Authors:Lucky L. Shokane, Selente Bezuidenhout, Maryke Lundie First page: 6 Abstract: Background: Febrile neutropaenia (FN) and resultant infections are the major cause of treatment-related morbidity and mortality in patients receiving chemotherapy. Clinical practice guidelines recommend the use of granulocyte colony-stimulating factors (G-CSF) to reduce the risk of FN and ensuing complications in patients receiving chemotherapy. Despite these recommendations, inappropriate usage of G-CSF has been reported.Aim: To assess prescribing patterns and adherence to international guidelines of G-CSF in adult patients with chemotherapy-induced neutropaenia (CIN) at the haematology oncology wards of the Dr George Mukhari Academic Hospital (DGMAH) and compliance to guidelines.Methods: Medical records of adult patients who received G-CSF were reviewed retrospectively between 01 January 2018 and 31 July 2018.Results: Of the 128 patient files screened, 57 cases met the inclusion criteria. Duration of treatment with G-CSF was not in accordance with guidelines in more than 50% of the patients and in 43.86%, G-CSF dosing deviated from recommended guidelines.Conclusion: The study demonstrated over-prescribing of G-CSF due to either increased doses or duration of G-CSF therapy. Although prescribed for the correct indication, the dosage was often too high or the duration was too long, even once an acceptable neutrophil nadir count was reached. Interventions to optimise the use of G-CSF are required and the pharmacist may play a role in this regard.Contribution: The administration of the correct doses of G-CSF can reduce both the severity and duration of neutropaenia. Over-prescribing and incorrect dosing may contribute to patient morbidity and add to the financial burden of healthcare. PubDate: 2023-03-31 DOI: 10.4102/hsag.v28i0.2221 Issue No:Vol. 28 (2023)
Authors:Reabetswe A. Mere, Thembi V. Simbeni, Mmampedi Mathibe, Ntlogeleng M. Mogale, Sam T. Ntuli First page: 7 Abstract: Background: Job satisfaction has become an area of relevance and debate in public health as it is directly linked to staff absenteeism, retention and turnover of the workforce and as such, influences the organisational commitment of the workers and the quality of health services provided. It is therefore essential to discern what drives healthcare professionals to remain working in the public health sector.Aim: This study aimed to determine job satisfaction and its associated factors among healthcare professionals.Setting: North-West province South Africa.Methods: A cross-sectional study was conducted among 244 healthcare professionals of different categories in three district hospitals. A self-administered structured questionnaire with 38 questions to measure job satisfaction was used to collect data. The chi-square test was used to compare groups, and a p-value < 0.05 was considered statistically significant.Results: Overall, 62% of the participants were not satisfied with their job. The most common factors that participants were not satisfied with include job security (52%), standard of care (57%), opportunity to develop (59%), payment or wages (76%), workload (78%) and working environment (89%). Job satisfaction was significantly influenced by age, job category and years of service.Conclusions: The predictors of job satisfaction include age, category of employees and years of service. Interventions are required to improve the degree of job satisfaction among health care professionals.Contribution: Findings of this study will assist informing plans that are geared towards enhancing healthcare worker job satisfaction, retention and consequent health systems strengthening. PubDate: 2023-05-22 DOI: 10.4102/hsag.v28i0.2234 Issue No:Vol. 28 (2023)
Authors:Stephan Acheampong, Mygirl P. Lowane, Lucy Fernandes First page: 8 Abstract: Background: Migration to South Africa is currently dominated by women and children, for socio-economic and refugee reasons or to utilise the healthcare system for various services. Migrants and refugees are at risk of vaccine-preventable diseases, and many of their children have an incomplete or unknown immunisation status.Aim: This study aimed to explore the experiences of migrant mothers in utilising child immunisation services in primary healthcare facilities.Setting: Ten primary healthcare facilities that were providing immunisation services, located in the Buffalo City Metropolitan Municipality, Eastern Cape province, South Africa.Methods: A qualitative research design, making use of in-depth interviews (IDIs) from 18 purposefully selected migrant women, was used for data collection. Thematic content analysis was used to analyse the recorded data of the experiences of study participants in their access to immunisation services.Results: From the IDIs, four themes were identified: difficulty in communicating with the healthcare workers because of language barriers, access challenges, interpersonal barriers and interpersonal relationships were identified in this study, which influenced the utilisation of immunisation services by migrant mothers.Conclusion: The findings of this study support and reinforce the duty of the South African government and healthcare facilities to work together to improve migrant women’s access to immunisation services.Contribution: A positive relationship between healthcare workers and migrant mothers while accessing immunisation services should contribute to reducing child mortality in South Africa and achieving Sustainable Development Goal 3 by the year 2030. PubDate: 2023-05-19 DOI: 10.4102/hsag.v28i0.2166 Issue No:Vol. 28 (2023)
Authors:Emmah M. Mokoena, Tinda Rabie, Antoinette du Preez First page: 9 Abstract: Background: Clinical associates were introduced in South Africa to address physician shortages in healthcare. Professional relationships between physicians and professional nurses (PNs) have been widely researched, but none specifically between the new cadre of clinical associates and PNs.Aim: This study aimed to understand the professional working relationship between PNs and clinical associates.Setting: Selected district hospitals within Mpumalanga Province, South Africa.Method: A qualitative descriptive design was used. Professional nurses were purposely sampled, and an all-inclusive sampling method was used for clinical associates in selected district hospitals within Mpumalanga Province, South Africa. Twelve (N = 12) semi-structured, individual interviews (PNs n = 6; clinical associates n = 6) guided by an interview guide were conducted in English. The interviews were audio recorded and transcribed verbatim by an independent transcriptionist. Tesch’s eight steps of data analysis were employed to analyse the data. An independent co-coder assisted with data analysis.Results: This study yielded four themes: (1) professional relationship defined, (2) professional relationship characteristics, (3) professional challenges applicable to both PNs and clinical associates and (4) personal professional challenges applicable to clinical associates only.Conclusion: This study demonstrated that the professional relationships between PNs and clinical associates are affected by various challenges, which could be resolved within the department through in-service training and good communication.Contribution: This is one of the first studies that highlight the professional relationship challenges between PNs and clinical associates. PubDate: 2023-04-28 DOI: 10.4102/hsag.v%vi%i.1927 Issue No:Vol. 28 (2023)
Authors:Jennifer Watermeyer, Sonto Madonsela, Johanna Beukes First page: 9 Abstract: Background: Little is known about the experiences and impact of coronavirus disease 2019 (COVID-19) on the mental health and wellbeing of healthcare workers (HCWs), particularly in Global South contexts.Aim: The authors aimed to explore the experiences of HCWs at different points during the COVID-19 pandemic in South Africa.Setting: This study’s sample included 621 HCWs from various professions and health sectors who completed the survey during the pandemic peaks of waves I, II and III in South Africa.Methods: The authors used a qualitative survey design exploring participants’ general work, life, mental health and wellbeing experiences, and their support mechanisms or strategies. Data were analysed using thematic analysis.Results: The authors identified three overarching themes in the data, namely stress, adjustment to work during COVID-19, and support experiences and needs. These themes were common across all three survey waves, with some minor differences noted across the waves.Conclusion: An overarching thread of uncertainty seems central to HCWs’ experiences of working during COVID-19, related to pressures in the South African healthcare system that have been aggravated by the pandemic.Contribution: These findings have the potential to inform the development of contextually relevant approaches to support the mental health and wellbeing needs of HCWs during and after a pandemic. In particular, workplaces need to actively offer psychological support to all HCWs, not just to workers traditionally defined as frontline. PubDate: 2023-03-31 DOI: 10.4102/hsag.v28i0.2159 Issue No:Vol. 28 (2023)
Authors:Francis Kobekyaa, Joanne R. Naidoo First page: 9 Abstract: Background: Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana.Aim: To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana.Setting: The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana.Methods: A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically.Results: Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication.Conclusion: This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students’ clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment.Contribution: This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students’ clinical learning. PubDate: 2023-03-31 DOI: 10.4102/hsag.v28i0.2121 Issue No:Vol. 28 (2023)
Authors:Je'nine Horn-Lodewyk, Tanya Wainwright, K-Cee Lessing, Daniel Otto, Jani H. Fourie First page: 10 Abstract: Background: Theatre personnel can spread healthcare-associated infections through contaminated surgical scrubs. Decontamination of surgical scrubs through optimal methods is important to minimise transmission of microorganisms from theatre personnel’s clothing to different areas in the hospital and their homes.Aim: This study aimed to review the literature on the optimal home and hospital laundering methods for the decontamination of reusable surgical scrubs worn by theatre personnel.Method: A systematic literature review of previous studies on laundering reusable surgical scrubs was performed. A review question was formulated using the patient, intervention, comparison and outcome (PICO) framework. A literature search was performed using ScienceDirect, Web of Science, ProQuest, EBSCOhost and Google Scholar.Results: A direct link could be established between the cycle length and water temperature. The higher the water temperature, the shorter the washing cycle required. After a load has been washed in low or medium water temperatures, tumble drying and ironing should follow. Despite the water temperature, a disinfectant must be added to the load.Conclusion: Health professionals and hospital management should be aware of optimal laundering guidelines for hospital and home laundering as part of infection control. Water temperature, time, mechanical action, type of disinfectant and heat are factors influencing the successful removal of bacteria and other pathogens and represent the baseline of this article.Contribution: Home-laundering of reusable surgical scrubs should follow strict guidelines. When these specific guidelines are applied, the effects of home-laundered scrubs will not negatively impact either the theatre or the home environment. PubDate: 2023-05-16 DOI: 10.4102/hsag.v28i0.2097 Issue No:Vol. 28 (2023)
Authors:Juan M. Jansen van Vuuren, Somasundram Pillay, Ansuya Naidoo First page: 10 Abstract: Background: The burden of stroke is increasing worldwide. The hierarchical healthcare referral system in South Africa (SA) poses unique challenges to clinicians when caring for people with suspected strokes (PsS). To improve health outcomes, novel strategies are required to provide adequate care, including prognostication, in SA.Aim: To determine the subjective burden of and challenges posed by suspected stroke cases and the potential usefulness of biomarkers in prognostication.Setting: This study was conducted in the uMgungundlovu Health District (UHD), KwaZulu-Natal, SA.Methods: An online questionnaire was distributed to doctors within the UHD. Demographic data and answers to a series of 5-point-Likert-type statements were collected.Results: Seventy-seven responses were analysed. A third of doctors worked in primary healthcare facilities (PHCare) and saw ≥ 2.15 suspected strokes-per-doctor-per-week, compared to ≥ 1.38 seen by doctors working in higher levels of healthcare. Neuroimaging was relied upon by > 85% of doctors, with nearly half of PHCare doctors having to refer patients to facilities 5 km – 20 km away, with resultant delays. Knowledge about prognostic biomarkers in strokes was poor, yet most doctors believed that a biomarker would assist in the prognostication process and they would use it routinely.Conclusion: Doctors in this study faced a significant burden of strokes and rely on neuroimaging to guide their management; however, many challenges exist in obtaining such imaging, especially in the PHCare setting. The need for prognostic biomarkers was clear.Contribution: This research lays the platform for further studies to investigate prognostic biomarkers in stroke in our clinical setting. PubDate: 2023-05-09 DOI: 10.4102/hsag.v28i0.1916 Issue No:Vol. 28 (2023)
Authors:Ashley Chetty, Tharina Guse, Mosa Malema First page: 10 Abstract: Background: The incidence of dual diagnosis (DD) (i.e. substance use disorders [SUD] and co-occurring mental disorders) is widespread; however, they vary widely in permutation and combination. As a result, establishing effective and empirically supported interventions for this clinical population remains challenging.Aim: This study aimed to examine current literature on the treatment outcomes for patients with DD.Method: A systematic review of randomised controlled trials (RCTs) published between 2009 and 2018 was conducted for two broad intervention categories identified by the literature: non-integrated and integrated treatment. Multiple electronic databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA).Results: The search generated a total of 743 studies, of which 11 satisfied the inclusion criteria. These studies were thematically synthesised into two main analytical themes: ‘treatment outcomes’ and ‘reported strengths and limitations of DD treatment’. Specifically, integrated treatment held an advantage over non-integrated treatment in significantly improving psychiatric symptomatology. However, no significant benefits were found between integrated and non-integrated treatment regarding substance misuse and treatment retention.Conclusion: Overall, the results provided insufficient evidence to support the enhanced efficacy of integrated or non-integrated treatment over the other in treating patients with DD.Contribution: The study’s findings were used to provide recommendations to inform the clinical psychological service delivery of dual diagnosis treatment in South Africa and also to identify gaps in the literature and highlight areas for future research. PubDate: 2023-04-25 DOI: 10.4102/hsag.v28i0.2094 Issue No:Vol. 28 (2023)
Authors:Sibongile Seroke, Sipho W. Mkhize First page: 11 Abstract: Background: Cerebral palsy (CP) is the most prevalent neurological illness in children, and it can cause permanent sensory, motor and cognitive problems for the rest of one’s life. Raising a child with special needs necessitates extensive resources. Women in the middle and lower income brackets are more likely to care for children with CP.Aim: To explore and describe the psychosocial experiences of mothers of children with CP in eThekwini.Setting: This study was conducted at KwaZulu-Natal Children’s Hospital and rehabilitation centre.Methods: The research methods were exploratory and descriptive in nature, with a qualitative approach. Purposive convenience sampling was used to select 12 participants who were parents of children with CP under the age of 18. For data collection, semistructured interviews were utilised. The purpose of thematic analysis is to uncover, analyse and summarise themes and patterns within a data set. Semistructured interviews were used to collect data.Results: The psychosocial experiences of mothers of children with CP revealed three key themes. Themes included the burden of care, a lack of social support and the impact of children with CP on mothers.Conclusion: Participants whose children with CP experienced physical, emotional, psychological and social issues, including inaccessible services and buildings and social isolation from family, friends and the community.Contribution: This study helps to strengthen the development and review of policies on care, support interventions and mother empowerment for children with CP. PubDate: 2023-05-22 DOI: 10.4102/hsag.v%vi%i.2072 Issue No:Vol. 28 (2023)
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