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Submitted in partial compliance for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2009. / The aim of this study was to investigate patient management protocols of low back pain (LBP) by chiropractors in the greater Durban metropolitan area. In this investigation a more generalized approach was chosen to investigate trends within the field of patient management and education for LBP. The study population of 80 chiropractors in the greater Durban metropolitan area, required a minimum response rate of 70% to obtain statistical significance (Esterhuizen, 2008), which was achieved. This study involved a quantitative descriptive design utilizing a questionnaire developed and validated by the researcher and focus group. The questionnaire was comprised of three sections, including personal information, treatment protocols and patient management with advice and education. Statistical analysis involved the use of SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA), a data analysis tool. Descriptive objectives were analysed with frequency tables and cross-tabulation tables (Esterhuizen, 2008). Demographic variables and practice variables were assessed for association with responses to the questionnaire using Pearson’s Chi square test in the case of categorical demographics and responses (Esterhuizen, 2008). Bar graphs were included to reflect the treatments that were always or frequently used by respondents (Esterhuizen, 2008). There appeared to be a wide range of influences on practice philosophy and methods, independent of demographics and training institute. A chiropractor’s age was regarded as significant with regard to philosophical orientation. However, the majority of these chiropractors obtained their qualifications from international colleges. vi Spinal manipulations directed at quadratus lumborum myofascial trigger points were strongly advocated by respondents. Specific short lever manipulations were the preferred manipulation technique for treatment of LBP. Sacroiliac joint manipulation was also considered important by a significant proportion of respondents. Respondents most commonly recommended the use of mobilizations and cryotherapy when contra-indications to manipulation were evident. There was consensus in the number of days before the first follow-up after an initial treatment for a presentation of acute LBP, where 96.42% of respondents recommended follow-up at day 1 or 2. In chronic LBP first follow-up after initial treatment was recommended by 41.1% of respondents on day 2; 28.6% day 3 and 8.9% on day 1. Management protocols for acute LBP appeared to be more uniform when compared to management of chronic LBP. Despite the variances in philosophy and management protocols amongst respondents, there remains consensus that manual articular manipulation remains the mainstay in chiropractic treatment protocols for both acute and chronic LBP.

This study was aimed at evaluating effects of psycho education on medication compliance and symptom management for clients with bipolar affective disorder attending community psychiatric clinics in the Ethekwini Health District of KwaZulu-Natal Province. A quantitative study was done using a quasi-experimental design. A one group pre-test and post-test design was used to assess the effects of psycho education. The population of the study were all clients with bipolar affective disorder attending Escoval House community psychiatric clinic and its satellite clinic (Austerville). Systematic sampling was used to select clients to participate in the study and a total of forty clients were selected. Two self-administered questionnaires were used to collect data. Clients were assessed in areas of their knowledge, medication compliance and symptom management (Pre-test). The group was then exposed to six sessions of psycho education, and they were assessed again a week after the psycho education (post-test) using the same instruments. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Descriptive statistics were used to analyse participants' characteristics and some selected variables. Cross tabulations, chi-squares and paired t-tests were used on dependent variables and on social variables of interest to compare the changes in scores and means respectively and lastly to determine the relationship of social variables and the dependent variables. The findings of this study revealed that psycho education improved respondents' knowledge about their illness and symptom management techniques (with P-values ranging from 0.0001- 0.03), psycho education also improved medication compliance with P-value =0.000, but it did not affect the respondents' ability to use new techniques in managing their symptoms (with P-values ranging from 0.125- 0.75). / Thesis (M.A.)-University of KwaZulu-Natal, 2005.

Optimising outcomes for children with hearing impairment (HI) requires a family centred approach that prioritises parent involvement. Families must be provided with information to encourage participation; and meet their need for emotional support and knowledge. Diagnostic audiology reports can help provide this information, but their delivery alone is insufficient. If these reports are not readable and comprehendible they cannot meet national and international legal standards, nor can they support the health literacy of parents. The majority of New Zealand adults have insufficient health literacy skills, a concerning fact given the strong association between poor health literacy and negative health outcomes. The aim of this study was to evaluate a paediatric diagnostic audiology report, revise it and verify the revision. A mock audiology report was evaluated via a readability analysis and semi-structured interviews with parent participants. Results confirmed that the report was difficult to read and understand. Next, the report was revised using best practice guidelines and parental recommendations. Verification of the revision process with 32 participants revealed that parents who read the revised report had significantly greater comprehension, self-efficacy and perception ratings than parents who read the unrevised report. Additionally, the report’s readability was markedly improved. These results may have critical implications for parents and their children with HI. Incomprehensible audiology reports fail to support parental health literacy, promote understanding, encourage participation or offer emotional support. Because knowledge is power for these families, it is hoped that the findings of this study will be recognised and implemented into clinical practice.

Stressrelaterad ohälsa är ett vanligt och ständigt ökande problem i dagens västerländska samhälle. I många fall leder denna typ av ohälsa till sjukskrivningar och stora kostnader för samhället. Det är inte alltid möjligt att undvika eller påverka de stressorer människan exponeras för i arbetslivet och på fritiden, utan människor får istället hitta sätt att minska stresspåverkan på kroppen. Arbetet med, och förebyggandet av, stressrelaterad ohälsa är ett högst aktuellt ämne, och är en central del inom hållbar utveckling. Syftet med detta arbete är att sammanställa och presentera en översikt av befintlig forskning gällande upplevelsen av fysisk aktivitet och dess effekt på stressrelaterad ohälsa. Denna litteraturstudie är baserad på 15 empiriska studier, och innefattar både kvalitativa och kvantitativa studier för ett bredare perspektiv. Resultatet bygger på två huvudteman; Relationen mellan fysisk aktivitet och stressrelaterad ohälsa samt hinder och möjligheter för fysisk aktivitet. Resultatet visar att fysisk aktivitet är en viktig faktor för att främja hälsa och förebygga ohälsa. Socioekonomisk status påverkar mängden fysisk aktivitet som utförs och hur stor stresspåverkan är på kroppen. Många upplever att en stor del av stressen är arbetsrelaterad, och att de då använder fysisk aktivitet för att hantera sin stress. Det är viktigt att individanpassa den aktivitet som utförs för att få ett mer positivt resultat. Genom att vårdpersonal får en fördjupad kunskap och förståelse inom området kan det underlätta arbetet kring att främja fysisk aktivitet hos människor och på så vis förebygga stress och ge ett ökat välbefinnande.

Introduction: Recent Ebola epidemic in West Africa have put viral hemorrhagic fever diseases in the spotlight. Uganda has had several outbreaks throughout the years, which have successfully been managed. Nurses’ patient education plays an important role in the work to increase public awareness about viral hemorrhagic fever diseases. Objectives: To assess how nurses at the emergency department educate the patients and relatives about the viral hemorrhagic fever diseases. Methods: An explorative and descriptive qualitative study with qualitative approach have been used. In-depth interviews with 18 open-ended questions have been conducted with nurses in the emergency department. Data was analyzed by qualitative content analysis and analyzed with Peplau’s theory of interpersonal relationship. Results: Through data analysis four categories were developed; Wide variety of educational techniques, Experienced obstacles, How to attain wider audience and Preferable characteristics as an educating nurse. Nurses used many different approaches when educating about viral hemorrhagic fever diseases, often uniquely combined. Lack of time and too unstable patients in the emergency department were seen as the main obstacles to educate. Methods to reach the community and employing a special education-nurse on the ward were suggestions to improve the preventive work against viral hemorrhagic fever diseases. Conclusion: Nurses are aware of the importance of patient education and use the educational methods they believe to be the most effective. However, patients in the emergency department often come in too late and priority should be on preventive measures. Training the nurses in educational techniques and patient education could be a key in decreasing the risk of coming outbreaks. / Bakgrund: Den senaste ebolaepidemin i västafrika har gjort att blödarsjukdomar hamnat i rampljuset. Uganda har genom åren drabbats av flera utbrott som framgångrikt hanterats. Sjuksköterskors patientutbildning spelar en viktig roll i arbetet för att öka allmänhetens medvetenhet om blödarsjudkomar. Syfte: Att undersöka hur sjuksköterskor på akutmottagningen utbildar patienter och anhöriga om blödarsjukdomar. Metod: En explorativoch deskriptiv kvalitativ studie med kvalitativ ansats användes. Sjuksköterskor som arbetar på akutmottagningen har djupintervjuats med 18 öppna frågor. Data har analyserats med en kvalitativ innehållsanalys och analyserats utifrån Peplaus ”interpersonal relationship theory”. Resultat: Genom dataanalysen utvecklades fyra kategorier; Stor variation på utbildningstekniker, Upplevda hinder, Hur man ska nå en bredare publik och Önskvärda egenskaper som utbildande sjuksköterska. Sjuksköterskorna använder många olika metoder för utbilda patienter och anhöriga om blödarsjukdomar, ofta i unika kombinationer. Tidsbrist och alltför instabila patienter på akutmottagningen sågs som de största hindren för att utbilda. Metoder för att nå allmänheten och att anställa en speciell utbildningssjuksköterska på avdelningen var några av förslagen för att förbättra det förebyggande arbetet mot blödarsjukdomar. Slutsats: Sjuksköterskorna är medvetna om vikten av patientutbildning och använder de pedagogiska metoder de anser vara mest effektiva. Då patienterna kommer till akutmottagningen är det dock ofta för sent och preventiva åtgärder borde prioriteras. Att öka sjuksköterskornas kunskap i utbildningstekniker och patientutbildning kan vara en viktig del i det preventiva arbetet för att minska risken för kommande utbrott.

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This study assessed differences in the knowledge of cardiac risk factors and the attitude toward computer assisted instruction (CAI) in cardiac rehabilitation patients instructed by lecture and transparencies or CAI. The quasi-experimental two-group posttest design used a convenience sample of 30 volunteers enrolled in a cardiac rehabilitation program. After randomization, cardiac risk factor instruction was conducted via lecture or the investigator developed CAI. The subjects completed a knowledge instrument which demonstrated content validity and a Kuder-Richardson formula 20 reliability coefficient of .0 and the Attitude Toward CAI scale which demonstrated content validity and a Cronbach's alpha .853 and .759. The data were analyzed by the two-sample t-test utilizing the .05 probability level. The results indicated a nonsignificant t value of .00 (df 28, p = 1.00) in the knowledge scores and a nonsignificant t value of 2.00 (df 28, p = .05) in attitude scores therefore the results failed to reject both null hypotheses. The conclusions drawn from this study are that CAI was as effective as lecture for patient education and that attitudes toward CAI were favorable. / School of Nursing

With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries. / School of Nursing

The purpose of this study was to determine if there was a difference in physical selfconcept due to level of physical activity or the subject's frame of reference. Participants included female students in two HSC-160 courses and members of the Ball State University women's softball, field hockey, and basketball teams in the fall of 2000. The study was conducted using a demographic questionnaire, the Physical Self-Description Questionnaire (PSDQ), and a physical activity log. Subjects received instructions to complete the PSDQ comparing themselves to either someone more physically fit or less physically fit. Subjects chose one of three physical activity levels, nonparticipant, exercisers, or athlete, based on definitions given on the demographic questionnaire. Results of the study indicated that as the level of physical activity increased, so did physical self-concept scores. Results did not find a significant difference in frame of reference and level of physical activity. / School of Nursing