Thesis (M. A. (Psychology)) -- University of Limpopo, 2016 / The deterioration of health associated with chronic diseases such as hypertension and diabetes mellitus often leads to psychological problems especially among ageing older persons. The aim of the present study was to explore the lived experiences of older persons living with chronic diseases in Ga-Dikgale community in the Limpopo Province. Specifically, the study sought to determine the subjective meanings that older persons living with chronic diseases attach to their conditions; to establish older persons’ causal explanations of their chronic diseases; and, to determine the psychological strategies that older persons use to manage their conditions. A qualitative approach, and in particular, the phenomenological method was used in the present study. Ten older persons living with the experiences of chronic diseases (male = 3: female = 7), aged between 60 and 90 were selected through purposive sampling and requested to participate in the study. Data were collected using semistructured interviews and analyzed using the Interpretive Phenomenological Analysis (IPA) method. The themes that emerged from the study included the following: a). The subjective explanations by older persons living with a chronic disease; b). Manifestations of chronic diseases; c). The psychological coping strategies used by older persons; d) The management of chronic diseases. The findings of the present study further suggest that the participants understand their illnesses as chronic conditions that require long-term management. A number of psychological strategies are utilised by the participants to cope with their chronic conditions. These include passive/active coping and cognitive reappraisal coping strategies. With regard to the management of chronic conditions, most participants were of the view that medical treatment received from the clinic is appropriate for the treatment of their conditions. Some of the participants were however of the view that the nurses did not give them enough information about their chronic condition. The study is concluded by making a number of recommendations that among others include calling for more studies that should be conducted on the impact of chronic diseases on the family structure.

Thesis (M.Pharm.) -- University of Limpopo -- 2020 / Background: Non-communicable diseases (NCDs) which are chronic diseases in nature, have been the most common cause of death and disability globally for the last three decades. The prevalence of hypertension in South Africa has been estimated to be 20% of the adult population with over six million people being affected. Patient’s knowledge and awareness of blood pressure plays an important role in achieving successful control of hypertension. Although it is important for a physician to be involved in this educational process, pharmacists also have a role to play in this regard. Given their accessibility and drug therapy expertise, pharmacists are a logical choice and a valuable asset to improve hypertension management via team-based care and also when they are in direct consultation with the patients. Methods: The study involved both qualitative and quantitative research methods. A pre-validated questionnaire was used to collect data from 341 patients attending the 4 clinics at Ga-Dikgale. A semi-structured one-on-one interviews were used as data collection for 20 pharmacists working at Mankweng hospital until saturation was reached. Results: On the knowledge about definition, 30.7% were knowledgeable and 5.8% were highly knowledgeable. On the knowledge about treatment, 48% were highly knowledgeable. With regards to lifestyle modifications 77.8% were highly knowledgeable. For complications of hypertension, 63.2% were highly knowledgeable. Amongst the participants level of education proved to play a significant role on the knowledge of hypertension. The study also revealed that pharmacists shared similar practices in the management of hypertension. The following themes emerged from the data analysis, using Tesch’s inductive, descriptive coding technique of qualitative data analysis: Perceived roles of pharmacists during the management of hypertensive patients, expectations of pharmacists during provision of medication to hypertensive patients, and challenges related to pharmacists’ practices during care of hypertensive patient}s. Conclusions: The results of the quantitative study indicated that participants at Dikgale have good knowledge about hypertension, although previous studies indicate high rates of cardio-metabolic risk factors for hypertension. Further studies need to be conducted to determine reasons for patients not practicing lifestyle modifications. The results of the qualitative study indicated that there are common practices of pharmacists in the management of hypertension. More attention should be focused on training pharmacists on how to provide comprehensive counselling to hypertensive patients. There should also be workshops for pharmacists on how to efficiently educate patients on hypertension. / VLIR

Patients who have chronic diseases are often readmitted to the hospital within 30 days of being discharged. In the United States preventable hospital readmissions cost approximately $12-$17.4 billion annually. The Institute of Healthcare Improvement [IHI] has identified one key measure for reducing preventable readmissions and that is a timely post hospital follow-up visit. Although this seems to be a simple task, studies have revealed that as many as one-third of patients discharged from the hospital are not following up with their primary care provider. In North Dakota the percentages of patients with chronic diseases such as heart failure, chronic obstructive pulmonary disease, type 2 diabetes, and pneumonia have steadily increased over the last several years. A North Dakota critical access hospital report revealed a high percentage of patients with a chronic disease are being readmitted within 30 days. Identifying barriers to care in North Dakota can help to reduce the rate of readmission within the state. This study seeks to identify perceived barriers as observed by primary care nurse practitioners to improve patient outcomes and reduce hospital readmission rates.

No description available.

The purposes of this study were: (a) to identify which of four competing theories best accounted for self help as a learned outcome of chronic illness experience, and (b) to generate a Self Help Model that could be used to explicate self help as a learned response to chronic illness. The concepts of severity of chronic illness, intimate dependency reinforcers, self induced dependency reinforcers, cue outcome independence reinforcers, enabling skill, self help and life quality were specified in a causal format that allowed a competitive test of four different theories. The theories tested were instrumental passivity theory, self induced dependency theory, an adaptation of learned helplessness theory and learned resourcefulness theory. The study utilized a causal modeling design to assess a five stage model. A judgment sample of 786 individuals having a diagnosis of arthritis or an arthritis related condition were mailed questionnaires. Two hundred seventy-eight subjects responded, a 36 percent return rate. Seven scales using a visual analogue response format indexed the theoretical concepts. Reliability and validity estimates were conducted to assess psychometric properties of the instruments. Model parameters were estimated using multiple regression statistical techniques. Residual analysis was conducted to estimate violations of the causal model and statistical assumptions. Factors from one theory, the learned resourcefulness theory, emerged as more credible than factors from any single other theory. However, the data did evidence factors from other theories that were significant. Self induced sick role reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of enabling skill (B = -.31 and B = -.12, respectively; R² = .11). Intimate dependency reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of self help (B = -.34 and B = -.24, respectively; R² = .19). These factors helped to identify environmental and intra-person contingencies that led to reduction in self help. The learned resourcefulness factor, enabling skill, demonstrated the mediating skills that worked to enhance self help (B = .44; R² = .29). The Self Help Model generated to explicate self help as a learned response to chronic illness explained 50 percent of the variance in perceived self help. Self help had a direct positive impact on life quality (B = .61; R² = .46). By knowing the factors influencing a patient’s self help response to chronic illness experience, the nurse is better able to plan more effective self help promoting interventions for individuals, or groups of patients. Nurses who promote a self help response in those having a chronic illness could improve their life quality.

PhD, Faculty of Health Sciences, University of the Witwatersrand / Background: Chronic diseases have increased worldwide. Despite the significant advances in medical science, the management of chronic diseases continues to be poor. To meet this challenge, we need to try to implement existing chronic illness models of prevention, early detection, and risk factor management. This is achievable in part by linking primary health care clinicians, such as primary health care nurses (PHCNs) and hospital-based medical specialists. This study evaluated a ‘real life’ chronic disease outreach program (CDOP), which assisted PHCNs with the early detection and management of chronic illnesses known to cause chronic kidney disease (CKD) and cardiovascular disease (CVD). PHCNs are critical in the management of chronic illnesses but they require ongoing support of and links with specialists. This will ensure that current guidelines reach the people receiving primary health care (PHC) and detection of those needing referrals. Aims: The study aimed to determine if CDOP was an effective method for the early detection and management of diabetic and hypertensive patients at high risk for complications like stroke, ischaemic heart disease and CKD. It also aimed to evaluate the PHCNs’ knowledge and motivation, and to elucidate the challenges facing the current health system in the management of patients with chronic conditions. Methods: Patients at risk for complications were enrolled for increased monitoring and clinical support and management, at 20 clinics in Soweto, South Africa (SA). CDOP used a paper-based support and patient care system, modelled on the Wagner Chronic Illness Care Model (CICM). The components for evaluation included: (i) Focus on monitoring functional and clinical outcomes (ii) Health system interventions, such as increased ‘decision support’ and the development of a ‘prepared motivated health care team’ and (iii) Enhancing PHCNs’ knowledge and motivation. The evaluation followed the various elements of the Wagner CICM, as well as drawing on the WHO Innovative Care for Chronic Conditions (ICCC) Framework. A cohort analysis of functional and clinical outcomes in enrolled patients was conducted. PHCN knowledge and motivation was assessed through self administered questionnaires. Health worker knowledge was evaluated through the use of case scenarios and multiple choice questions. On the theme of health worker motivation, Franco’s model, with Penn-Kekana’s adaptation, was used to develop the questions and analyse diary recordings. Diary recordings of PHCNs and meetings with regional and provincial health managers’ discussions were collected by CDOP staff during follow-up focus groups and feedback meetings. Diaries were analysed thematically. The CDOP evaluation is thus a triangulated analysis of clinical and functional outcomes, diary recordings, and the self-administered questionnaire. Results: The CDOP ran from 2003-2006, during which time 618 patients (61% females, 39% males) deemed at risk of CKD or CVD were enrolled; 55% had uncontrolled hypertension (HTN), 45% DM with HT and/or proteinuria. Patients were followed for 2 years. In total, 108 patients completed 2 years of follow up, most of whom were referred for specialist support (n=69, 11%), more intensive medication regimes or because were not available in the PHC system. Most did not require referral (515, 82%), 35 (6%) were referred but never arrived at the hospital and 6 (1%) died. Twelve percent had advanced CKD, 2% required dialysis, 6.9% required medications not available to primary care clinics, and 1% died. As a tool to detect those needing referral, the program was successful. The sensitivity and specificity for detecting those needing referral was 95% and 100%, respectively.. However, although PHCNs were able to detect high risk patients, not all those referred arrived at the hospital. Hypertension, blood glucose, cholesterol and proteinuria control significantly improved in those followed (p<0.01) over 2 years, but no improvement was noted with weight control. Importantly, proteinuria and kidney function, in patients with static stable renal function, measured by estimated GFR equations and urine dipstick or albumin creatinine ratio (ACR), did not worsen significantly. Of the remaining 510 patient enrolled but not followed up, 213 (35%) were reabsorbed into the routine clinics, and a further, 123 (20%) of patients enrolled were lost to follow up completely. The diary recording thematic analysis revealed the problem of poor patient follow up, attributed to the poor existing health system in the clinics, competing demands on PHCNs, staff shortages, high staff turnover, and the low motivation and morale of clinicians. The analysis of the health worker questionnaire showed improved motivation and statistically better knowledge in those PHCNs involved with CDOP compared to those who were not exposed to the program (p<0.0034). Conclusions: CDOP was successful in supporting PHCNs, detecting patients with advanced disease and ensuring their early referral. Such programs are able to correctly detect people with disease, but this is dependent on the health and program systems being intact. It also improved patient risk factor control in the sub-set of referred patients and impacted on PHCNs’ existing knowledge and motivation for caring for patients. Its weaknesses were related to the poor existing health systems and infrastructure, and the poor integration of chronic illness care in the region. The PHC clinics had poor follow up compared with that in the hospital setting. The study also revealed an overworked, poorly supported, and frustrated primary health care team. This was despite the fact that the PHCNs were willing and motivated to deliver a good service.

Introdução: A hipertensão arterial tem alta prevalência, porém o controle dos níveis pressóricos é pouco satisfatório, provavelmente devido a baixa adesão ao tratamento. Assim, faz-se necessário buscar estratégias para aumentar o controle e adesão ao tratamento e modificar o estilo de vida. O Objetivo principal desse estudo foi caracterizar um grupo de hipertensos monitorados por enfermeiros dentro de um programa de gestão de doenças crônicas. Casuística e Métodos: O estudo foi realizado com 283 hipertensos em uma instituição particular na cidade de São Paulo, que praticava a gestão de doenças crônicas. Os hipertensos foram orientados por um período de 17 meses, com contatos telefônicos mensalmente e duas visitas domiciliares nos meses 9 e 17. A pressão arterial, peso e altura foram referidos nos contatos telefônicos e aferidos nas visitas domiciliares. Foram avaliados também ingestão de bebida alcoólica, tabagismo e sedentarismo. A adesão ao tratamento medicamentoso foi avaliada pelo teste de Morisky Green. A avaliação foi realizada em cinco momentos (a cada três meses) e nas duas visitas domiciliares. Valores de p<0,05 foram considerado significantes. Resultados: A maioria do sexo feminino (62,5%), idade 73,4 (10,9) anos. Houve mudança significativa no comportamento das seguintes variáveis(p<0,05): Etilismo (10,2% vs 3,2%); Sedentarismo (96,8% vs 71,7%); Adesão avaliada por Morisky Green (25,1% vs 85,5%); Pressão Arterial Sistólica (128,8 (11,4) vs 125,1 (11,6) mmHg); Pressão Arterial Sistólica (78,9 (7,8) vs 77,2 (8,0) mmHg). O Controle da pressão arterial se associou ao tabagismo no momento 5 do acompanhamento (p=0,02), verificou-se menor controle entre os tabagistas ( 3,7% vs 11,9%). A adesão ao tratamento medicamentoso avaliado pelo teste de Morisky Green se associou (p<0,05) a presença de insuficiência renal crônica, houve maior adesão na presença dessa comorbidade (20,6% vs 3,3%), ao uso de Inibidores da Enzima Conversora de Angiotensina (18,6% vs 3,3%) e uso de Bloqueadores dos Receptores de Angiotensina (53,0% vs 73,3%). A segunda pergunta do teste de Morisky Green Você é desatento, de vez em quando sobre tomar o seu remédio se associou (p<0,05) ao uso de Inibidores da Enzima Conversora de Angiotensina ( 21,3% vs 12,0%). A terceira pergunta do instrumento \"Deixa de tomar a medicação caso sinta-se melhor?\" se associou ao histórico de infarto do miocárdio (8,2% vs 2,0%), uso de Bloqueadores do Receptor de Angiotensina(62,6% vs 51,1%), uso de Inibidores da Enzima Conversora de Angiotensina (21,7% vs 8,1%) e com os tabagistas no primeiro e no terceiro momento de participação no programa respectivamente (7,1% vs 1,6%) e (10,1 vs 3,3%). A quarta pergunta do teste de Morisky Green Deixa de tomar a medicação caso sinta-se pior?\" se associou com portadores de Insuficiência Renal Crônica (22,5 % vs 8,1%), o uso de Diuréticos (93,2% vs 6,8%), uso de Inibidores da Enzima Conversora de Angiotensina (20,6% vs 6,8%) e etilistas no segundo, terceiro e quarto momentos de participação no programa respectivamente (8,1 vs 1,9%), (8,1% vs 1,9%) e (8,1% vs 1,9%). Houve associação estatisticamente significativa entre o uso de Bloqueadores do Receptor de Angiotensina e a ocorrência de internação hospitalar, houve maior número de internações entre aqueles em uso desta classe farmacológica (63,0% vs 48,7%). Conclusão: Os hipertensos monitorados pela enfermagem dentro do programa de doenças crônicas apresentaram ao longo do seguimento mudanças significativas na pressão arterial, nos hábitos de vida e aumento da adesão ao tratamento medicamentoso. / Introduction : Hypertension has a high prevalence , but the control of the hypertension is unsatisfactory , probably due to poor adherence to treatment . Thus , it is necessary to develop strategies to increase the control and treatment adherence and modify lifestyle . The main objective of this study was to characterize a group of hypertensive patients monitored by nurses within a program of chronic disease management . Methods: The study was conducted with 283 hypertensive patients in a private institution in the city of São Paulo , who practiced the management of chronic diseases . Hypertensive patients were instructed for a period of 17 months, with monthly telephone contacts and home visits in the months 9:17 . Blood pressure , height and weight were said to phone contacts and home visits measured . Alcohol consumption , smoking and physical inactivity were also evaluated . The adherence to therapy was assessed by the Morisky Green test . The evaluation was performed in five times ( every three months) and in home visits . P values < 0.05 were considered significant. Results: Most women ( 62.5 % ) , age 73.4 ( 10.9) years. Was no significant change in the behavior of these variables ( p < 0.05 ) : Alcohol consumption ( 10.2 % vs 3.2% ) ; Sedentary lifestyle ( 96.8 % vs 71.7 % ) ; Adhesion evaluated by Morisky Green ( 25.1% vs. 85.5%) ; Systolic blood pressure ( 128.8 ( 11.4 ) vs 125.1 ( 11.6 ) mmHg ) ; Systolic blood pressure ( 78.9 ( 7.8 ) vs 77.2 ( 8.0 ) mmHg ) . Control of blood pressure was associated with smoking at the time of the 5 follow-up ( p = 0.02 ) , there was less control among smokers ( 3.7% vs. 11.9 % ) . Adherence to drug treatment assessed by the Morisky Green test was associated ( p < 0.05 ) the presence of chronic renal failure , there was greater adherence in the presence of this comorbidity ( 20.6 % vs 3.3% ) , the use of inhibitors Angiotensin Converting Enzyme ( 18.6% vs 3.3% ) and use of Angiotensin Receptor blockers ( 53.0 % vs 73.3 % ) . The second question Morisky Green test \"You\'re inattentive, from time to time about taking your medicine\" was associated ( p < 0.05 ) at the use of inhibitors of Angiotensin Converting Enzyme ( 21.3 % vs 12.0 %). The third question of the instrument \" Stop taking the medication if you feel better? \" was associated with a history of myocardial infarction ( 8.2% vs 2.0% ) , use of Angiotensin Receptor Blockers ( 62.6 % vs 51.1 % ) , use of inhibitors of Angiotensin Converting Enzyme ( 21 , 7 % vs 8.1% ) and smokers in the first and third moment of participation in the program respectively ( 7.1% vs 1.6%) and ( 10.1 vs. 3.3% ) . The fourth question of the Morisky Green \" Stop taking the medication if feel worse? \" Test was associated with patients with chronic renal failure ( 22.5 % vs 8.1% ) , use of diuretics ( 93.2 % vs 6.8% ) , use of inhibitors of Angiotensin Converting Enzyme ( 20.6 % vs 6.8% ) and alcoholics in the second , third and fourth moments of participation in the program respectively ( 8.1 vs. 1.9 % ) ( 8.1% vs 1.9%) and ( 8.1% vs 1.9 % ) . a statistically significant association between the use of Angiotensin Receptor Blockers and the occurrence of hospitalization , a greater number of hospitalizations among those using this drug class ( 63.0 % vs 48.7 % ) . Conclusion : Hypertensive monitored by nursing within the chronic disease program presented along the following significant changes in blood pressure , in lifestyle and increased adherence to medication.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Consumer Science: Food and Nutrition in the Faculty of Applied Sciences at the Cape Peninsula University of Technology 2014 / The prevalence of nutrition-related chronic diseases of lifestyle (CDL) is escalating in South Africa (SA). Studies suggest that poor nutrition plays a major role in the aetiology of these diseases. Phytochemicals present in plant foods, namely fruit, vegetables, whole grains and tea, may prevent the onset of CDL. Most South African diets appear to be deficient of these plant foods. Achieving enhanced phytochemical intake amongst South Africans may therefore have to be supported in other ways. The objectives of this research were to determine whether consumers in the professional sector in the City of Cape Town would be (i) likely to consume proficient home-cooked category prepared dishes and (ii) purchase and consume commercially manufactured category prepared dishes for enhanced phytochemical intake and, if so, (iii) which dietary source adjustment category/categories and (iv) food vehicle category/categories they would be likely to consume, and (v) who would be likely to consume them. After obtaining ethical approval, a survey was conducted amongst 184 white collar workers (87% response rate) representing the professional sector (professional, technician and associate professional) occupational groups. The respondents were approached for voluntary participation based on their occupation and age, representing adulthood to the elderly life stage as a risk factor for the development of lifestyle diseases. A pilot-tested questionnaire was used to obtain information regarding the respondents awareness of phytochemicals, whether or not they were involved in the preparation of food at home, their degree of ‘likelihood’ to consume proficient home-cooked and commercially manufactured category prepared dishes for enhanced phytochemical intake, their current daily intake of fruit, vegetables, whole grains and tea, and demographic, health and lifestyle information. The frequencies of the respondents’ consumption of phytochemical-rich dietary sources pertaining to the stages of change model were assessed using Pearson’s chi-squared analysis to determine significant associations/differences (p < 0.05) between the data sets. The repeated measure analysis of variance (ANOVA) on Bonferroni correction was used to assess the ‘likeliness’ scale (from ‘extremely unlikely’ as ‘1’ to ‘extremely likely’ as ‘5’) for the household and commercial dietary source adjustment and food vehicle categories. The respondents were mostly female (58.7%), 31 to 44 years of age (67.9%) and of White ethnicity (72.3%). The majority (61.5%) had obtained grade 12 and a diploma (29.4%) or a degree (32.1%). Almost half were married or living together with children (48.9%) and were English (48.9%) or Afrikaans (47.3%) speaking. The majority of respondents were non-smokers (69%), and approximately half (54.4%) consumed alcohol less than three times per week (54.4%). About fifty percent used dietary supplements (50.5%) and exercised (59.2%) regularly. A small percentage of the respondents were obese (7.6%), had diabetes mellitus (4.4%) or cardiovascular disease (CVD) and cancer (2.2% or four respondents each). Cancer was most prevalent (36.4%) within the respondents’ family, followed by diabetes mellitus (29.9%), CVD (26.6%) and obesity (7.6%). The majority (77.7%) were not aware of phytochemicals and about half (55.4%) could not indicate the role these compounds play in the human diet. Half of the respondents consumed the recommended two to four servings of fruit daily, very few (10.9%) consumed the recommended three to five servings of vegetables daily, only about 10% (9.2% or 17 respondents) consumed the recommended three servings of whole grains daily, and about a third (36.4%) consumed two to three cups of tea daily. The respondents who considered phytochemicals to be very necessary to support health were more likely to consume rooibos herbal tea added to category prepared dishes than those who considered phytochemicals to be necessary to support health (p < 0.05) and those who did not know the role phytochemicals played in the diet (p < 0.05). The likelihood to consume category prepared dishes with added vegetables and added fruit respectively was lower (p < 0.05) amongst those respondents who consumed none to one serving of vegetables daily than amongst those who consumed two to four servings of vegetables daily. The respondents who did not consume tea were less likely to consume category prepared dishes with added rooibos herbal tea than those who consumed one cup (p < 0.05) or two to three cups (p < 0.001) daily. Furthermore, the respondents who did not consume tea were also less likely to consume category prepared dishes with added herbs than those who consumed one cup (p < 0.05), two to three cups (p < 0.001) or four to six cups (p < 0.05) daily. The likelihood to consume category prepared dishes with fruit additions was lower amongst those respondents who did not consume tea than amongst those who consumed two to three cups (p < 0.05) or four to six cups (p < 0.05) daily. The respondents were more likely (p < 0.05) to consume herb, vegetable and fruit additions respectively than rooibos herbal tea addition, and more likely to consume vegetable additions than herb (p < 0.05) or fruit (p < 0.001) additions as dietary source adjustment options. Furthermore, vegetable additions to category prepared dishes were more likely to be consumed by the respondents than fruit additions (p < 0.001), and starch-based dishes more likely to be consumed than vegetable-based dishes (p < 0.001) or fruit-based dishes (p < 0.05) for the addition of rooibos herbal tea. The respondents were likely to consume the food vehicle categories egg and chicken for added herbs in comparison to other starch (p < 0.05) and vegetables (p < 0.001) respectively. Chicken was a likely option over pasta for added broccoli (p < 0.05). Crêpe was a likely option over compote for added mixed berries (p < 0.001). Potato was a likely option over vegetables (p < 0.05) as well as other starch over vegetables (p < 0.05) for added herbs. Carrot salad with raisins was a likely option above carrot salad with raisins and parsley (p < 0.05). Poached pear in red grape juice was a likely option over poached pear in rooibos herbal tea (p < 0.001). Tomato (p < 0.001) and broccoli (p < 0.05) were more likely to be consumed than spinach, while spinach (p < 0.05) and roasted butternut (p < 0.05) respectively were likely options over onion as vegetables added to a quiche. Onion was a less likely option over broccoli (p < 0.001), tomato (p < 0.001) and roasted butternut (p < 0.001) as respective vegetables in a soup. Tomato soup was a likely option over tomato soup with rooibos herbal tea (p < 0.001). Roasted butternut soup was a likely option over butternut and orange soup (p < 0.001) and butternut and rosemary soup (p < 0.001). Berries as fruit addition were a likely option over pome fruit as pear (p < 0.05) and citrus fruit (p < 0.001), and furthermore citrus fruit over pome fruit as pear (p < 0.05). Raw apple with its skin on was a more likely option over chicken breast salad with apple pieces (p < 0.001), and chicken breast salad with apple a likely option over chicken and apple casserole (p < 0.001). Parsley was a likely option over basil (p < 0.001), and mixed herbs (p < 0.001) and rosemary (p < 0.001) respectively were likely options over basil as herb addition. Commercially manufactured category prepared dishes likely to be purchased and consumed by the respondents included category prepared dishes with added fibre more than added herbs (p < 0.05), fruit (p < 0.001), vegetables (p < 0.001) or tea (p < 0.001), and added herbs than added vegetables (p < 0.05) or tea (p < 0.05). Pizza/pasta was a likely option over beverages (p < 0.05), grains/bake (p < 0.001) and dairy (p < 0.001) respectively, and baked goods than grains/bake (p < 0.001), dairy (p < 0.001) and beverages (p < 0.05) respectively as food vehicles. A baked dish with added fibre was more likely to be consumed than with added fruit (p < 0.001), tea (p < 0.001) or vegetables (p < 0.001), and added fruit more likely to be consumed than added vegetables (p < 0.05). Pasta incorporating vegetables was a more likely option than pasta incorporating fruit (p < 0.001). Shortbread with added fruit was a likely option over added herbs (p < 0.05), and a muffin with bran (p < 0.001) or blueberries (p < 0.001) a likely option over a muffin with spinach. Fruit juice incorporating rooibos herbal tea (p < 0.001) or herbs (p < 0.001) were likely options over fibre incorporation. The female respondents were more likely to consume category prepared dishes with added fruit than the male respondents (p < 0.05), while the older respondents (55 to 64 years) were more likely to consume category prepared dishes with added herbs than the younger respondents (31 to 44 years) (p < 0.05). The older respondents were also more likely to consume category prepared dishes with fruit additions than the younger respondents aged 31 to 44 (p < 0.05) and 45 to 54 (p < 0.05) respectively. The respondents involved in the preparation of food at home were more likely to consume category prepared dishes with the addition of rooibos herbal tea (p < 0.05), herbs (p < 0.05) and fruit (p < 0.05) respectively than those who were not involved in preparing food at home.

No description available.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Background: One of the most significant current discussions in public health and occupational therapy is the challenges facing adults with chronic diseases. Adults living with chronic diseases experience challenges of activity limitations and occupational disruptions which may influence their health, quality of life and well-being. Chronic diseases seem to have implications for adults’ areas of occupation, client factors and performance patterns as well as performance skills. Spirituality is considered as important in the lives of adults living with chronic diseases as a coping strategy assisting them to deal with the challenges of life in relation to physical, social, emotional and functional well-being. Despite the importance of spirituality in adults with chronic diseases, there is little known about the relationship between spirituality, health-related quality of life and occupational balance among adults with chronic diseases in the Western Cape, South Africa. Aim: The aim of the study was to examine the relationship between spirituality, healthrelated quality of life and occupational balance from the perspectives of adults living with chronic diseases. Methods: A sequential exploratory mixed methods two phase design approach was used for the purpose of the study. Thus, to examine the perspectives and determine the relationship on spirituality, health related quality of life and occupational balance of adults living with chronic diseases. Furthermore, to explore and describe the perceptions of adults with chronic diseases regarding the relationship between spirituality, health related quality of life and occupational balance.