People living with heart failure (PLHF) should be screened for symptoms at every healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires were compared and assessed with the gold standard laboratory test for HF (NT-proBNP) for sensitivity and specificity. For HF, the SHEFS was the most sensitive (83%) compared to the NT-proBNP, but the MLHFQ was most specific (89%). When compared to the MLHFQ as the standard, SHEFS was 71% sensitive, and 73% specific for HF. Similarly, when compared to the KCCQ, the SHEFS was both, 75% specific and sensitive in identifying HF. However, the rate of correlation to a positive or negative NT-proBNP test results was the highest for the SHEFS (87%). All 3 questionnaires were statistically significant in predicting admission to hospital for HF in the past 6 months (p = 0.02 to 0.03). Finally, given the shortest length and simplicity of use, the SHEFS was selected by the stakeholders to be the standard screening tool for the clinic. This project contributes to positive social change by providing the first reported comparison in the literature to implement questionnaires in a clinic to assess symptoms for PLHF attending an arrhythmia devices clinic.

Data quality has become an area of increasing concern in marketing research. Methods of collecting data, types of data analyzed, and data analytics techniques have changed substantially in recent years. It is important, therefore, to examine the current state of marketing research, and particularly self-administered questionnaires. This paper provides researchers important advice and rules of thumb for crafting high quality research in light of the contemporary changes occuring in modern marketing data collection practices. This is accomplished by a proposed six-step research design process that ensures data quality, and ultimately research integrity, are established and maintained throughout the research process—from the earliest conceptualization and design phases, through data collection, and ultimately the reporting of results. This paper provides a framework, which if followed, will result in reduced headaches for researchers and more robust results for decision makers.

The modern hospice movement emerged in the 1960s as a grassroots social movement that attempted to restore an holistic and contextualised approach to the care of people at the end of life. This approach embraced the lived experience of the dying person at the centre of care across physical, emotional, social and spiritual domains of life. To achieve this, the care of dying people was largely removed from mainstream health care systems to promote more holistic and socially contextualised dying. In recent decades, the evolution of palliative care demonstrates the gradual return of palliative care services to the mainstream. It has been asserted that, in this process, palliative care services have progressively abandoned the social context of dying people, increasing instead an emphasis on "physical care [while] simultaneously de-emphasizing psychological, social and spiritual care" (Kellehear, 1999a, p.76). Kellehear and others have proposed that the repositioning of palliative care within mainstream health care systems has increased a focus upon illness and disease at the expense of health and wellbeing. Subsequently, conventional palliative care services have been criticised for not adequately locating end of life care within the social contexts in which death and dying take place. In an attempt to address this problem, Australian sociologist Allan Kellehear proposed an approach to end of life care that brought together the core concerns of palliative care with the principles and practices of health promotion (Kellehear, 1999b). Whilst their congruence is not immediately apparent, these two fields have been increasingly examined for their potential benefits in the provision of end of life care. In the current policy climate in Australia, there is an imperative to consider how end of life support services might be improved through adopting a health promoting palliative care approach. The aim of this study has been to investigate the integration of health promotion principles and practice by a selected palliative care service by examining the qualitative impact of this change on the organisation. Specifically, it endeavoured to identify the factors that advanced or impeded this integration by examining how the structures and processes of, and outcomes for, the organisation reflected a health promoting approach. To meet these aims, this study undertook an in-depth examination of the implementation of a health promoting palliative care model by a community based palliative care organisation. Based in a constructionist-interpretivist paradigm, a mixed-method (QUAL+quant), instrumental case study research design was utilised to capture multiple perspectives of the implementation process. Data collection comprised examination of 127 organisational documents, 32 in-depth interviews with staff, volunteers and consumers, 5 focus groups with staff and volunteers, and 25 carer questionnaires. Qualitative data were subject to thematic analysis, with supplementary quantitative data analysed to generate descriptive statistics. The findings demonstrated a large number of complex and interrelated enabling and impeding factors to the implementation in the case study site. These factors have been grouped into four key themes which have been examined in light of the aims of this study and the issues identified in a comprehensive review of the literature. This study found that: ◦ Conceptual congruence between health promotion and palliative care was a fundamental starting point in the implementation of a health promoting palliative care model. ◦ Where conceptual congruence was clear, activities associated with the model that were regarded as beyond conventional approaches to palliative care core business were viewed favourably by stakeholders and were less likely to encounter resistance within the organisation. ◦ When systematic approaches to organisational change, such as quality improvement systems, were rigorously applied, the impact of the transition upon stakeholders was qualitatively less. ◦ Where this transition had been effectively made, consumers, staff, volunteers and members of the wider community were seen to benefit. This study adds to the current discourse regarding the intersection between end of life support and health promotion, and provides insight into how palliative care organisations might undertake the transition from conventional models to a health promoting palliative care approach.

In disseminating information about health issues, government health departments and NGOs use, inter alia, written health texts. In a country like South Africa, these texts are generally written by medical experts and thereafter translated into the languages of the people. One of these languages is Zulu, which is spoken by the majority of South Africans. A large percentage of Zulu speakers are illiterate or semi-literate, especially in the rural areas. For this reason, Zulu translators have to use ‘simple’ language that these readers would understand when translating English texts into Zulu. Translators are expected to use strategies that can deal with non-lexicalized, problematic or other related terms that appear in health texts, as well as geographical and cultural constraints. This study focuses on the strategies used by Zulu translators in an attempt to make translated Zulu health texts accessible to the target readership. The investigation includes the use of self-administered questionnaires for respondents from two of South Africa’s nine provinces, where Zulu speakers are found (Gauteng and KwaZulu-Natal), to determine whether the health texts do reach the target readership. Focus groups, semi-structured interviews and other complementary techniques were used to collect data from the selected respondents. Furthermore, a parallel concordance called ParaConc was used to extract and analyse data from the corpus as compiled for the present study, in an attempt to investigate the strategies used to make the translated health texts easier to read. The study uncovers various strategies which are used when translating English health texts into Zulu. These strategies include the use of loan words, paraphrasing, cultural terms and so on. In future, the use of ParaConc can be broadened to investigate newly discovered translation strategies, with the aim of making health texts more accessible to the target readers. Furthermore, this software programme can also be used to study translation strategies as used in other types of texts, for example journalistic texts. / Linguistics / D. Litt. et Phil. (Linguistics (Translation Studies))

In disseminating information about health issues, government health departments and NGOs use, inter alia, written health texts. In a country like South Africa, these texts are generally written by medical experts and thereafter translated into the languages of the people. One of these languages is Zulu, which is spoken by the majority of South Africans. A large percentage of Zulu speakers are illiterate or semi-literate, especially in the rural areas. For this reason, Zulu translators have to use ‘simple’ language that these readers would understand when translating English texts into Zulu. Translators are expected to use strategies that can deal with non-lexicalized, problematic or other related terms that appear in health texts, as well as geographical and cultural constraints. This study focuses on the strategies used by Zulu translators in an attempt to make translated Zulu health texts accessible to the target readership. The investigation includes the use of self-administered questionnaires for respondents from two of South Africa’s nine provinces, where Zulu speakers are found (Gauteng and KwaZulu-Natal), to determine whether the health texts do reach the target readership. Focus groups, semi-structured interviews and other complementary techniques were used to collect data from the selected respondents. Furthermore, a parallel concordance called ParaConc was used to extract and analyse data from the corpus as compiled for the present study, in an attempt to investigate the strategies used to make the translated health texts easier to read. The study uncovers various strategies which are used when translating English health texts into Zulu. These strategies include the use of loan words, paraphrasing, cultural terms and so on. In future, the use of ParaConc can be broadened to investigate newly discovered translation strategies, with the aim of making health texts more accessible to the target readers. Furthermore, this software programme can also be used to study translation strategies as used in other types of texts, for example journalistic texts. / Linguistics and Modern Languages / D. Litt. et Phil. (Linguistics (Translation Studies))