South African Family Practice最新文献_第10页

Assessing index CD4 and associated outcomes at 1-year in a tertiary HIV clinic, KwaZulu-Natal 评估夸祖鲁-纳塔尔省一家三级艾滋病毒诊所的 CD4 指数和 1 年后的相关结果

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South African Family Practice Pub Date : 2024-01-25 DOI: 10.4102/safp.v66i1.5803

Zanele R. Moya, S. Pillay, N. Magula

{"title":"Assessing index CD4 and associated outcomes at 1-year in a tertiary HIV clinic, KwaZulu-Natal","authors":"Zanele R. Moya, S. Pillay, N. Magula","doi":"10.4102/safp.v66i1.5803","DOIUrl":"https://doi.org/10.4102/safp.v66i1.5803","url":null,"abstract":"Background: Human immunodeficiency virus (HIV) management guidelines have evolved from initiating therapy at CD4 counts of ≤ 200 cells/m3 to implementing universal test and treat (UTT). This study aimed to assess whether in clinical practice, patients are presenting with higher baseline CD4 counts, describe the incidence of opportunistic infections and the proportion that achieved viral suppression.Methods: A retrospective cohort design with convenience sampling was conducted. Cohort 1 included patients initiated on antiretroviral therapy (ART) between 01 January 2014 and 31 December 2014, when criteria were set at CD4 count ≤ 350 cells/mm3. Cohort 2 included patients initiated on ART between 01 January 2019 and 31 December 2019, during the UTT era.Results: At ART initiation, the median CD4 cell was 170 cells/mm3 (interquartile range [IQR]: 85.5–287) in Cohort 1 cells/mm3 and 243 cells/mm3 (IQR: 120–411) in Cohort 2. Tuberculosis was the predominant OI in the group with CD4 cell count ≤ 200 cells/m3 in both Cohort 1 (26.8%) and Cohort 2 (27.9%), p = 0.039. At 1 year, virological suppression was achieved in only 77.7% and 84.7% of Cohorts 1 and 2 patients.Conclusion: A notable portion of patients at King Edward VIII Hospital’s HIV clinic commenced ART with CD4 counts significantly below the recommended guideline thresholds.Contribution: The research revealed a delay in initiating ART. A comprehensive reevaluation is essential to pinpoint the factors contributing to this delay and to devise customised interventions.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139599036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental illness attitudes, service provision interest and further training preferences of clinical associates 临床助理人员对精神疾病的态度、提供服务的兴趣和进修偏好

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South African Family Practice Pub Date : 2024-01-23 DOI: 10.4102/safp.v66i1.5808

S. Moodley, J. Wolvaardt, C. Grobler

{"title":"Mental illness attitudes, service provision interest and further training preferences of clinical associates","authors":"S. Moodley, J. Wolvaardt, C. Grobler","doi":"10.4102/safp.v66i1.5808","DOIUrl":"https://doi.org/10.4102/safp.v66i1.5808","url":null,"abstract":"Background: Non-specialist health professionals are required to provide mental health services given the burden of disease due to mental illness. The study aimed to explore the attitudes of clinical associates towards those with mental illness as well as their interest in mental health work and additional mental health training.Methods: A cross-sectional study design was utilised. The study population consisted of clinical associates based in South Africa. An electronic questionnaire was developed that incorporated the 16-item Mental Illness Clinicians’ Attitudes version 4 scale (MICA-4), which is scored out of 96 with higher scores indicating more stigmatising attitudes. Multivariate linear regression was used to determine factors associated with the MICA-4 score.Results: The mean MICA-4 score for the 166 participants who completed all 16 questions was 37.55 (standard deviation 7.33). In multivariate analysis, the factors associated with significantly lower MICA-4 scores were falling in the 25- to 29-year-old age category and indicating that a mental health rotation formed part of the undergraduate degree. More than 80% of the participants (140/167, 83.8%) indicated an interest in mental health work. Two-thirds of the participants (111/167, 66.5%) indicated an interest in a specialisation in mental health.Conclusion: The mean MICA-4 score recorded for clinical associates indicates low stigma levels towards those with mental illness. Additionally, there is significant interest in working and training in mental health.Contribution: Training programmes should take note of the contribution of a mental health rotation to a positive attitude to mental health patients. Clinical associates’ attitudes towards mental illness together with their interest in working and training in mental health suggest that they could be more widely utilised in mental health service provision.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing sexual health in primary care: Guidance for practitioners 加强初级保健中的性健康：从业人员指南

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South African Family Practice Pub Date : 2024-01-19 DOI: 10.4102/safp.v66i1.5822

P. Ramlachan, K. Naidoo

{"title":"Enhancing sexual health in primary care: Guidance for practitioners","authors":"P. Ramlachan, K. Naidoo","doi":"10.4102/safp.v66i1.5822","DOIUrl":"https://doi.org/10.4102/safp.v66i1.5822","url":null,"abstract":"Sexual health is an integral aspect of overall health and well-being and is fundamental to the sustainable development of societies worldwide. The World Health Organization (WHO) defines sexual health as ‘a state of physical, emotional, mental, and social well-being in relation to sexuality’. However, addressing sexual health has been afforded low priority in primary healthcare systems. Primary care practitioners (PCPs), who play a crucial role in providing comprehensive care to communities, receive little training on screening and managing individuals with sexual health problems. The scope of services ranges from education, prevention and screening, to management of sexual health matters. Patients with noncommunicable diseases (NCDs), such as stroke, cancer, heart disease and diabetes, are at increased risk for sexual dysfunction, possibly because of common pathogenetic mechanisms, such as inflammation. This is of considerable importance in the sub-Saharan African context where there is a rapidly increasing prevalence of NCDs, as well as a high burden of HIV. Strategies to improve the quality of sexual health services in primary care include creating a safe and non-judgemental practice environment for history-taking among gender-diverse populations, utilising effective screening tools aligned with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for sexual dysfunctions. In particular, the International Consultation on Sexual Medicine (ICSM -5) diagnostic and treatment algorithm can empower primary care providers to effectively address sexual dysfunctions among patients and improve the quality of care provided to communities regarding sexual and reproductive health.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mastering your fellowship: Part 1, 2024 掌握你的奖学金第 1 部分，2024 年

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South African Family Practice Pub Date : 2024-01-04 DOI: 10.4102/safp.v66i1.5829

K. V. von Pressentin, Mergan Naidoo, F. Mayanja, S. Rangiah, Ramprakash Kaswa

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Brain drain in South Africa is affecting health care 南非人才外流影响医疗保健

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South African Family Practice Pub Date : 2024-01-03 DOI: 10.4102/safp.v66i1.5830

Indiran Govender

引用次数: 0

The support group impact on enhancing the self-worth of women who terminated a pregnancy in adolescence. 支持小组对提升青春期终止妊娠妇女自我价值的影响。

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South African Family Practice Pub Date : 2023-12-27 DOI: 10.4102/safp.v65i1.5707

Botshelo R Sebola, Patrone R Risenga

{"title":"The support group impact on enhancing the self-worth of women who terminated a pregnancy in adolescence.","authors":"Botshelo R Sebola, Patrone R Risenga","doi":"10.4102/safp.v65i1.5707","DOIUrl":"10.4102/safp.v65i1.5707","url":null,"abstract":"Background: Terminating a pregnancy can be a traumatic life event, resulting in negative emotions that can diminish women's self-worth. Support from different sources, including health support groups, could be beneficial in restoring a woman's self-worth. This article aimed to present findings on the impact of a support group intervention on the self-worth of women who terminated a pregnancy in adolescence.Methods: A qualitative, exploratory and descriptive approach, using in-depth, semi-structured interviews, was used to collect data. Thematic analysis guided the data analysis.Results: Five themes emerged from the data: reasons for joining the support group; enhanced emotional and physical wellbeing; self-forgiveness; spiritual growth and participants' voices.Conclusion: Participants described why they needed to join the support group. It became clear that the intercession was effective in the short term as it enhanced participants' self-worth by encouraging them to accept themselves thereby altering their self-condemning emotions, replacing them with self-love.Contribution: The study recommends that a support group should be considered as a backup for women who terminated a pregnancy and have lost their self-worth.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10784272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

South African medical interns’ perspectives on the use of point of care ultrasound 南非医学实习生对使用护理点超声波的看法

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South African Family Practice Pub Date : 2023-12-26 DOI: 10.4102/safp.v65i1.5772

P. Mans, O. Adeniyi

{"title":"South African medical interns’ perspectives on the use of point of care ultrasound","authors":"P. Mans, O. Adeniyi","doi":"10.4102/safp.v65i1.5772","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5772","url":null,"abstract":"Background: Point of care ultrasound (POCUS) has become such a part of patient care that it is included in undergraduate medical training in many high-income countries. In South Africa, despite the availability of ultrasound units, there is no information on the exposure or training required for medical interns to perform POCUS in their community service year. This study examines interns’ self-reported POCUS training and competency, as well as their perceived readiness for their community service year.Methods: In this cross-sectional web-based survey, 43 interns were invited to complete a self-administered questionnaire after completing their 6-month decentralised family medicine rotation in 2022.Results: Thirty complete responses (69% response rate) were included for analysis. Eleven graduates from three medical schools reported undergraduate exposure to POCUS. Ten participants completed formal postgraduate ultrasound training. Eight participants felt confident to independently perform POCUS. Thirteen participants felt adequately prepared for their community service year, 10 of whom had received POCUS training. Nearly all the participants (29 of 30) felt that ultrasound training should be incorporated into both undergraduate and internship training.Conclusion: Medical interns expressed a need for more POCUS training. Most of the studied sample did not feel adequately prepared to perform POCUS independently. The high uptake of additional ultrasound courses highlights the need to include POCUS training. More research is needed to determine the extent and level at which POCUS training should be offered to medical interns in the South African setting.Contribution: This study looks at the perceived need of South African medical interns for formal POCUS training. It highlights a potential gap in training based on the expected clinical requirements of the community service year.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A qualitative study of pharmacists’ perceptions and awareness of homoeopathic medicines in Durban, South Africa 关于南非德班药剂师对同种疗法药物的看法和认识的定性研究

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South African Family Practice Pub Date : 2023-12-26 DOI: 10.4102/safp.v65i1.5698

Nokuthula H. Mavela, Ingrid M.S. Couchman, Themba Mgwaba, C. Nxumalo

{"title":"A qualitative study of pharmacists’ perceptions and awareness of homoeopathic medicines in Durban, South Africa","authors":"Nokuthula H. Mavela, Ingrid M.S. Couchman, Themba Mgwaba, C. Nxumalo","doi":"10.4102/safp.v65i1.5698","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5698","url":null,"abstract":"Background: There is growing interest in the demand for and use of homoeopathic medicines by the public; however, little is known about the perspectives of pharmacists regarding the use of these medicines, particularly in the South African private health context.Methods: A qualitative approach using an exploratory cross-sectional descriptive design was used. Data were collected from a purposive sample of 15 participants comprising pharmacy managers, pharmacists and pharmacy assistants from six different conveniently selected private pharmacy retail outlets. Data were collected using individual interviews utilising a semi-structured interview guide. An audiotape was used to record the data which were transcribed verbatim and analysed thematically, following Tech’s steps of data analysis. Ethical approval to conduct the study was obtained from the Durban University of Technology’s Institutional Research Ethics Committee.Results: The findings of this study revealed four superordinate themes related to pharmacists’ perceptions and self-reported awareness regarding homoeopathic medicines. These are (1) negative perceptions regarding homoeopathic medicines, (2) perceived benefits of homoeopathic medicines, (3) poor knowledge and awareness of homoeopathic medicines and (4) capacity development and curriculum aspects.Conclusion: The findings highlight the need for an educational intervention on homoeopathic medicines targeting pre-service and in-service pharmacy practitioners, to enable them to provide effective education regarding all types of medicines as the demand for homoeopathic medicines increases.Contribution: The study findings provide evidence to support advocacy for an educational intervention to improve awareness and knowledge of pharmacists to enable provision of effective health education for patients. More research, however, is required to inform the contents of this training intervention for pharmacists.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The psychological impact of COVID-19 on frontline doctors in Tshwane public hospitals COVID-19 对茨瓦尼公立医院一线医生的心理影响

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South African Family Practice Pub Date : 2023-12-22 DOI: 10.4102/safp.v65i1.5807

Juliet D. Duffton, Marthinus J. Heystek, Andreas Engelbrecht, Suma Rajan, Renier A. Du Toit

{"title":"The psychological impact of COVID-19 on frontline doctors in Tshwane public hospitals","authors":"Juliet D. Duffton, Marthinus J. Heystek, Andreas Engelbrecht, Suma Rajan, Renier A. Du Toit","doi":"10.4102/safp.v65i1.5807","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5807","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic placed immense pressure on frontline doctors. Burnout is a psychological syndrome that develops in response to chronic work stress. It consists of emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA). Burnout is associated with personal dysfunction and compromises the work profession and patient safety. International studies suggest burnout is exacerbated during a pandemic.Methods: We conducted a descriptive cross-sectional observational study. Respondents included frontline doctors working in emergency medicine, family medicine and internal medicine during COVID-19 in Tshwane public hospitals. The survey included two validated questionnaires, the Maslach Burnout Inventory and the Depression, Anxiety, Stress Scale-21. The aim was to determine the prevalence and severity of burnout, psychological and somatic symptoms in frontline doctors.Results: Of the 163 participants, we found clinical burnout to be present in 58.9% (n = 96) and extreme burnout in 19.6% (n = 32). Moderate to extremely severe levels of stress, anxiety and depression were present in 55.1% (n = 90), 43.6% (n = 71) and 22.1% (n = 36) of participants, respectively. We found significant correlations between burnout and psychological symptoms. Increased levels of burnout, anxiety, depression and stress were found to be meaningfully associated with adverse somatic symptoms.Conclusion: Our study demonstrated an insufferably high prevalence of burnout and psychosomatic symptoms in frontline doctors during COVID-19. In the event of future pandemics, more measures should be taken to support frontline doctors.Contribution: Pandemic-associated burnout and its psychophysical consequences have not been studied in frontline doctors in South Africa.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neonatal death audits at Kgapane Hospital, Limpopo province 林波波省 Kgapane 医院新生儿死亡审计

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South African Family Practice Pub Date : 2023-12-22 DOI: 10.4102/safp.v65i1.5815

Gert J.O. Marincowitz, C. Marincowitz

{"title":"Neonatal death audits at Kgapane Hospital, Limpopo province","authors":"Gert J.O. Marincowitz, C. Marincowitz","doi":"10.4102/safp.v65i1.5815","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5815","url":null,"abstract":"Background: Neonatal deaths (NNDs) are a global public health challenge, predominantly affecting low- and middle-income countries. The causes of most NNDs are preventable. Therefore, this study reviewed perinatal clinical audit data at Kgapane Hospital over a 4-year period with a special focus on the factors associated with NNDs.Methods: File audits were performed for all NNDs occurring at Kgapane Hospital and its catchment area from 2018 to 2021. The data from these audits were analysed to identify factors associated with NNDs.Results: The NND rate for the study period was 12.6/1000 live births. In this study (n = 236), 90% of the deaths could be associated with four factors, namely prematurity (44%); intrapartum complications (19%) including asphyxia, meconium aspiration and breech deliveries; neonatal infections (16%) of which human immunodeficiency virus (HIV) positivity was the most prevalent; and foetal congenital abnormalities (11%). The modifiable factors included inadequate intrapartum foetal monitoring; delays in management interventions; instances where no attempts were made to refer patients for specialised care, or where no beds were available at the next level of care; patient-related factors; and inadequate adherence to management protocols, such as for the management of prematurity and HIV.Conclusion: Understanding factors associated with NNDs can guide health worker training and improvement strategies to reduce this heart-breaking complication of pregnancy.Contribution: Family physicians working in rural hospitals are also responsible for newborn care. Understanding the factors associated with NNDs will guide them to focus training and develop improvement strategies to reduce these preventable deaths.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0