Thesis (MScMedSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Lower limb amputations cause multiple physical, psychological, environmental and socioeconomic barriers. Individuals who have suffered a lower limb amputation require comprehensive rehabilitation to ensure social integration and economic self-sufficiency. In addition, constant monitoring and evaluation is an essential part of human service delivery programmes. However, the amputation rehabilitation programme offered at Elangeni an outpatient rehabilitation centre for clients with physical disabilities in Paarl, Western Cape, South Africa is not monitored, and has not been evaluated since its inception in 2000. Thus, the current study evolved to describe and evaluate the rehabilitation programme for persons with lower limb amputations at Elangeni. A mixed method descriptive design was implemented. All persons who received rehabilitation, after a major lower limb amputation at Elangeni, between 2000 to 2011, were included in the study population. In addition, the physiotherapist and occupational therapist that provided amputation rehabilitation at Elangeni, at the time of the study, were interviewed. Thirty participants who met the study inclusion criteria were identified. Quantitative data was collected using a researcher designed, structured demographic questionnaire, an International Classification of Function checklist based questionnaire and a participant rehabilitation folder audit form. Two interview schedules one for clients and one for therapists were used for guidance during semi structured interviews. Quantitative data was entered onto a spread sheet and analysed by a statistician using Statistica, version 8. Qualitative data was thematically analysed according to predetermined themes. No programme vision, mission or objectives could be identified for the amputation rehabilitation programme. Poor record keeping practices and a lack of statistics were found. Rehabilitation was impairment focused with no attention given to social integration. Clients who received prosthetic rehabilitation showed improved functional ability with regard to picking up objects from the floor (p = 0.031) getting up from the floor (p = 0.00069), getting out of the house (p = 0.023), going up and down stairs with a handrail (p = 0.037) and moving around in the yard (p = 0.0069), climbing stairs without a handrail (p = 0.037), going up and down a kerb (p = 0.0082) walking or propelling a wheelchair more than 1km (0.0089) and walking in inclement weather (0.017). A lack of indoor mobility training had a statistically significant negative impact on the participants’ ability to lift and carry objects (p 0.011), standing up from sitting (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016), going up and down stairs with a handrail (p = 0.019), moving around in the yard (0.0013), going up and down stairs with-out a hand-rail (p = 0.019), getting up and down a kerb (p = 0.0022), walking or wheeling 1km or more (p = 0.0032) and using transport (p = 0.0034). Failure to address community mobility during rehabilitation had a statistically significant negative impact on all aspects of community mobility scores except doing transfers and driving. In conclusion, for the study participants, Elangeni failed to provide rehabilitation according to the social model of disability and Community Based Rehabilitation principles. It is recommended that managers, service providers, and clients re-consider the purpose of Elangeni and develop a vision and objectives for that service. In addition, management should take an active role in service monitoring and evaluation and provide guidance and mentorship to therapists. / AFRIKAANSE OPSOMMING: Onderste ledemate amputasies impak negatief op `n persoon se fisiese, sielkundige en sosiale funksionering. Individue wat ’n amputasie ondergaan het benodig omvattende rehabilitasie om sosiale integrasie en ekonomiese onafhanklikheid te verseker. Konstante monitering en evaluasie is ’n essensiële deel van rehabilitasie programme. Nietemin die amputasie rehabilitasie program wat by Elangeni aangebied word, word nie gemoniteer nie en was nog nooit geëvalueer nie. Dus het hierdie studie dit ten doel om die rehabilitasie programme vir persone met onderste ledemate amputasies by Elangeni te beskryf en te evalueer. Kwantitatiewe en kwalitatiewe navorsingsmetodes is in kombinasie gebruik in die studie. Alle persone wat rehabilitasie by Elangeni ontvang het na ’n onderste ledemaat amputasie, sowel as die terapeute wat by Elangeni werk, het die studie populasie gevorm. In totaal het 32 persone aan die studie deelgeneem. Kwantitatiewe data is met behulp van `ʼn demografiese vraelys, `ʼn ICF gebaseerde vraelys, en `ʼn leer oudit vorm ingesamel. Twee onderhoud skedules, een vir die kliënte en een vir die terapeute, is gebruik as riglyn tydens insameling van kwalitatiewe data. Kwantitatiewe data is statisties ontleed deur ʼn statistikus wat gebruik gemaak het van Statistica 8. Voorafbepaalde temas is gebruik tydens tematies ontleding van kwalitatiewe data. Geen program visie, missie of doelwitte kon geïdentifiseer word nie. Swak rekord houdings praktyke was gevind. Rehabilitasie het gefokus op die fisiese en nie op sosiale integrasie nie. Die kliënte wat prostetiese rehabilitasie ontvang het, het statisties beduidend beter gevaar ten opsigte van optel van voorwerpe van die vloer af (p = 0.031), om van die vloer af op te staan (p = 0.00069), om uit die huis uit te kom (p = 0.023), om trappe met `ʼn handreling te klim (p = 0.037), om op die erf rond te beweeg (p = 0.0069), om trappe sonder `ʼn reling te klim (p = 0.037), om by sypaadjies op en af te gaan (p = 0.0082), om meer as `ʼn kilometer te loop of met die rolstoele te ry (0.0089) en om in ongure weer te loop (0.017). `ʼn Tekort aan heropleiding van mobiliteit binne die huis het `ʼn statisties beduidende impak gehad op die vermoë om goed te dra (p 0.011), op te staan van sit af (p = 0.042), in die huis rond te beweeg (p = 0.00023), voorwerpe van die vloer af op te tel (p = 0.00068), van die vloer af op te staan (p = 0.0072), uit die huis uit te kom (p = 0.0016), trappe met `ʼn handreling te klim (p = 0.019), in die erf rond te beweeg (0.0013), trappe sonder `ʼn handreling te klim (p = 0.019), by `n sypaadjie op en af te gaan (p = 0.0022), meer as 1km te loop of met die rystoel te ry (p = 0.0032) en om vervoer te gebruik (p = 0.0034). `ʼn Gebrek aan heropleiding van gemeenskapsmobiliteit het `ʼn statisties negatiewe impak gehad op alle aspekte van gemeenskapsintegrasie behalwe die doen van oorplasings en bestuur. Rehabilitasie praktyke was nie gebaseer op die sosiale model van gestremdheid en Gemeenskap Gebaseerde Rehabilitasie beginsels nie. Dit word aanbeveel dat diens verskaffers, kliënte en bestuurders oor die fokus van rehabilitasie by Elangeni moet besin. Daar moet ʼn visie en doelwitte vir die diens ontwikkel word. Voorts moet bestuurders van distrik vlak ʼn aktiewe rol speel in die monitering en evaluasie van dienste en mentorskap aan terapeute verseker.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Child abuse is a problem worldwide and also a serious problem in South Africa. Recent statistics revealed an increase in reported cases. Incidence of abuse is difficult to determine accurately but there might be a million children involved annually (Berkow 1977: 1040). Available research indicates that disabled children across all types of disabilities are at a greater risk of all forms of abuse than non-disabled children. The causes of child abuse are complex and involve social factors. The general effect of poverty, unemployment, alcohol and drug abuse are likely to be associated with child abuse. In addition the disability and its effects on the child and family as well as wider societal views of disability exacerbates the risk for disabled children and make apprehending and bringing perpetrators to justice more difficult. But, the topic requires further exploration. Thus the study evolved with the aim to explore parents‟ and caregiver‟s knowledge, attitudes and practices towards the abuse of children with disabilities in the Willowvale area of the Eastern Cape of South Africa. A qualitative, descriptive study with a small quantitative component was done. The sample consisted of 24 participants, identified through snowball sampling, in five purposively sampled study areas in the Eastern Cape. Data was collected in March 2009 through a self-designed questionnaire that focused on knowledge of abuse and a focus group discussion in each site. Content analysis of data according to pre-determined themes was done. Results indicated low levels of knowledge on abuse as well as difficulties defining the concepts of disability and abuse. However, participants had a general awareness of the presence of abuse of children with disabilities and could provide many an example from personal experience. In addition participants indicated challenges with reporting of abuse such as being unsure what constitutes a criminal offence, what the lines and procedures of reporting are, being scared of the perpetrator and his or her family, being scared of losing social support and poor support from the police and legal system. It is recommended that customized education programs on disability and child abuse are developed and implemented for both parents of children with disabilities in the study communities as well as the communities at large. Developing and implementing these educational packages can be structured along community based rehabilitation guidelines. The current study participants can form the core group to represent children with disabilities. Implementation, monitoring and evaluation can be linked to local rehabilitation projects. In addition various local and provincial departments such as social services, health, education and safety and security must collaborate to develop and assist with implementing the education programs and materials. / AFRIKAANSE OPSOMMING: Statistiek dui op `n toename in kindermishandeling. Die probleem kom wêreldwyd voor en neem ook in Suid Afrika ernstige afmetings aan. Spesifieke insidensiesyfers is moeilik bepaalbaar, maar dit wil voorkom asof `n miljoen gestremde kinders jaarliks mishandel word. Die risiko van mishandeling is groter vir gestremde kinders as vir nie-gestremde kinders. `n Komplekse interaksie tussen sosio- ekonomiese faktore soos armoede, werkloosheid, alkohol- en dwelmmisbruik kan dikwels met kindermishandeling geassosieer word. In die geval van gestremde kinders dra die effek van die gestremheid op die kind en familie, sowel as gemeenskappe se negatiewe houding teenoor gestremde kinders, by tot die risiko vir mishandeling en vergroot die uitdaging om die oortreder op te spoor en suksesvol te verhoor. Daar is egter steeds verskeie onduidelikhede oor die onderwerp en verder studie is nodig. Die huidige studie het beoog om ondersoek in te stel na die kennis, houdings en optrede van ouers en voogde van gestremde kinders in die Willowvale area van die Oos-Kaap, Suid-Afrika, ten opsigte van mishandeling van gestremde kinders. `n Kwalitatiewe beskrywende studie met `n klein kwantitatiewe komponent is gedoen Vier en twintig ouers of voogde van gestremde kinders uit vyf plekke in die Willowvale-gebied het aan die studie deelgeneem. Die studieplekke is doelbewus geselekteer en die deelnemers is deur middel van sneeubalseleksie geïdentifiseer. Data-insameling is deur middel van fokusgroepbesprekings en `n vraelys oor kennis van kindermishandeling in Maart 2009 gedoen. Die inhoud van die fokusgroep-besprekings is volgens voorafbepaalde temas geanaliseer. Die resultate dui daarop dat die deelnemers beperkte kennis van kindermishandeling het. Hulle het ook gesukkel om begrippe soos gestremdheid en kindermishandeling te definieer. Hulle was egter bewus daarvan dat mishandeling van gestremde kinders voorkom en kon vele voorbeelde uit eie ervaring opnoem. Volgens die data het deelnemers verskeie probleme met betrekking tot die aanmelding van kindermishandeling ervaar. Die probleme sluit onsekerheid oor wanneer mishandeling `n kriminele oortreding is, watter prosedure om te volg om mishandeling aan te meld, vrees vir die mishandelaar en sy/haar familie, vrees dat die gemeenskap hulle sal verwerp, asook onvoldoende ondersteuning van polisie en regssisteme in. Na aanleiding van die bevindinge word aanbeveel dat `n opvoedingsprogram oor gestremheid en kindermishandeling saamgestel en in die studiegemeenskappe geïmplimenteer word. Die program behhort op ouers en voogde van gestremde kinders sowel as op die breër gemeenskap te fokus. Deelnemers aan hierdie studie en bestaande gemeenskapsrehabilitasieprojekte kan genader word om die proses te bestuur. Voorts moet plaaslike en provinsiale regeringsverteenwoordigers van Gesondheid, Gemeenskaspontwikkeling, Opvoeding sowel as Veiligheid en Sekuriteit betrokke wees by die ontwikkeling, implementering en monitoring van die opleiding.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Several legislative documents that promote the inclusion and economic integration of persons with disabilities have been introduced over the previous two decades in South Africa. However, it is still estimated that as many as 99% of persons with disabilities are unemployed (Dube, 2005). Employment equity quotas for persons with disabilities have not been met in either the public or the private sector (CEE Report, 2007).The reasons for this remain largely unexplored in many sectors including the hospitality sector. The hospitality sector - the focus of this study - makes a significant economic contribution to the country and is the largest most diverse labour force sector in South Africa (THETA, 2009). The aim of the study is to examine the employment of persons with disabilities in three hotels in the Victoria and Alfred Waterfront, Cape Town. A descriptive, qualitative case study methodology was implemented for the study. Three purposively sampled hotels in Cape Town`s Victoria and Alfred Waterfront provided the study setting. Participants included managers from these hotels as well as employees with and without disabilities from each of the hotels. Data was collected through semi-structured interviews and content analysis was conducted to identify emerging issues according to themes. Findings indicate a medically oriented perception of disability with a focus on physical impairments. A lack of knowledge and guidance in policy documents and from the Department of Labour perpetuate these perceptions. Participants were aware of employment equity policy, but saw it as being orientated to race and gender and did not apply it to persons with disabilities. Application was also not enforced through monitoring by the Department of Labour. Barriers to employment include discrimination and stereotyping, the physical nature and type of jobs, physical access barriers, a lack of education and skills as well as a lack of applications from persons with disabilities. Facilitators included improved Black Economic Empowerment scoring, a motivational aspect, the variety of jobs available and guests and employees with disabilities. Findings on the provision of reasonable accommodation focused mainly on the accommodation of guests and examined physical and structural aspects of the environment. One of the conclusions of the study was that legislation governing the employment of persons with disabilities was poorly implemented in the hotels examined by this study. It is recommended that hotels contract a disability consultant to run disability awareness campaigns within the hotels. In addition, the Department of Labour must monitor policy implementation with regard to persons with disabilities. Disabled people`s organisations should create a platform for communication with government departments responsible for social policy and legislation in an effort to promote and encourage the debate on disability definitions and to act as a watchdog over the implementation of policy. / AFRIKAANSE OPSOMMING: Wetgewing met die doel om ekonomiese integrasie van persone met gestremdhede te bevorder is in die laaste twee dekades in Suid Afrika aanvaar. Ten spyte daarvan word daar beraam dat soveel soos 99% van persone met gestremdhede in Suid Afrika werkloos is (Dube, 2005). Nie die staat of die privaatsektor kon nog daarin slaag om die twee present kwota te bereik nie (CEE Verslag, 2007). Die redes daarvoor is tot `n groot mate onbekend in veskeie sektore, insluitende die gasvryheidheidsektor, waar hierdie studie gedoen is. Die gasvryheidsektor maak `n beduidende bydrae tot die Suid Afrikaanse ekonomie en het van die grootste en mees diverse arbeidsmagte in Suid Afrika (THETA, 2009). Die doel van die studie was om die situasie aangaande werk en persone met gestremdhede in drie hotelle in die Victoria en Alfred Waterfront, Kaapstad, te beskryf. `n Beskrywende, kwalitatiewe, geval studie metodologie is geimplimenteer. Drie studie hotelle is doelbewus geselekteer. Bestuurders sowel as werknemers met en sonder gestremdhede uit die drie hotelle het aan die studie deelgeneem. Data is ingesamel deur middel van semi gestruktureerde onderhoude. Ontluikende temas is geidentifiseer tydens analise van data. Deelnemers se persepsies van gestremdheid het gefokes op fisiese en mediese probleme. `n Gebrek aan kennis en te min leiding uit beleidsdokumente en van die Department van Arbeid het die persepsie versterk. Deelnemers was bekend met gelyke indiensnemingsbeleid, maar dit is net ten opsigte van ras en geslag in die studie hotelle toegepas. Toepassing van beleid is nie gemonitor deur die Department van Arbeid nie. Aanstelling van persone met gestremdhede is bemoeilik deur diskriminasie, stereotipering, die fisiese aard van die werk, die tipe werk, `n ontoeganklike fisiese omgewing, `n tekort aan opleiding en onderrig by persone met gestremdhede en geen aansoeke van persone met gestremdhede. Fasiliteerders het Swart Ekonomiese Bemagtigings punte, die verskeidenheid van werk, die motiverings aspek sowel as gaste en bestaande werknemers met gestremdhede ingesluit. Redelike Akkommodasie het meestal op gaste gefokus and was beperk tot fisiese en strukturele omgewings aspekte. Daar is tot die gevolgtrekking gekom dat wetgewing met betrekking tot aanstelling van persone met gestremdhede swak geimplimenteer was in die studie hotelle. Daar word aanbeveel dat die hotelle `n konsultant aanstel om `n interne bewustheidsveldtog van stapel te stuur. Die Department van Arbeid moet implementering van beleid met betrekking tot persone met gestremdhede monitor. Organisasies vir mense met gestremdhede moet `n platform skep vir kommunikasie met die regering ten opsigte van beleids implimentering en om die debat rondom sosiale insluiting en definisies van gestremheid te bevorder.

MPhil (Rehabilitation) / Thesis (MPhil (Interdisciplinary Health Sciences))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: A stroke comes suddenly and has a devastating effect on the lives of the patient and the caregiver. It is disabling and often leaves the patient dependent on care. Providing this care can put tremendous physical, emotional, social and financial demands on the caregiver. The purpose of the study is to determine the impact of caregiving on the primary caregivers of patients who suffered a stroke and were admitted to the Western Cape Rehabilitation Centre (WCRC), for intensive rehabilitation during 2006. This is a descriptive study that utilised both quantitative and qualitative methods of data collection. Quantitative data were collected through two data coding forms, one for caregivers and one for patients, the Bartel Index, the Caregiver Strain Index (CSI) and the Satisfaction With Life Scale (SWLS). Qualitative data were collected through indepth interviews with caregivers. Fifty-seven caregivers participated in the study. According to CSI findings 58% of caregivers were under levels of strain high enough to require support and intervention. The SWLS indicated that the life areas most adversely affected were employment and self and social life. Loss of employment by the caregiver (p = 0.04) and financial difficulties (p = 0.06), cognitive and perceptual problems (p = 0.01), personality changes (p = 0.01), level of physical dependency of patient (0.0012) and nervous strain experienced by the caregiver (0.01) were found to significantly impact on caregiver strain. Caregivers perceived their caregiving duties as overwhelming and a great strain. This was aggravated in some instances by poor health care service delivery at the time of the stroke, no or inadequate explanations on stroke, poor or no training of caregivers, no home visits and a lack of follow-up services in the community. They experienced the period just after discharge as especially challenging and required support, assistance and guidance at that time. Caregivers identified a need for community rehabilitation facilities, adult day care centres, outpatient rehabilitation services, home-based nursing care and caregiver support groups in the community. / AFRIKAANSE OPSOMMING: ’n Beroerte gebeur skielik en sonder enige waarskuwing met ’n vernietigende uitwerking op die lewens van die pasiënt asook die versorger. Dit veroorsaak gestremdheid en laat dikwels die pasiënt afhanklik van sorg. Die voorsiening van hierdie sorg kan erge fisiese, emosionele, sosiale en finansiele eise aan die versorger stel. Die doel van die navorsing is om die impak van versorging op die primêre versorger van beroerte pasiënte, wat gedurende 2006 intensiewe rehabilitasie by WKRS ontvang het, te ondersoek. Dit is ’n beskrywende studie wat gebruik gemaak het van beide kwantitatiewe en kwalitatiewe metodes om data in te samel. Kwantitatiewe data was verkry deur twee datakoderingsvorms, een vir pasiente en een vir versorgers, die Bartel Index, die Caregiver Strain Index (CSI) en die Satisfaction With Life Scale (SWLS). In diepte onderhoude was gevoer met versorgers om kwalitatiewe data te verkry. Sewe en vygtig versorgers het aan die studie deelgeneem. Bevindinge van die CSI dui daarop dat 58% van versorgers hoë vlakke van spanning ervaar en ondersteuning sowel as intervensie benodig. Volgens die SWLS was die areas wat die ernstigste be-invloed was werk en eie en sosiale lewe. Die volgende areas het volgens resulate ’n statisties beduidende impak op die spanning wat versorgers ervaar het gehad: finansiële spanning en verlies van werk (p = 0.04), in gevalle waar pasiente persoonlikheids veranderinge ondergaan het (p = 0.01) of kognitiewe en perseptuale skade oorgehou het (p = 0.01) na die beroerte en die emosionele impak van versorging (p = 0.01). Versorgers het hulle versorgings take as oorweldigend en as ’n bron van groot spanning gesien. Dit is in sommige gevalle vererger deur swak ondersteuning van gesondheidssorgdienste direk na die beroerte, geen of swak verduidelikings oor wat ’n beroerte is, geen of swak opleiding aan versorgers, geen tuisbesoeke en ’n tekort aan opvolg dienste in die gemeenskap. Die tydperk direk na ontslag uit die rehabilitasie sentrum was besonder uitdagend en hulle het ondersteuning, hulp en leiding nodig in daardie tyd. Swak ondersteuning en ’n tekort aan of afwesigheid van hulpbronne in die gemeenskap het die situasie vererger. Versorgers het ’n behoefte aan gemeensskapsrehabilitasie fasiliteite, volwasse dagsorg sentrums, buite patiënte rehabilitasie dienste, tuis verpleegsorg en ondersteuningsgroepe uitgespreek.

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The Centre for Rehabilitation Studies, Faculty Health Sciences, University of ENGLISH ABSTRACT: Stellenbosch, South Africa, delivers a rehabilitation training programme to its MBChB students. The aim of this programme is to equip graduates with the knowledge, skills and attitudes to manage persons with disabilities in the community which aligns with both the faculty mission and the National Department of Health’s 2010 Plan. In line with rehabilitation philosophies a generic approach using the International Classification of Function, Disability and Health is used in this programme. Feedback has been received from the students at the end of each of the rehabilitation modules and the programme has been reviewed annually by the Module Chair Persons and Rehabilitation Programme Co-ordinator. It had however never been formally evaluated and hence the need for this study. In this study a cross-sectional description of the programme was made using the framework of the World Health Organisation approved World Federation for Medical Education’s Global Standards for basic medical education. Sixty five themes were arranged according to the original nine areas of the standards. Interviews and questionnaires were designed and documentation was reviewed to obtain quantitative and qualitative data from direct and indirect stakeholders from nine population samples. Participants included faculty staff, students as well as rehabilitation experts and persons with disabilities. The analysis of the results of the data collected between March and September 2011 showed that the programme was compliant against 40 of the 65 indicators. The programme was compliant regarding the area pertaining to the mission and objectives and largely compliant regarding the content and delivery of the programme. Where there was non compliance or room for improvement regarding the content, delivery and assessment of the students, recommendations were made, reviewed by the programme committee in November 2011 and implementation was planned for January 2012. Shortcomings identified in the training and support of teaching staff, availability of training resources and in the administrative support of the programme were referred to the Head of the Centre for Rehabilitation Studies. Non-compliance regarding electives and enrolment of medical students with disabilities was considered beyond the immediate control of the programme and were to be referred to the Faculty Health Sciences management. The results showed non-compliance of monitoring and evaluation of the programme, supporting the original need for this study. The indicators were deemed comprehensive and relevant for this evaluation of the rehabilitation programme. It was recommended that four indicators be refined according to the results of this study and that the lists of heath conditions and bio psychosocial problems that persons with disability experience be further validated. Three changes to the tools were recommended should they be used for repeat evaluations of the programme. It was recommended that the methods used to monitor the programme be reviewed allowing for more specific feedback against selected indicators, with wider stakeholder input including lecturers. A final recommendation was that the post of the Rehabilitation Programme Co-ordinator be evaluated in order to effect these recommendations. / AFRIKAANSE OPSOMMING: Die Sentrum vir Rehabilitasie Studies, Fakulteit Gesondheidswetenskappe, Universiteit van Stellenbosch, Suid-Afrika, lewer 'n rehabilitasie-opleidingsprogram aan sy MBChB-studente. Die doel van hierdie program is om gegradueerdes met die nodige kennis, vaardighede en gesindhede toe te rus om persone met gestremdhede in die gemeenskap te kan behandel wat in lyn is met die fakulteit se missie en die Nasionale Departement van Gesondheid se 2010 Plan. In ooreenstemming met rehabilitasie filosofieë word 'n generiese benadering volgens die Internasionale Klassifikasie van Funksie, Gestremdheid en Gesondheid in hierdie program gebruik. Terugvoer is van die studente aan die einde van elk van die rehabilitasie modules ontvang en die program is jaarliks deur die Module voorsitter en Rehabilitasie Program-koördineerder hersien. Dit was egter nooit formeel geëvalueer nie en daarom die behoefte vir hierdie studie. In hierdie studie is 'n deursnee beskrywing van die program gemaak deur gebruik te maak van die raamwerk van die Wêreld-Gesondheidsorganisasie goedgekeurde Wêreld Federasie van Mediese Onderwys se globale standaarde vir basiese mediese opleiding. Vyf-en-sestig temas is volgens die oorspronklike nege gebiede van die standaarde gerangskik. Onderhoude en vraelyste is ontwerp en dokumentasie is hersien om kwantitatiewe en kwalitatiewe data te verkry van direkte en indirekte belanghebbendes uit nege bevolking monsters. Deelnemers het fakulteit personeel, studente, sowel as rehabilitasie kundiges en persone met gestremdhede ingesluit. Die ontleding van die resultate van die data wat ingesamel is tussen Maart en September 2011 het getoon dat die program aan 40 van die 65 aanwysers voldoen. Die program voldoen met betrekking tot die gebied van die missie en doelwitte en is grootliks in ooreenstemming met betrekking tot die inhoud en aflewering van die program. Waar daar nie-nakoming was of ruimte vir verbetering ten opsigte van die inhoud, lewering en beoordeling van die student was, is aanbevelings gemaak in November 2011, deur die program komitee hersien en implementering was vir Januarie 2012 beplan. Leemtes geïdentifiseer in die opleiding en ondersteuning van die doserende personeel, die beskikbaarheid van opleiding hulpbronne en in die administratiewe ondersteuning van die program is verwys na die Hoof van die Sentrum vir Rehabilitasiestudies. Nie-nakoming ten opsigte van elektiwe en die inskrywing van mediese studente met gestremdhede was buite die onmiddellike beheer van die program oorweeg en sou na die Fakulteit Gesondheidswetenskappe verwys word. Die resultate het nie-nakoming van monitering en evaluering van die program getoon, wat die oorspronklike behoefte vir hierdie studie ondersteun het. Die aanwysers was omvattend geag en relevant vir die evaluering van die rehabilitasieprogram. Dit was aanbeveel dat vier van die aanwysers volgens die resultate van hierdie studie verfyn moet word en dat die lyste van die Gesondheids kondisies en bio-psigososiale probleme wat persone met gestremdhede ervaar verder valideer moet word. Drie veranderinge is aan die instrumente aanbeveel sou hulle vir herevaluering van die program gebruik word. Dit is aanbeveel dat die metodes wat gebruik word om die program te monitor, hersien moet word, met voorsiening vir meer spesifieke terugvoer teen gekose aanwysers, met wyer belanghebbendes se insette insluitend dosente. 'n Finale aanbeveling was dat die pos van die rehabilitasie-program-koördineerder geëvalueer moet word ten einde hierdie aanbevelings aan te bring.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: Rehabilitation is recognised as important in helping stroke survivors achieve their highest levels of functional independence and best quality of life. Conversely, a lack of rehabilitation services, and other environmental barriers, can prevent the attainment of optimal levels of functioning and advanced outcomes, such as community integration and employment. Aim of the study: To determine if uninsured stroke survivors living in the Helderberg Basin (Western Cape) reached their optimal rehabilitation outcome levels and if not, what environmental barriers contributed to this. Methods: A descriptive study was conducted. Quantitative data was obtained from 53 participants, who were selected through proportional stratified random sampling. Demographic information and the health status of participants were recorded. Other instruments utilised were the Stroke Impact Scale (SIS3), Modified Barthel Index (MBI), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), language screening test and the ICF Core Set for Stroke (Environmental Factors). Outcome levels were categorised as described by Landrum, Schmidt and McLean, 1995. Data was subjected to statistical analysis. Qualitative data was obtained from five participants, who were chosen by means of purposive sampling. Data were analysed according to predetermined themes. Results: Six (11%) participants were classified as being on rehabilitation level 1; 21 (40%) on level 2; 16 (30%) on level 3; 8 (15%) on level 4; 2 (4%) on level 5. According to the MBI, 65% of participants required assistance with activities of daily living LOTCA scores showed that most difficulty was experienced with tests for visuomotor organization and thinking skills. Participants experienced varying degrees of difficulty with the speech and language test. A mean score of 50.84 for questions related to feelings on the SIS3 is indicative of underlying depression. Stroke survivors received limited physiotherapy and occupational therapy and even less speech therapy and dietary counselling. Occupational therapy had a significant impact on MBI (<0.01) and SIS3.6 (community mobility) (0.02) scores. Six (12%) reported assistance from a social worker. No psychological counselling was reported by any participant. A limited number of assistive devices, focussing mainly on mobility appliances had been issued. Participants regarded the most significant environmental barriers as being lack of assets (89%), transportation (88%) and general social support services, systems and policies (87%). Qualitative data showed a lack of counselling, education and training by health professionals regarding primary and secondary prevention of stroke and rehabilitation. Conclusion: Numerous environmental barriers impacted on the achievement of advanced rehabilitation outcomes. In addition to shortcomings in the primary and secondary prevention of stroke, many of the minimum standards for rehabilitation, as stipulated in the Western Cape Comprehensive Service Plan for the Implementation of Healthcare 2010, were not being met. Recommendations include establishing a designated stroke unit at Helderberg Hospital, ensuring transport, and improving the referral system to existing rehabilitation services. Increased input from core disciplines essential to stroke rehabilitation has the potential to improve outcomes. A concerted effort by health professionals is required in terms of counselling, education and training with regards to primary and secondary prevention of stroke and rehabilitation. / AFRIKAANSE OPSOMMING: Inleiding: Daar word algemeen aanvaar dat rehabilitasie na 'n beroerte uiters belangrik is, want dit kan beroerte oorlewendes help om die hoogste moontlike vlak van onafhanklikheid te bereik. Daarenteen kan‘n gebrek aan rehabilitasiedienste en omgewingsstruikelblokke verhoed dat ‘n oorlewende weer sy volwaardige plek in die samelewing en werksplek inneem. Doel van die projek: Om vas te stel of beroerte oorlewendes, woonagtig in die Helderberg Kom (Weskaap), sonder mediese versekering, wel hulle hoogste vlak van funksionering bereik het, en indien nie, om vas te stel watter omgewingsstruikelblokke bydraende faktore was. Metode: ‘n Beskrywende studie is uitgevoer. Kwantitatiewe data is verkry van 53 deelnemers wat lukraak gekies is deur gestratifiseerde, ewekansige steekproefneming. Demografiese inligting en die gesondheidstatus van deelnemers is aangeteken. Ander toetse wat gebruik is, is die Stroke Impak Skaal (SIS3), Gewysigde Barthel Indeks, Loewenstein Arbeidsterapie Kognitiewe Bepaling (LOTCA), taalsiftingstoets en die ICF kern stel vir beroerte (omgewingsfaktore). Uitkomsvlakke was bepaal, soos beskryf deur Landrum, Schmidt en McClean, 1995. Die data is statisties geanaliseer. Kwalitatiewe data was verkry van vyf deelnemers wat deur middel van doelgerigte steekproeftrekking gekies is. Tydens data analise is voorafbepaalde temas geidentifiseer. Resultate: Ses (11%) deelnemers was geklassifiseer as op rehabilitasie vlak 1; 21 (40%) op vlak 2; 16 (30%) op vlak 3; ag (15%) op vlak 4; twee (4%) op vlak 5. Volgens die MBI het 65% van die deelnemers bystand nodig vir daaglikse aktiwiteite. LOTCA uitslae toon dat die grootste probleme ondervind is met toetse vir visumotoriese organisasie en denkvermoëns. Deelnemers het verskillende grade van probleme ondervind met die spraak en taaltoets. ‘n Gemiddelde telling van 50.84 vir vrae met betrekking tot gevoelens in die SIS3, mag aanduidend wees van onderliggende depressie. Beroerte oorlewendes het min fisioterapie en arbeidsterapie ontvang en nog minder spraakterapie en raad van dieetkundiges. Arbeidsterapie insette het 'n beduidende impak op MBI telling (<0.01) en SIS3.6 (mobiliteit in die gemeenskap) (0.02) gehad. Ses (12%) het aangedui dat hulle hulp van maatskaplike werkers ontvang het. Nie een van die deelnemers het sielkundige berading ontvang nie. Beperkte hoeveelhede en tipes hulpmiddels is uitgereik, en was meesal om mobiliteit te verbeter. Volgens deelnemers was die grootste struikelblokke 'n gebrek aan bates (89%); vervoer (88%) en algemene sosiale ondersteuningsdienste, stelsels en beleid (87%). Kwalitatiewe data het 'n gebrek aan berading, onderrig en opleiding by gesondheidswerkers in terme van primêre en sekondêre voorkoming van beroerte en rehabilitasiedienste getoon.

Thesis (MScMedSc)--University of Stellenbosch, 2009. / Thesis presented in partial fulfilment of the requirements for the degree of Master of Medical Science. (rehabilitation) at the University of Stellenbosch / ENGLISH ABSTRACT: For physically disabled learners to achieve successful participation in sport requires the synergistic interaction of many diverse factors. The Limpopo province of South Africa produces fewer physically disabled athletes at the junior, senior and elite levels than any other province in South Africa. This study identifies and examines the key aspects that affected the development of physically disabled athletes in the Limpopo province in 2006/2007. Factors that both facilitate or inhibit the development of physically disabled athletes in the province are identified and discussed. This highlights aspects that need to be addressed in seeking to bridge the gap between current deficiencies and an optimised future for participants in disabled sport in Limpopo province. The study is descriptive, using a case-study design as part of a situational analysis. Physically disabled athletes from one school were selected using a convenience sample and key informants were selected through purposive sampling. Questionnaires were completed by ten physically disabled athletes as well as by staff involved in their athletic development. Interviews were also conducted among key informants from the sport and education sectors. The questionnaires were analysed quantitatively and the interviews underwent qualitative content analysis. The findings indicated that there are seven critical areas/key factors influencing the development of physically disabled athletes in Limpopo province. These are: 1. Support systems; 2. Sports participation; 3. Attitudinal facilitators and barriers; 4. Environmental accessibility; 5. Resources; 6. Education and training; 7. Politics. The above elements impacting on the development of physically disabled athletes in Limpopo province are compared with the five key areas of the International Paralympic Committee (IPC) Development Model. It was found that numerous challenges exist in Limpopo, namely: a lack of sufficient humanresource capacity, funding, sponsorships and the necessary financial resources for adequate infrastructure sustainability and support services. Therefore, in order for physically disabled athletes in Limpopo province to be successfully developed within the framework of the IPC Development Model, the challenges and key factors/critical areas identified by this study need to be addressed. The following recommendations were made following the outcomes of the study: 1. Establish a discussion forum for all stakeholders; 2. Take steps to elevate the status of sport for physically disabled athletes in Limpopo province; 3. Improve the co-operation between sports federations, government departments and disabled people’s organisations Limpopo province; 4. Educate stakeholders; 5. Improve coaching expertise and knowledge; 6. Have specialist rehabilitation expertise in the LSEN schools; 7. Monitor and evaluate sports programmes. / AFRIKAANSE OPSOMMING: Die deelname van fisiek-gestremde leerders aan sport het verskeie aspekte wat wedersyds verband hou. Die interaksie van hierdie aspekte is noodsaaklik om ‘n suksesvolle uitkoms te verseker. Hierdie tesis identifiseer en ondersoek die sleutelaspekte wat ‘n impak het op die ontwikkeling van fisiek-gestremde atlete in die Limpopo provinsie van Suid-Afrika in 2006/2007. Dit is bekend dat hierdie provinsie heelwat minder fisiek-gestremde atlete op junior, senior en elite vlak lewer as enige ander provinsie in die land Faktore wat hierdie studiegroep se ontwikkeling bevorder, sowel as die faktore wat dit benadeel,, word in hierdie tesis geïdentifiseer en bespreek. Dié bespreking is van nut vir die identifisering van huidige probleemareas, wat spesifieke aandag sal verg om die vooruitsigte vir gestremde atlete in die provinsie te verbeter. Die tesis is beskrywend van aard en maak gebruik van ’n gevallestudieformaat en omstandigheidsontleding. ’n Gerieflikheidsteekproef van fisiek-gestremde atlete is by een skool gekies terwyl ’n versameling van sleutel inligtingsbronne doelgerig geïdentifiseer is. Vraelyste is deur tien fisiek-gestremde atlete, sowel as personeellede betrokke by hulle atletiese ontwikkeling, voltooi. Onderhoude is ook gevoer met sleutelinformante in die Sporten Onderwyssektore. Die vraelyste is kwantitatief ontleed met die hulp van Professor Nel van die Departement Statistiek aan die Universiteit Stellenbosch, terwyl transkripsies van die onderhoude kwalitatief geëvalueer is. Die bevindinge het daarop gedui dat daar sewe sleutelfaktore is wat die ontwikkeling van fisiek-gestremde atlete in hierdie provinsie beïnvloed: 1. Ondersteuningstelsels; 2. Sport deelname; 3. Omgewingstoeganglikheid; 4. Onderwys en opleiding; 5. Gesindhede en struikelblokke; 6. Bronne; en 7. Politiek. Die invloed wat hierdie aspekte op die ontwikkeling van fisiek-gestremde atlete in Limpopo provinsie uitoefen, word met die vyf sleutelgebiede van die Internasionale Paralimpiese komitee se Ontwikkelingsmodel vergelyk. Dit is bevind dat talle uitdagings Limpopo provinsie in die gesig staar, naamlik, ’n gebrek aan menslike hulpbronne, ’n tekort aan befondsing en borgskappe asook ontoereikende finansiële voorsiening om behoorlike infrastruktuur te verskaf. Dus, om fisiek-gestremde atlete in Limpopo provinsie die geleentheid te bied om binne die voorgeskrewe raamwerk van die Internasionale Paralimpiese Ontwikkelingsmodel te vorder, moet aandag geskenk word aan die sleutelfaktore en tekortkominge wat hierdie studie identifiseer. Die volgende aanbevelings word gemaak : 1. Vestig ‘n gespreksforum vir alle belanghebbendes; 2. Neem die nodige stappe vir die opheffing van die status van sport vir fisiek-gestremde atlete in die Limpopo provinsie; 3. Verbeter die samewerking tussen Sportfederasies, Staatsdepartemente en Organisasies vir Gestremde Persone in die Limpopo provinsie; 4. Lei alle belanghebbendes op; 5. Verbeter afrigtingskundigheid; 6. Sorg vir spesialis rehabilitasiekundigheid by die LSEN-skole; en 7. Moniteer en evalueer sportprogram.

Thesis (MPhil (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy. Centre for Rehabilitation Studies))--University of Stellenbosch, 2007. / Current emphasis for rehabilitation in South Africa remains on individual intervention within the move towards primary health care. Primary health care is the strategy that has been adopted by the South African department of health to bring access and equity in health care services. Even so, the burden of providing effective rehabilitative services with limited resources requires innovative strategies, such as the use of therapeutic groups, to address certain aspects of rehabilitation. These strategies must be proven effective. There is a paucity of literature detailing the uses of group therapy in physical rehabilitation, and particularly the use of interdisciplinary group work in stroke rehabilitation. Furthermore, evidence shows that stroke survivors feel ill equipped to return to their communities despite rehabilitation. Stroke is a major cause of death and disability in South Africa, and is a condition shown to benefit from rehabilitation. These factors led to the selection of the Bishop Lavis Rehabilitation Centre stroke group as the setting for this study, which aims to describe the range of experiences relating to attendance or non-attendance of those referred to this programme. This descriptive study, employing quantitative means (to describe the demographic details of the participants) and qualitative means (to describe the experiences of participants), was conducted with twenty participants. Data was collected by means of an administered questionnaire. Following that, a focus group discussion involving six participants was used to gather in-depth information. Quantitative data was analysed with the assistance of a statistician, utilising the computer program, Statistica. The Chi-Squared, Kruskal-Wallis and ANOVA tests were used, with p>0.05 showing statistical significance. Qualitative data was thematically analysed, whereby data was categorised by means of an inductive approach. The study population consisted of 20 participants, with an average age of 59 years, of whom 15 were female and five male. The stroke group provided meaning to participants on two levels. On a psychosocial level, the phenomena of universality (identifying with others in a similar position), development of socialising techniques, imparting information and cohesiveness emerged strongly. On the level of meaning related to stroke recovery, improvement in ability to execute activities of daily living, mobility and strength were most frequently mentioned. Transportation issues were most commonly mentioned as factors negatively influencing attendance. Staff attitude and activities of the programme were most often cited as positive factors. Given the positive response of study participants, and the programme’s ability to sustain intervention with limited resources, it was concluded that this programme has a valid place within stroke rehabilitation in Bishop Lavis. Recommendations in terms of the group programme included investigating methods of providing transportation, providing childcare facilities and expanding the content of educational sessions. Further recommendations were to maintain the positive attitude of staff and the current activities of the programme. Frequency of group outings should also be increased and compensatory strategies for inclement weather must be explored.

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Rehabilitation therapists are at risk for burnout as a result of their emotionally challenging and stressful jobs. No South African studies could be found that focus on burnout in therapists who work in the field of rehabilitation. This study attempted to determine the prevalence of burnout amongst a select group of therapists in South Africa i.e. therapy staff employed by Life Rehabilitation. In addition, contributing factors to burnout in this environment, current management of the problem and suggestions for future management were explored. A descriptive design which used both quantitative and qualitative methods was utilised. Forty-nine therapists and seven managers participated in the study. No sampling was done. Quantitative data was collected through a demographic coding sheet and the Maslach Burnout Inventory (MBI). Data were statistically analysed and a p value of < 0.05 was deemed statistically significant. Interview schedules were used to guide the qualitative interviews on participants’ understanding of burnout, contributing factors, its impact on the therapists and company as well as management strategies. Qualitative data was analysed according to the inductive method. Regarding burnout prevalence in each of the subsections of the MBI, 57.14% of the therapy staff had high levels of Emotional Exhaustion (EE), 20.4% reported depersonalisation (DP) and 38.77% had low levels of Personal Accomplishment (PA). The variables associated with high burnout scores were: male gender (p=0.0238) (PA), absence of children (P=0.02994) (EE), (p=0.03895) (PA), ≤ four years tertiary education (p=0.03640) (PA), ≤ R15 000 income (p=0.02262) (PA), not working weekends (p=0.02882) (DP), none or poor coping skills (p=0.03180) (EE), high overwhelming work load (p=0.03972) (EE), (p=0.01227) (DP), overwhelming/too small patient load (p=0.02365) (EE), high administration load (p=0.00302) (PA), seldom achievable deadlines (p=0.03693) (DP), postponed contact with patients (p=0.02023) (DP), (p=0.01164) (PA) and a poor work environment (p=0.02162) (EE), (p=0.04034) (DP). The qualitative data identified the following factors as causes of burnout: relationship challenges, lack of planning and coping skills, personality type, disempowerment, the nature of rehabilitation work, private health care environment, ethical dilemmas, time pressures, lack of rewards, lack of space and resources, uncertainty/change, lack of support from management and high workload. The following burnout management strategies emerged from the qualitative data: psycho-social intervention, team building, decrease in workload/increase in staff, adjustment of administrative workload, acknowledgement of staff through salaries and other rewards, adjustment to leave package, improved orientation and induction of staff, “time-out” opportunities, development of staff and managers, improved treatment facilities, feedback from discharged patients as well as implementation of burnout monitoring systems and development of a burnout policy and burnout management system. Recommendations to Life Rehabilitation focus on practical strategies regarding the detection, prevention and management of burnout in therapists. The groundwork has been done through this research. Successful strategic implementation will depend on the leadership of the organisation and without these key players and all the other role players involved, commitment in terms of time, money and allocation of resources it will remain an academic exercise. / AFRIKAANSE OPSOMMING: Die gevaar bestaan dat gesondheidswerkers hulle kan “uitbrand” as gevolg van die emosioneel uitmergelende aspekte van hul werk en die kroniese inspanning waaraan hulle blootgestel word. Geen Suid-Afrikaanse studies kon gevind word wat op uitbranding van die terapeut of die terapeut-assistent in die rehabilitasieveld fokus nie. Hierdie studie het die oogmerk om die prevalensie van uitbranding onder ’n selektiewe groep terapeute, die terapeute in diens van Life Rehabilitasie in Suid Afrika, te bepaal. Ter aanvulling van die prevalensie van uitbranding, is die bydraende faktore van uitbranding in hierdie omgewing, die huidige bestuur van die probleem en voorstelle vir toekomstige bestuur ondersoek. ’n Beskrywende studie-ontwerp, wat sowel kwantitatiewe as kwalitatiewe metodes insluit, is vir data-insameling en -ontleding gebruik. ’n Steekproef is nie gebruik nie. Nege-en-veertig terapeute en sewe bestuurders het aan die studie deelgeneem. Die demografiese inligting is met behulp van ’n demografiese kodeblad ingesamel en maak deel uit van die kwantitatiewe data. ’n P waarde van < 0,05 is as statisties beduidend beskou. Daar is van die Maslach Uitbranding-Inventaris (Maslach Burnout Inventory) gebruik gemaak om die prevalensie van uitbranding te bepaal. Onderhoudskedules is gebruik tydens die kwalitatiewe onderhoude waartydens deelnemers se begrip van uitbranding, die bydraende faktore en die impak op die terapeute en maatskappy, asook die bestuurstrategieë te bepaal. Die kwalitatiewe data is volgens die induktiewe metode ontleed. Aangaande die dimensies van uitbranding, het die studie bevind dat 57,14% van die terapeute hoog getoets het vir emosionele uitputting (EU), 20.4% het in die hoë kategorie vir depersonalisasie (DP) geval en 38,77% het lae vlakke van persoonlike vervulling (PV) gehad. Die veranderlikes wat met hoë uitbranding-tellings verband gehou het, was manlike geslag (p=0.0238) (PV), gebrek aan kinders (p=0.02994) (EU), (p=0.03895) (PV), ≤ vier jaar tersiêre opleiding (p=0.03640) (PV), ≤ R15 000 inkomste (p=0.02262) (PV), geen werk oor naweke (p=0.02882) (DP), geen of min bybly-vermoëns (p=0.03180) (EU), hoë, oorweldigende werklas (p=0.03972) (EU), (p=0.01227) (DP), oorweldigende of ontoereikende pasiënt-belading (p=0.02365) (EU), hoë administratiewe werklas (p=0.00302) (PA), selde bereikbare spertye (p=0.03693) (DP), uitgestelde kontak met pasiënte (p=0.02023) (DP), (p=0.01164) (PV), ’n swak werksomgewing (p=0.02162) (EU), (p=0.04034) (DP). Die hoof-oorsake van uitbranding is faktore wat met individue, pasiënt/werk, bestuur en administrasie verband hou. Strategieë is geïdentifiseer wat gebruik kan word om uitbranding konstruktief in hierdie omgewing te bestuur en sluit psigiese-sosiale behandeling, spanverbeteringe, werk/pasiënt aanpassings, erkenning van personeel, verlofaanpassings, vakansietyd-geleenthede, personeelontwikkeling en bestuursverbetering, asook die implementering van moniteringsisteme en beleidsontwikkeling in. Aanbevelings vir Life Rehabilitation is onder meer praktiese strategieë vir die opsporing, voorkoming en bestuur van uitbranding onder terapeute. Die aanvoorwerk is deur hierdie navorsing gedoen. Suksesvolle implementering van die strategieë sal van die leierskap in die organisasie afhang. Sonder hierdie en ander sleutelfigure, hul toegewydheid ten opsigte van tyd, geld en toewysing van middele sal dit slage akademise waarde hê.

Thesis (MPhil (Rehabilitation))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: In South Africa, rapid urbanisation and epidemiological transition have left the black urban population vulnerable to diseases of lifestyle such as chronic heart failure. This is in part due to the fact that changes in dietary patterns during urbanization play an important role in the increase of risk factors of these diseases. However, there is a lack of information on dietary choices of black urban populations. Therefore the current study evolved to describe the food choices and macro-and micronutrient intake of black, urban Sowetans, newly diagnosed with chronic heart failure, who attended the outpatient cardiac clinic at Chris Hani Baragwanath Hospital. A descriptive study methodology that made use of quantitative methods of data collection was used. Study participants comprised Sowetans with chronic heart failure who attended the Chris Hani Baragwanath Hospital outpatient cardiac clinic for the first time. Consecutive sampling followed by stratified random sampling was used to identify study participants. Participants were stratified for gender. Hundred persons participated in the study. Data was collected through the Food Frequency Questionnaire, a demographic questionnaire and measuring of height and weight. Data from the FFQ's was analysed for macro- and micronutrient intake by using the MRC "Food Finder 3‟ programme. Data were analysed by a statistician using StatSoft, Inc. (2009) STATISTICA, version 9.0. A p value of 0.05 was seen as statistically significant. The most significant clinical finding is an inadequate intake of certain micro nutrients and excessive salt consumption. Study participants continued to eat the more traditional carbohydrate foods. These staples were supplemented by highly refined carbohydrate sources, such as added sugar, sweets and chocolates, cakes, biscuits and cold drinks. Women ate significantly more maltabella (p=0.04), sweets and chocolates (p=0.01) than men, while men consumed significantly more, meat (p=0.01), milk and milk products (p=0.04), additional salt (p=0.02) and take away foods (p=0.05). Both genders had inadequate intake of Vitamin D [men 4 mcg/day (p=0.00), and women, 4 mcg/day (p=0.01)], selenium, [46 mcg/day (p=0.03) and 32 mcg/day (p=0.00)], folate [215 mcg/day (p=0.00) and 179 mcg/day (p=0.00)] and Vitamin C [71 mg/day (p=0.05) and 66 mg/day (p=0.07)]. Women had an inadequate intake of iron of 9 mg/day (P=0.00). It is recommended that dietary health promotion packages are developed and targeted specifically at this high risk community. Key words: Chronic heart failure, black, urban, food choices, macro-and micronutrients. / AFRIKAANSE OPSOMMING: Die swart stedelike bevolking in Suid Afrika gaan gebuk onder 'n al groter wordende risiko vir leefstyl siektes soos kroniese hartversaking. Dit kan gedeeltelik toegeskryf word aan veranderinge in dieet patrone as gevolg van verstedeliking en die epidemiologiese oorgang. Daar is egter nie genoeg inligting oor die voedselkeuses van swart stedelike bevolkingsgroepe nie. Die huidige studie het dus ontwikkel uit die behoefte om die voedselkeuses en mikro- en makronutrient inname van swart, stedelike Soweto inwoners wat nuut gediagnoseer is met hartversaking en die buitepasiënt kardiologie kliniek by Chris Hani Baragwanath Hospitaal bygewoon het, te bepaal. Daar was gebruik gemaak van 'n beskrywende studie metodologie wat gebruik gemaak het van kwantitatiewe metodes van data insameling. Deelnemers aan die studie het bestaan uit swart inwoners van Soweto met kroniese hartversaking wat die buitepasiënt kardiologie kliniek by Chris Hani Baragwanath Hospitaal vir die eerste keer bygewoon het. 'n Opeenvolgende steekproef, gevolg deur gestratifiseerde steekproefneming was gebruik om die studie deelnemers te identifiseer. Deelnemers was gestratifiseer volgens geslag. Eenhonderd pesone het aan die studie deelgeneem. Data is ingesamel deur gebruik te maak van die Voedsel Frekwensie Vraelys, a demografiese vraelys en die meet van lengte en gewig. Data van die Voedsel Frekwensie Vraelyste was ge-analiseer vir mikro-en makronutrient inname met die MRC ”Food Finder 3” program. Data is ge-analiseer deur 'n statistikus met die „StatSoft, Inc. (2009) STATISTICA, version 9.0‟. 'n P waarde van 0.05 is gesien as statisties beduidend. Mees beduidendste kliniese bevinding was die ontoereikende inname van sekere mikro-nutriënte en die verhoogde inname van sout. Studie deelnemers het nog steeds die meer tradisionele koolhidraat voedsels geëet. Hierdie stapel voedsels was aangevul deur hoogs verfynde bronne van koolhidrate, soos ekstra suiker, lekkergoed en sjokolade, koek, koekies en koeldrank. Die vrouens het beduidend meer maltabella (p=0.01), lekkergoed en sjokolade (p=0.01) geëet as mans, terwyl mans beduidend meer vleis (p=0.01), melk en melkprodukte (p=0.04), bygevoegde sout (p=0.02) en wegneem kosse (p=0.05) ingeneem het. Beide geslagte het ontoereikende innames van vitamiene D [mans 4 mcg/dag (p=0.00), en vrouens, 4 mcg/dag (p=0.01)], selenium [46 mcg/dag (p=0.03) en 32 mcg/dag (p=0.00)], foliensuur [215 mcg/dag (p=0.00) en 179 mcg/dag (p=0.00)] en vitamiene C [71 mg/dag (p=0.05) en 66 mg/dag (p=0.07)]. Vrouens het 'n ontoereikende inname van yster van 9 mg/dag (p=0.00) gehad. Daar word aanbeveel dat gesonde voedingsprogramme ontwikkel word, spesifiek gemik op hierdie bevolkingsgroep. Sleutelwoorde: Kroniese hartversaking, swart, verstedeliking, voedselkeuses, makro- en mikronutriënte.