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Patient and nurse perspectives on loss to follow-up in HIV careModipane, Mahlatse Bridgette 16 May 2020 (has links)
PhD (Psychology) / Department of Psychology / Background: South Africa has world’s highest prevalence of HIV-positive people with
approximately 7.06 million HIV-positive people with 110 000 HIV- related deaths reported by
Statistics South Africa in 2017. South Africa has expanded access to anti-retroviral therapy
services, from urban centers to resource-constrained rural communities. The rate of loss,
however, to follow-up for patients on anti-retroviral treatment continues to increase.
Aim of the Study: The aim of this study was to determine patient and nurse perspectives on loss
to follow up among HIV-positive patients in Sekhukhune District of Limpopo Province, South
Africa. The findings of the study guided the development of a proposed strategy to decrease loss
to follow up among HIV-positive patients.
Method: A qualitative research design was used with non-probability purposive sampling and with
probability systematic sampling. The sample of patients comprised 30 HIV-positive people
classified as lost to follow-up from clinics with high prevalence rates of lost to follow-up patients.
Eight nurses, four from clinics with high rates and four from clinics with low lost to follow-up rates
comprised the sample of nurses. Semi-structured interviews were conducted using the study
research questions as a guide. Eight interviews were conducted with nurse clinic managers and
30 with the patients. Content analysis was used to analyze the data.
Results: The key themes that emerged from the study included patients’ and nurses`
perspectives on factors contributing to loss to follow up among HIV- positive patients; and
Patients’ and nurses’ perspectives on strategies that would address barriers to loss to follow up
among HIV- positive patients. Sub-themes on patients’ and nurses’ perspectives on factors
contributing to loss to follow up among HIV- positive patients included: Lack of understanding of
anti-retroviral treatment; fearful to disclose HIV status; lack of confidentiality; negative side effects;
use of traditional medicine; self-transfer from one clinic to another. Patients’ and nurses’ elicited
the strategies that would assist patients to remain in care and to take antiretroviral treatment
consistently. The strategies included: providing patients with health education; working as a team;
implementing social support group programme; providing nurses with in-service education on
ethics and ethos. Informed by various intervention models in HIV care: Information Motivational
Behavioural model; Health Belief Model; Social Action Theory and Social Cognitive Theory; I
proposed a strategy that may reduce the rate of non-adherence and loss to follow up among
patients with HIV in Limpopo Province. / HWSETA
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Comparing adherence patterns to standard precautions and infection control amongst health care providers in public and private hospitals in BotswanaYilma, Nebeyou Aberra 23 January 2015 (has links)
This study aimed to provide evidence on knowledge of attitudes toward standard precautions (SPs) and its practice of Healthcare Workers (HCWs) in government and private hospitals in Botswana. It utilised descriptive cross-sectional methodology. A range of significant findings were revealed. Good practice of SPs was noted more amongst the HCWs in government than in private hospitals. Knowledge of SPs amongst HCWs in government hospital was significantly and positively correlated to good practice of SPs. Registered Nurses (RNs) had better knowledge of SPs than HealthcareAssistants (HCAs).There was no significant difference between RNs and HCAs practice of SPS and attitudes toward the same. No significant difference in the knowledge, attitudes and practice of SPs was noted between General Practitioners (GPs) and RNs. No significant difference in the knowledge, attitudes and practice of SPs was observed between GPs and HCAs. The study findings have implications for the application of SPs in practice / Health Studies / M.A. (Public Health)
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Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case StudyTorres Ospina, Sara 29 January 2013 (has links)
“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice.
I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services.
Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship.
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Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case StudyTorres Ospina, Sara 29 January 2013 (has links)
“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice.
I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services.
Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship.
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Uncovering the Role of Community Health Worker/Lay Health Worker Programs in Addressing Health Equity for Immigrant and Refugee Women in Canada: An Instrumental and Embedded Qualitative Case StudyTorres Ospina, Sara January 2013 (has links)
“Why do immigrants and refugees need community health workers/lay health workers (CHWs) if Canada already has a universal health care system?” Abundant evidence demonstrates that despite the universality of our health care system marginalized populations, including immigrants and refugees, experience barriers to accessing the health system. Evidence on the role of CHWs facilitating access is both lacking and urgently needed. This dissertation contributes to this evidence by providing a thick description and thorough analytical exploration of a CHW model, in Edmonton, Canada. Specifically, I examine the activities of the Multicultural Health Brokers Co-operative (MCHB Co-op) and its Multicultural Health Brokers from 1992 to 2011 as well as the relationship they have with Alberta Health Services (AHS) Edmonton Zone Public Health. The research for this study is based on an instrumental and embedded qualitative case study design. The case is the MCHB Co-op, an independently-run multicultural health worker co-operative, which contracts with health and social services providers in Edmonton to offer linguistically- and culturally-appropriate services to marginalized immigrant and refugee women and their families. The two embedded mini-cases are two programs of the MCHB Co-op: Perinatal Outreach and Health for Two, which are the raison d’être for a sustained partnership between the MCHB Co-op and AHS. The phenomenon under study is the Multicultural Health Brokers’ practice.
I triangulate multiple methods (research strategies and data sources), including 46 days of participant and direct observation, 44 in-depth interviews (with Multicultural Health Brokers, mentors, women using the programs, health professionals and outsiders who knew of the work of the MCHB Co-op and Multicultural Health Brokers), and document review and analysis of policy documents, yearly reports, training manuals, educational materials as well as quantitative analysis of the Health Brokers’ 3,442 client caseload database. In addition, data include my field notes of both descriptive and analytical reflections taken throughout the onsite research. I also triangulate various theoretical frameworks to explore how historically specific social structures, economic relationships, and ideological assumptions serve to create and reinforce the conditions that give rise to the need for CHWs, and the factors that aid or hinder their ability to facilitate marginalized populations’ access to health and social services.
Findings reveal that Multicultural Health Brokers facilitate access to health and social services as well as foster community capacity building in order to address settlement, adaptation, and integration of immigrant and refugee women and their families into Canadian society. Findings also demonstrate that the Multicultural Health Broker model is an example of collaboration between community-based organizations and local systems in targeting health equity for marginalized populations; in particular, in perinatal health and violence against women. A major problem these workers face is they provide important services as part of Canada’s health human resources workforce, but their contributions are often not recognized as such. The triangulation of methods and theory provides empirical and theoretical understanding of the Multicultural Health Brokers’ contribution to immigrant and refugee women and their families’ feminist urban citizenship.
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Exploring the practice of HIV self-testing among health care workers at Nyeri Provincial Hospital in KenyaKennedy, Muthoka Joseph 22 November 2013 (has links)
The purpose of the study was to describe the determinants and practice of HIV self-testing
among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A
descriptive cross-sectional study was conducted to determine the rate of HIV self-testing,
explore the factors influencing the practice and describe access to HIV
psychosocial support, care and treatment. The study was guided by the concepts of the
protection motivation theory. Data was collected from 348 HCWs and analysed by
means of logistic regression. Results showed that 65.8% of the HCWs had practiced
HIV self-testing among themselves. Age, self efficacy and response efficacy were found
to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial
support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya / HIV self-testing among health care workers / Public Health / M.A. (Public Health)
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Evidence-based guidelines to promote the health and safety of health care workers in selected public hospitals in the Tshwane health care district in Gauteng, South AfricaSehume, Odilia Monica Mamane 11 1900 (has links)
Text in English / The purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa.
Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association.
Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs.
The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs.
Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs. / Health Studies / D.Litt et Phil. (Health Studies)
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Exploring the practice of HIV self-testing among health care workers at Nyeri Provincial Hospital in KenyaMuthoka, Joseph Kennedy 11 1900 (has links)
The purpose of the study was to describe the determinants and practice of HIV self-testing
among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A
descriptive cross-sectional study was conducted to determine the rate of HIV self-testing,
explore the factors influencing the practice and describe access to HIV
psychosocial support, care and treatment. The study was guided by the concepts of the
protection motivation theory. Data was collected from 348 HCWs and analysed by
means of logistic regression. Results showed that 65.8% of the HCWs had practiced
HIV self-testing among themselves. Age, self efficacy and response efficacy were found
to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial
support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / Public Health / M.A. (Public Health)
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Nurses perceptions of the factors contributing to the spread of tuberculosis in a clinic in the Odi Moretele sub district of GautengMolele, Mahlodi Annah 06 1900 (has links)
Introduction: Despite being one of the most preventable diseases, TB still remains a
serious and largely neglected disease. Nurses as compared to the general population
are at greater risk of acquiring nosocomial TB. This study was conducted to describe
the perceptions of nurses on the underlying contributory factors that may lead to the
spread of TB in the clinics treating TB patients.
Methods: Quantitative, non – experimental, descriptive, exploratory and cross sectional
design was used. A structured and pretested questionnaire was used.
Findings: The key contributory factors identified were insufficient TB training for staff
and lack of knowledge on the TB legislative framework and TB policy directives.
Conclusion: The findings indicate the need for a comprehensive TB infection prevention and control policy, with associated standards for provision and practice. / Health Studies / M.A. (Public Health)
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Nurses perceptions of the factors contributing to the spread of tuberculosis in a clinic in the Odi Moretele sub district of GautengMolele, Mahlodi Annah 06 1900 (has links)
Introduction: Despite being one of the most preventable diseases, TB still remains a
serious and largely neglected disease. Nurses as compared to the general population
are at greater risk of acquiring nosocomial TB. This study was conducted to describe
the perceptions of nurses on the underlying contributory factors that may lead to the
spread of TB in the clinics treating TB patients.
Methods: Quantitative, non – experimental, descriptive, exploratory and cross sectional
design was used. A structured and pretested questionnaire was used.
Findings: The key contributory factors identified were insufficient TB training for staff
and lack of knowledge on the TB legislative framework and TB policy directives.
Conclusion: The findings indicate the need for a comprehensive TB infection prevention and control policy, with associated standards for provision and practice. / Health Studies / M.A. (Public Health)
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