South African Family Practice最新文献

{"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":"60 4","pages":""},"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}

{"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":"21 5","pages":""},"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}

{"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":"24 4","pages":""},"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}

{"title":"Local language proficiency of fourth-year medical students at the University of the Free State","authors":"Peter Ngobeni, Maleho Sebolai, Licham Hlotshana, Tshwanelo Henani, Siphosomusa Masango, Smangaliso Hlongwane, Samkelo Ngqulu, Thabelo Makhaba, Carl Van Ramesdonk, Gina Joubert","doi":"10.4102/safp.v65i1.5800","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5800","url":null,"abstract":"Background: Language proficiency is beneficial for doctor–patient communication and health outcomes. Poor communication can lead to misdiagnosis by the doctor and/or non-adherence from the patient. This study aimed to evaluate medical students’ proficiency in the most commonly spoken local languages.Methods: This cross-sectional study was conducted in the class of 119 fourth-year medical students at the University of the Free State (UFS) in 2019. Students’ proficiency was tested for Sesotho and Afrikaans, as these are the most widely spoken languages in the Free State province. The study consisted of two phases: completing a self-administered questionnaire where students self-rated their proficiency in the two languages, followed by telephonic interviews consisting of a series of proficiency-testing questions.Results: Of the 119 fourth-year medical students at UFS, 96 (80.7%) completed the self-administered questionnaires. Forty-six students (47.9%) rated themselves as either advanced or proficient in Afrikaans, whereas only 23 students (23.9%) rated themselves as advanced or proficient in Sesotho. Only 28 students were subsequently interviewed. Their actual language proficiency matched their self-rating.Conclusion: The findings suggest a need for language skills training improvement in the curriculum for undergraduate medical students for languages most commonly encountered locally. We also found that students report their language capabilities accurately.Contribution: The research findings reinforce the need for language skills training in the curriculum of undergraduate medical students regarding languages commonly encountered in the local area.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"45 11","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950146","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}

{"title":"Healthcare access for children in a low-income area in Cape Town: A mixed-methods case study","authors":"Luke B. Profitt, Graham Bresick, L. Rossouw, Ben Van Stormbroek, T. Ras, K. V. von Pressentin","doi":"10.4102/safp.v65i1.5754","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5754","url":null,"abstract":"Background: In Cape Town, the under-5 mortality rate has plateaued to 20 per 1000 live births, with 60% of child deaths occurring out of hospital. The southern subdistrict has the largest paediatric population in Metro West and accounts for 31% of deaths. This study aimed to uncover the access barriers and facilitators underlying this high burden of out-of-hospital deaths.Methods: An exploratory mixed-methods case study design employed three data collection strategies: a quantitative survey with randomly sampled community members, semi-structured interviews with purposively sampled caregivers whose children presented critically ill or deceased (January 2017 – December 2020) and a nominal group technique (NGT) to build solution-oriented consensus among purposively sampled health workers, representing different levels of care in the local health system.Results: A total of 62 community members were surveyed, 11 semi-structured caregiver interviews were conducted, and 11 health workers participated in the NGT. Community members (74%) experienced barriers in accessing care. Knowledge of basic home care for common conditions was limited. Thematic analysis of interviews showed affordability, acceptability, and access, household and facility factor barriers. The NGT suggested improvement in community-based services, transport access and lengthening service hours would facilitate access.Conclusion: While multiple barriers to accessing care were identified, facilitators addressing these barriers were explored. Healthcare planners should examine the barriers within their geographic areas of responsibility to reduce child deaths.Contribution: This study uncovers community perspectives on childhood out-of-hospital deaths and makes consensus-based recommendations for improvement.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"125 28","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953490","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}

{"title":"Guiding the emerging primary care researcher: A report of research capacity-building workshop","authors":"Shane D. Murphy, A. Nair, Ramprakash Kaswa, Indiran Govender, K. V. von Pressentin","doi":"10.4102/safp.v65i1.5769","DOIUrl":"https://doi.org/10.4102/safp.v65i1.5769","url":null,"abstract":"There is an escalating interest in research capacity building across the globe. Research is an integral part of the continuous improvement process, clinical decision making and health system strengthening and should be embedded into the health system. The South African Family Practice Journal editorial team held a workshop on 19 August 2022 at the 24th National Family Practitioners Congress in Cape Town, with the aim of supporting primary care clinicians in their development from early-career researchers to established clinician-scientists. Small group and plenary discussions yielded valuable insights into the lived experiences of early career researchers and highlighted critical action areas to build the landscape of clinician-led research in the South African context.Contribution: This article contributes to current literature by providing insight into the lived experiences of early-career researchers and explores opportunities for research capacity-building.","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"7 6","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138956029","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}

{"title":"Medical registrars at the University of the Free State: Burnout, resilience and coping strategies.","authors":"Lynette J Van der Merwe, Nakedi Motlapema, Tsiu Matsepe, Karabo Nchepe, Pearl Ramachela, Tshilidzi Rangolo, Zizipho Kutu, Gina Joubert, Cornel Van Rooyen","doi":"10.4102/safp.v65i1.5788","DOIUrl":"10.4102/safp.v65i1.5788","url":null,"abstract":"<p><strong>Background: </strong>Burnout among doctors has been linked with decreased quality of patient care. The coronavirus disease 2019 (COVID-19) pandemic highlighted the need to protect doctors' mental health and well-being. This study aimed to investigate burnout, resilience and coping strategies among registrars in the MMed programme of the University of the Free State (UFS) in 2020.</p><p><strong>Methods: </strong>In this quantitative, cross-sectional study, a link to an online anonymous self-administered questionnaire with socio-demographic questions, perceived stress, Copenhagen Burnout Inventory (CBI), Connor-Davidson Resilience Scale and Brief Cope was emailed to all 278 registrars.</p><p><strong>Results: </strong>Sixty registrars responded (response rate 21.6%). More than half (55.0%) were male and 73.3% were married. There were 28.3% second- and third-year students, respectively. Most (58.3%) had 5-10 years' work experience. The CBI personal scale had the highest median value (58.3; interquartile range [IQR]: 43.3; 70.8) with 70% scoring ≥ 50. The median score for resilience was 78 of 100 (IQR: 69; 84). There were weak negative correlations between resilience and burnout scores (r = -0.31 to r = -0.37). Planning, positive reframing and acceptance were the most frequently used adaptive coping mechanisms; self-distraction was the most frequently used maladaptive coping mechanism. There was no association between gender and burnout and resilience scores.</p><p><strong>Conclusion: </strong>Registrars were resilient with low levels of patient- and work-related burnout, and higher personal burnout, using mostly positive coping strategies.Contribution: This study gives insight into the well-being of registrars at the UFS during COVID-19. Continuous monitoring and support for this population are essential to foster mental health and well-being.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e7"},"PeriodicalIF":1.2,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810222","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}

{"title":"Mistrust in government and National Health Insurance: A qualitative study of solo private practitioners in Cape Town.","authors":"Bridget L Perrow, Helen Schneider","doi":"10.4102/safp.v65i1.5768","DOIUrl":"10.4102/safp.v65i1.5768","url":null,"abstract":"<p><strong>Background: </strong>The participation of independent private general practitioners (GPs) is of fundamental importance to the successful implementation of key elements of the proposed National Health Insurance (NHI) reform, notably the contracting units for primary health care (CUPS). This study explored knowledge and perceptions of the NHI reforms of private GPs following the tabling of the NHI Bill in parliament in 2019.</p><p><strong>Methods: </strong>An explorative qualitative research methodology was adopted. Using a semi-structured guide, nine solo private GPs, purposefully selected to represent the range of practices in the southern peninsula of Cape Town were interviewed in depth by B.L.P. over the period from January 2021 to March 2022.</p><p><strong>Results: </strong>The GPs indicated support for the values of greater equity outlined in the NHI proposals. However, they had little engagement on or knowledge of their potential future roles in NHI. Concerns over financial viability and design were underpinned by an overall mistrust in the public sector to implement and manage NHI.</p><p><strong>Conclusion: </strong>The study concurs with previous research that private GPs are broadly in support of the principles of, and are potential allies, in advancing NHI. General practitioners need a platform to share their concerns and contribute as co-designers of NHI reforms. In the interim, steps to increase collaboration between private and public sectors at local and provincial level through, for example, referral processes may help to build the trust that is necessary between the sectors.Contribution: This study foregrounds the role of trust relationships in advancing NHI.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810231","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}

{"title":"The family dynamics of children on the streets of Ibadan, Southwest Nigeria.","authors":"Abimbola M Obimakinde, Moosa Shabir","doi":"10.4102/safp.v65i1.5774","DOIUrl":"10.4102/safp.v65i1.5774","url":null,"abstract":"<p><strong>Background: </strong>Children roaming the streets estimated at 1 in 10 by a 2021 United Nation Children's Funds (UNICEF) report is a growing problem, in cities of lower- and middle-income African countries. Studies of street children with no family ties abound, but there is a paucity of studies on children on the street who exist within families and return home daily. We explored the family dynamics of children on the streets of Ibadan, emphasising family structure, resources and relationships.</p><p><strong>Methods: </strong>Using an exploratory design based on a qualitative approach 53 participants were interviewed, including children on the streets, parental figures, child-welfare officers and street shop owners. Participants were selected from streets in the five urban local government areas of Ibadan, Nigeria. Recorded data were transcribed, and framework analysis was performed.</p><p><strong>Results: </strong>The family dynamics included family structural problems, poor family resources and poor parent-child relationships. The family structural problems included: broken homes, large families and ambivalence around polygamy as subthemes. Family resources comprised: poor economic resources, poor social resources, educational challenges, cultural ambivalence and spiritual backdrops. The family relationships patterns included: poor adaptability, economic-oriented partnership, poor growth support, poor emotional connection and poor family bonding.</p><p><strong>Conclusion: </strong>The dynamics driving a family's choice for child streetism in Ibadan, mostly to hawk, are devaluation of family life, parenting irresponsibility, and poor filial relationship, underscored by economic constraints and socio-cultural decadence. The results of this research buttress the need for family-level interventions to forestall the escalating phenomenon of child streetism in Ibadan, Nigeria.Contribution: This research highlights the family dynamics of children on the streets, and buttresses family-level interventions are necessary to forestall escalating child-streetism in Ibadan, Nigeria.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"e1-e11"},"PeriodicalIF":1.2,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10730446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810337","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}

{"title":"Erratum: South African Family Practice Manual, fourth edition: Meeting expectations?","authors":"Arun Nair, Talat Habib","doi":"10.4102/safp.v65i1.5843","DOIUrl":"10.4102/safp.v65i1.5843","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"65 1","pages":"5843"},"PeriodicalIF":1.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478611","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}