African
Journals Online
Health SA Gesondheid : interdisciplinary research journal
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
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