / VIGS word ondersoek asook die geslagsrolle wat gebruik word om idees rondom seksualiteit en die uitlewing van hierdie individuele seksualiteit te verklaar. Die artikel plaas die epidemie binne die groter politieke strukture wat die daaglikse omgewing vorm en bied duidelike bewyse vir die invloed van die land se historiese verlede op die hedendaagse persepsie van MIV / VIGS. Uiteindelik is dit duidelik dat enige poging om die subjektiewe ervaring van MIV / VIGS te bekyk, die effek van kultuur, geslag en die breër politieke arena sal moet in ag neem om sodoende die individue se ervarings van, en reaksies op, die infeksie te begryp.

Key words: Social construction, HIV, Aids, Meaning making, Preparation for death

 

 

The attitudes of nurses towards HIV positive patients

Deetlefs, Estelle; Greeff, M.; Koen, M.P.

Abstract: AIDS is increasing in South Africa at an alarming rate. Registered nurses consequently have more frequent contact with HIV positive patients. During this contact the nurses' behaviour are influenced by their attitudes. Negative attitudes may influence the quality of nursing care. In the light of this problem, the aim of this study was to investigate the attitudes of nurses towards HIV positive patients and to set guidelines for potentially changing these attitudes, in an attempt to improve the quality of care rendered to HIV positive persons. A qualitative design was used. An interview schedule was compiled after a literature study of the construct attitude, the components of attitude, differences between values and attitudes, the purpose of attitudes and the way in which attitudes can be changed. Nurses were identified for participation through purposive, voluntary sampling. Semi-structured interviews were conducted. The interviews were transcribed verbatim. The researcher and a co-coder analysed the data using a combination of Giorgi and Kerlinger's methods of coding. Consensus on the main categories was reached after discussion with the co-coder. The conclusion was made that the attitudes of nurses towards the HIV positive patient are mostly negative. Conflict between the personal and professional value systems of nurses exists. Nurses cope with the resulting discomfort by using defence and coping mechanisms, which hamper the development of a therapeutic relationship between them and HIV positive patients. Nurses entertain a biased view of their own risks, considering risks only from occupational exposure. According to these findings, general and specific guidelines for changing attitudes were set.

VIGS neem drasties toe in Suid-Afrika. Geregistreerde verpleegkundiges het gevolglik meer gereelde kontak met MIV-positiewe pasiënte. Gedurende hierdie kontak word verpleegkundiges se optrede beïnvloed deur hulle houdings. Negatiewe houdings mag die kwaliteit van verpleging beïnvloed. In die lig hiervan, was daar in die navorsing gepoog om die houdings van verpleegkundiges teenoor MIV-positiewe pasiënte te bepaal en om riglyne daar te stel wat potensiële houdingsveranderinge by die verpleegkundiges teweeg sal bring en sodoende die kwaliteit van verpleging van MIV-positiewe persone te verbeter. 'n Kwalitatiewe ontwerp is gebruik. 'n Onderhoudskedule is na 'n literatuurstudie van die konstruk-houding, die komponente van houdings, verskille tussen waardes en houdings, die doel van houdings en die wyse waarop houdings verander kan word, saamgestel. Verpleegkundiges is deur middel van 'n doelgerigte, vrywillige steekproef as deelnemers geïdentifiseer. Semigestruktureerde onderhoude is daarna gevoer. Die onderhoude is woordeliks getranskribeer. Die navorser en 'n mede-kodeerder het die data geanaliseer volgens 'n kombinasie van Kerlinger en Giorgi se metodes van kodering. Konsensus oor die kategorieë in die data was bereik na gesprek met die mede-kodeerder. Dit blyk dat die houdings van verpleegkundiges teenoor MIV-positiewe pasiënte oorwegend negatief is. Daar bestaan konflik tussen die persoonlike en professionele waardesisteme van die verpleegkundiges. Die verdedigings- en hanteringsmeganismes van verpleegkundiges om die gevolglike interne ongemak te verminder, belemmer die opbou van 'n terapeutiese verhouding tussen hulle en MIV-positiewe pasiënte. Verpleegkundiges handhaaf 'n eensydige siening van die risiko om MIV-positief te raak deur slegs die moontlikheid van infektering deur hulle werk te oorweeg. Hierdie gevolgtrekkings het gelei tot die stel van algemene en spesifieke riglyne om houdingsverandering by verpleegkundiges teweeg te bring.

Key words: Attitudes, Nursing, Nurse, Human Immune Deficiency Virus, HIV, Acquired Immune Deficiency Syndrome, AIDS

 

 

Die vroeë kommunikasieontwikkeling van 'n groep babas met pediatriese MIV / Vigs in sorgsentrums

Bam, Isabel; Kritzinger, Alta; Louw, Brenda

Abstract: Die hoë prevalensie en ernstige gevolge van die pediatriese menslike immuniteitsgebrek-virus (MIV / VIGS) in Suid-Afrika stel groot uitdagings aan klinici betrokke by vroeë intervensie om toepaslike interdissiplinêre programme te ontwikkel vir primêre voorkoming van oordrag van die virus asook sekondêre intervensies gerig op die vroeë hantering van die babas se unieke kombinasie van ernstige gesondheidsprobleme, neuro-ontwikkelingsbehoeftes en versorgingsomstandighede. Die studie was 'n verkennende, beskrywende opname met die doel om die vroeë kommunikasieontwikkeling van tien 6-12 maande oue babas met pediatriese MIV / VIGS in twee sorgsentrums in Gauteng te beskryf. Neonatale risikofaktore soos lae geboortegewig en prematuriteit is by die proefpersone geïdentifiseer. Herhaaldelike siektetoestande, abnormale middeloorfunksionering aanduidend van otitis media, en oormatige hoeveelhede oorwas het voorgekom. Die resultate het ook aangetoon dat beperkte geleentheid vir die ontwikkeling van interaksie-gehegtheid tussen die proefpersone en sorggewers voorgekom het. 'n Algemene ontwikkelingsagterstand, veral met betrekking tot hulle kommunikasieontwikkeling, is by al die proefpersone gevind. Die vertraagde kommunikasieontwikkeling kan met beide die pediatriese MIV / VIGS-status asook nie-optimale sorggewer-baba-interaksie en -stimulasie in die sorgsentrums verband hou. Die studie beklemtoon die belang van toepaslike vroeë kommunikasie-intervensiedienste aan babas met pediatriese MIV / VIGS in sorgsentrums in Suid-Afrika.

The high prevalence and serious sequelae of the pediatric human immunodeficiency virus (HIV / AIDS) in South Africa pose great challenges for clinicians involved in early intervention to develop appropriate interdisciplinary programmes for primary prevention of transmission of the virus as well as secondary interventions directed at the early management of the unique combination of serious health problems, neuro-developmental needs and caregiving circumstances of the infants. This study was an explorative, descriptive survey with the aim to describe the early communication development of ten 6-12 month old infants with pediatric HIV / AIDS in two care centres in Gauteng. Neonatal risk factors identified in the subjects were low birth weight and prematurity. Recurrent illnesses, abnormal middle ear functioning indicative of otitis media, and excessive amounts of ear wax occurred. The results also indicated limited opportunity for the development of interaction-attachment between the subjects and their caregivers. A general developmental delay, particularly with regard to their communication development, was present in all the subjects. The delayed communication development can be associated with both their HIV / AIDS status as well as the non-optimal caregiver-infant interaction and stimulation in the care centres. The study emphasises the importance of appropriate early communication intervention services to infants with pediatric HIV / AIDS in care centres in South Africa.

Key words: Pediatric HIV / Aids, Early communication development, Care centres, Interaction-attachment, Early communication intervention, Pediatriese MIV / Vigs, Vroeë kommunikasie-ontwikkeling, Sorgsentrums, Interaksie-gehegtheid, Vroeë kommunikasie-intervensie

 

 

Opname van tevredenheid van B.Cur. - finalejaarstudente aan die Randse Afrikaanse Universiteit

Lemmer, A.M.; Jooste, K.; Botes, A.C.

Abstract: Die doel van die studie was om die B.Cur.-vierdejaarstudente aan die Randse Afrikaanse Universiteit (RAU), van die jaar 2001, se tevredenheid ten opsigte van hulle B.Cur.-program te bepaal. Om die doelstelling te bereik, was die volgende doelwitte relevant, naamlik:

  • 'n Beskrywing van die vlakke van tevredenheid van die B.Cur.-vierdejaarstudente aan die RAU.
  • 'n Beskrywing van die verhouding tussen tevredenheid van die studente en hoe belangrik hulle sekere aspekte in die struktuur, prosesse en uitkomste van die universiteitsomgewing beskou.

Die navorsingstudie was binne die konteks van die RAU uitgevoer. Die B.Cur.-kurrikulum is in 1998 gewysig. Dit is 'n graadkursus wat vier jaar duur, en tot registrasie as verpleegkundige (algemene, psigiatriese en gemeenskapsverpleegkunde) en vroedvrou lei. Die vierdejaarstudente van 2001 was die eerste groep wat die hersiene kurrikulum voltooi het. Dit was dus om hierdie rede sinvol om die studente-tevredenheid te evalueer. Ten einde die doelstelling te bereik is 'n kwantitatiewe opname-ontwerp gebruik. Die totale populasie (N=18) van die B.Cur.-vierdejaargroep is gebruik. 'n Bestaande instrument wat deur die RAU se Sentrum vir Hoëronderwysstudies, in die jaar 2000 ontwikkel is, is gebruik. Die meetinstrument was in die vorm van 'n Likertskaal wat op 'n numeriese waarde van 1 tot 7 gemeet het. Twee aspekte is aangeraak: die studente se metings van hulle vlakke van tevredenheid met elke item en hulle evaluering van die belangrikheid van elke item vir studente. Die navorser het die vraelys persoonlik aan elke student uitgedeel. Al 18 vraelyste wat uitgedeel was, is terugontvang. 'n Statistiese konsultant was behulpsaam met die beskrywende statistiek (frekwensies, persentasies, korrelasies, gemiddeldes en standaardafwykings) wat gebruik is om die data te ontleed en te beskryf. Die bevindings van die navorsing dui op 'n hoë vlak van tevredenheid van die studente.

The purpose of this study was to determine the satisfaction of the B Cur fourth-year students (2001) at the Rand Afrikaans University (RAU), in terms of their B Cur programme. The following objectives were important for achieving this goal:

  • A description of the levels of satisfaction of the B Cur fourth year students at the RAU.
  • A description of the relationships between the satisfaction of the students and their rated importance of aspects like structure, process and outcomes of the university environment.

This research study was carried out within the context of the RAU. The B Cur curriculum was modified in 1998. This is a four year degree course which leads to registration as a nurse (general, psychiatric and community) and midwife. The fourth-year students of 2001 were the first group to complete their studies with the revised curriculum. Thus it was important to evaluate student satisfaction. In order to achieve the purpose of the study, a quantitative survey design was used. The total population (N = 18) of the B Cur fourth-year group participated in the survey. An existing instrument (developed by the RAU's Centre for Higher Education Studies in 2000) was used to gather data. This measuring instrument comprises a Likert scale which measures numerical values from 1 to 7. Two important aspects were addressed: the students' ratings of their levels of satisfaction with each item and the evaluation of the importance of each item to students. The researcher personally handed the questionnaires to each student. All 18 questionnaires handed out, were returned to the researcher. With the help of a statistics consultant, descriptive statistics (frequency, percentages, correlations, standard deviation and mean) were used to analyse and describe the data. The findings of the research indicate a high level of students' satisfaction with their studies.

Key words: Student / consumer satisfaction, Quality assurance, University education, Education programmes, Studente- / verbruikerstevredenheid, Kwaliteitversekering, Universiteitsopleiding, Opvoedkundige programme

 

 

Professional nurses' requests to remove their names from the South African Nursing Council's register, Part 1: introduction and literature review

Ehlers, Valerie J.

Abstract: Worldwide a severe shortage of professional nurses is expected to occur between 2005 and 2020 - when the "baby boomers" born between 1947 and 1962 reach retirement age. This shortage will differ from any previous shortage because there will be no large pool of non-practising professional nurses as was the case during the nurse shortages encountered during the 1980s. The countries paying better salaries will continue to attract professional nurses from the poorer paying countries (including the Republic of South Africa); further depleting their supplies of professional nurses. This scenario makes it imperative for poorer paying countries to start monitoring the professional nurses who leave the nursing profession, and make plans to address the potential crisis which could be precipitated by a severe shortage of professional nurses. This article discusses the shortage of nurses in South Africa and in other countries. The literature review addresses the anticipated shortage of professional nurses in a number of countries, concluding that a global shortage of nurses could be anticipated between 2005 and 2020 when the majority of nurses are expected to reach retirement ages. This discussion is followed by the problem statement, as well as the objectives for this research and the significance of investigating why South African nurses request their names to be removed from the SANC's register. The next article will describe the research process and results indicating why nurses in South Africa requested their names to be removed from the SANC's register.

Wêreldwyd word daar tussen 2005 en 2020 'n ernstige tekort aan professionele verpleegkundiges voorspel - wanneer die "baby boomers" wat tussen 1947 en 1962 gebore is, gaan aftree. Hierdie tekort gaan verskil van enige vorige tekort omdat daar dan nie groot getalle nie-praktiserende professionele verpleegkundiges gaan wees soos tydens die 1980s se tekorte nie. Die lande wat beter salarisse betaal, sal voortgaan om professionele verpleegkundiges vanaf swakker betalende lande te werf (insluitende die Republiek van Suid-Afrika) - wat die swakker betalende lande se professionele verpleegkundiges verder gaan verminder. Hierdie scenario noodsaak die swakker betalende lande om daadwerklik die verpleegkundiges wat die verpleegberoep verlaat te monitor, ten einde die moontlike krisis wat kan ontstaan weens 'n ernstige tekort aan verpleegkundiges, aan te spreek. Hierdie artikel bespreek verpleegtekorte in Suid-Afrika en in ander lande. Die literatuuroorsig spreek die verwagte tekort van verpleegkundiges in verskeie lande aan, wat lei tot die gevolgtrekking dat daar 'n wêreldwye tekort aan verpleegkundiges tussen 2005 en 2020 verwag kan word, wanneer die meeste verpleegkundiges aftreeouderdomme sal bereik. Die bespreking word gevolg deur die stelling van die navorsingsprobleem en doelwitte vir die studie asook 'n aanduiding van die belangrikheid van navorsing oor redes waarom Suid-Afrikaanse verpleegkundiges versoek dat hulle name van die SARV se register verwyder word. Die volgende artikel bespreek die navorsingsproses en resultate aangaande redes waarom professionele verpleegkundiges in Suid-Afrika versoek dat hulle name van die SARV se register verwyder word.

Key words: Baby boomers, Migration of nurses, Non-practising nurses, Nurses' turnover, Nursing shortages, Professional re-entry of nurses, Retirement of nurses

 

 

Professional nurses' requests to remove their names from the South African Nursing Council's register, Part 2: research process and results

Ehlers, Valerie J.

Abstract: In this article data obtained from questionnaires, completed by 91 professional nurses who requested their names to be removed from the South African Nursing Council's register for the 2000 registration year, are presented and discussed. The ages, marital status, professional and academic qualifications of these 91 respondents provided background information for interpreting their major reasons for leaving and / or re-entering the nursing profession. Recommendations are provided to address the anticipated depletion of registered nurses, and to increase the number who re-enter the nursing profession in South Africa.

In hierdie artikel word data wat vanaf 91 vraelyste verkry is en deur professionele verpleegkundiges voltooi is wat versoek het dat hulle name van die Suid-Afrikaanse Raad op Verpleging se register verwyder word vir die 2000 registrasiejaar, bespreek. Die ouderdomme, huwelikstatus, professionele en akademiese kwalifkasies van die 91 respondente verskaf agtergrondinligting, waarteen die hoofredes vir hulle uittrede uit en / of hertoetrede tot die verpleegprofessie, vertolk word. Aanbevelings word gedoen om die verwagte uitgedunde geledere van professionele verpleegkundiges aan te spreek, asook wyses waarop die getal wat hertoetree tot die verpleegprofessie in Suid-Afrika verhoog kan word.

Key words: Baby boomers, Migration of nurses, Non-practising nurses, Nurses' turnover, Nursing shortages, Professional re-entry of nurses, Retirement of nurses

 

 

Family murder in post-apartheid South Africa: reflections for mental health professionals

Marchetti-Mercer, M.C.

Abstract: In the late eighties the phenomenon of family murder was closely linked to Afrikaans-speaking families faced with political change and uncertainty. A large study carried out by the Human Sciences Research Council (HSRC) at the time disputed this overly simplistic explanation and proposed a complex interplay of interpersonal and intrapsychic factors reflecting a phenomenon which took place under all population groups. Recent cases of family murder reported in the media have once again posed serious questions regarding possible etiological explanations for this phenomenon in post-apartheid South Africa. In this article the author reviews the original HSRC findings as well as exploring social and psychological factors, which may be relevant in present day South Africa. A social constructionist perspective is used as a theoretical framework for understanding the wider context of this type of violence. In conclusion possible interventions, which move beyond the simplistic but focus rather on the social responsibility of mental health professionals are proposed.

In die laat 1980s het die opvatting ontstaan dat daar 'n noue verband bestaan tussen gesinsmoord en Afrikaansprekende gesinne wat met politieke veranderinge en onsekerheid gekonfronteer word. 'n Omvattende studie wat op dié stadium deur die Raad vir Geesteswetenskaplike Navorsing (RGN) uitgevoer was, het hierdie oorsimplistiese standpunt bevraagteken. 'n Komplekse wisselwerking tussen interpersoonlike en intrapsigiese faktore, as 'n refleksie van 'n verskynsel wat onder alle bevolkingsgroepe voorkom, is as alternatief voorgestel. Onlangse gevalle van gesinsmoord wat in die media geraporteer is, het opnuut ernstige vrae oor moontlike etiologiese verklarings vir hierdie verskynsel in post-apartheid Suid-Afrika na vore gebring. Die skrywer neem in hierdie artikel opnuut die oorspronklike RGN-bevindinge in oënskou, terwyl sosiale en sielkundige faktore in post-apartheid Suid-Afrika, wat ook 'n impak hierop kan hê, ondersoek word. 'n Sosiaal-konstruksionistiese perspektief is as teoretiese raamwerk vir 'n beter begrip van die breër konteks van hierdie tipe geweld gebruik. Ten slotte word moontlike intervensies voorgestel wat verder as simplistiese verklarings kyk, en eerder op die sosiale verantwoordelikeheid van geestesgesondheidswerkers fokus.

Key words: Family murder, Family violence, Violent crime, Mental health care, Psychological services