Submitted in fulfillment of the Masters degree in Technology: Community Health Nursing, Durban University of Technology, 2013. / Background One of the major challenges for the Department of Health in South Africa today is inequity and the need to provide quality integrated health care for all its citizens. Primary Health Care (PHC) has been declared as the way to achieve this goal, through the District Health System. Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML) have been developed and are used at PHC clinics and hospitals. This study explored the use of STGs and the EML by professional nurses at PHC clinics in the UMgungundlovu District, KwaZulu-Natal, South Africa. Methods A quantitative descriptive research design was used. Questionnaires were used to collect data from respondents at the PHC clinics. A retrospective review of facility registers kept by the respondents on the rational use of drugs was also carried out by the researcher. Results The findings of the study revealed that the respondents had a good understanding of the use of the STGs and the EML. There was no evidence of polypharmacy, and medications were prescribed according to guidelines. Areas that were suboptimal were related to prescription writing in writing of schedules and routes of medication as indicated in facility records. The results further showed that training on the use of the STGs and EML were inadequate, which implies the need for strengthening of training programmes.

Submitted in compliance with the requirements for the Master's Degree in Technology: Nursing, Durban University of Technology, 2014. / Background : Tuberculosis (TB) is a global public health concern and is identified as the leading cause of morbidity and mortality in the population infected with Human Immune Deficiency Virus (HIV). South Africa (SA), particularly the KwaZulu-Natal Province, is burdened with persistently high rates of both TB and HIV infections. In an attempt to improve TB and HIV co-infection outcomes the South African health care system has adopted the World Health Organisation (WHO) guidelines for intensified TB case findings in all HIV positive individuals for regular screening of TB symptoms in order to promptly diagnose and treat active TB disease or to exclude TB for initiation Isoniazid Prophylactic Therapy (IPT). IPT has proven effective in preventing TB disease in People Living with HIV or AIDS (PLWHA). This critical first step of TB symptom screening is regarded as the intervention that could significantly reduce the challenge currently faced with TB-HIV co-infection. The study was conducted in selected eThekwini Municipality Primary Health Care (PHC) facilities with the focus on an investigation to determine the extent of the implementation of the TB symptom screening tool in HIV infected individuals, in addition to identifying treatment initiation or further investigations based on the tool implementation. It has been found during the literature review, that there is a lack of research in SA to show that this critical first step in TB identification has been investigated, yet one in six South African’s is HIV positive and the incidence of TB-HIV co-infection is not declining. Methodology : A quantitative, descriptive approach was utilised to conduct a retrospective patient chart review. A multistage cluster sampling technique comprising three stages was implemented to identify the sample. There was a random selection of clinics, and the required number of client records was obtained through convenience sampling from the selected clinics. Results : The findings of this study revealed there is inadequate implementation of the current national and provincial TB protocols. The study provides varied levels of information about TB symptom screening in HIV infected individuals in the PHC clinics of eThekwini Municipality. It was observed that Health Care Worker’s (HCW) in some facilities carried out TB symptom screening to an extent. However, the inconsistent and partial application of this screening tool warrants improvement to facilitate the broad success of TB-HIV care strategies.

Thesis (MA (Psychology))--University of Stellenbosch, 2007. / South Africa has been a democratic country for more than ten years, and still transformation is not visible in many areas. Psychological services are inaccessible and unaffordable for the larger part of South-Africans. The B.Psych degree was specifically implemented to address this problem. The course aims to give graduates access to registration as counsellors at the HPCSA in order to bring psychological services to people more easily. This study thus explores the employment patterns of registered counsellors in South Africa. These counsellors have been trained to deliver services within the primary health care sector because most people use services within this sector. Only eight percent of registered counsellors in South Africa are working within this sector. Most registered counsellors are working in the education sector or the private sector. Counsellors that are working in the education sector are primarily delivering educational services and not psychological services. Counsellors that are working in the private sector are contributing to making services inaccessible and unaffordable to many people. The absence of workers in the primary healthcare sector is mainly because there is little employment for registered counsellors within this sector. The findings of this study are in accordance with the findings of Kotze (2005) that accessibility to psychological services did not significantly change with the implementation of the B.Psych course.

Thesis (MA (Psychology))--University of Stellenbosch, 2006. / An immense burden is placed on families caring for a member with a mental disorder as a result of deinstitutionalisation in South Africa. The aim of present study was to identify resilience factors in families living with and caring for a member with a mental disorder. The focus was on families living in an underprivileged, semi-rural area; caring for a patient using the state-sponsored psychiatric services. Using a cross-sectional survey design, interviews were conducted with 34 family representatives. During these interviews, qualitative and quantitative data was gathered by means of a biographical questionnaire, an open-ended question and set of self-report questionnaires. The results yielded from the data analysis are in keeping with findings from international and South African family resilience studies. After content analysis of the qualitative data, three themes related to resilience factors emerged: internal factors within the home, external factors outside of the home and factors related to the member with a mental disorder. The most commonly mentioned resilience factors cited by the family representative were religion and spirituality, characteristics of individual family members (excluding the patient), family characteristics, and social support. Spearman’s correlations and best subsets multiple regression analysis were performed on the data to ascertain which factors are significantly correlated or associated with family adaptation. In both statistical analyses, communication styles of the family unit were the most important. Spearman’s correlations further revealed that in addition to family communication, the ability of the family to work together, and communication between the marital couple had the strongest correlation with adaptation. Passive acceptance of problematic issues in the family has a negative correlation with family adaptation. The two most significant predictor variables of family adaptation are the family’s style of family communication during crises and the family’s use of passive appraisal as a coping style.

Thesis (MA (Psychology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: This literature review follows the early origins of the integration of psychological services into Primary Health Care (PHC) to its promulgation by law under the new dispensation in South Africa post-1994. With a recent re-commitment in 2008 by government to PHC for health service delivery, the biomedical orientation of PHC is inherently problematic as the location for psychological services and runs contrary to a comprehensive discourse of care as envisioned locally and by the World Health Organisation (WHO). With such shifts in policy at a macro level and in a context in which the relevance of psychological theorising and praxis is under scrutiny, this review has highlighted that a bottom-up approach is necessitated; specifically one that will facilitate a convergence between policy, theory and practice, with its foundations informed by research. / AFRIKAANSE OPSOMMING: Hierdie literatuuroorsig begin by die vroeë beginpunt waar sielkundige dienste by Primêre Gesondheidsorg (PHC) ingelyf is, en volg die gebeure tot waar nuwe wetgewing hieroor in die nuwe post-1994-dispensasie in Suid-Afrika uitgevaardig is. Met die regering wat homself in 2008 herverbind het tot PHC vir gesondheiddiensverskaffing is die biomediese fokus van PHC vir sielkundige dienste inherent problematies, omdat dit in teenstelling met omvattende diskoers oor versorging staan, soos dit plaaslik en deur die Wêreldgesondheidsorgorganisasie (WHO) in die vooruitsig gestel word. Met makrovlakverskuiwings in beleid en in konteks waarin die toepaslikheid van teoretisering en praktyk op die gebied van die sielkunde onder die loep is, beklemtoon hierdie verslag dit dat onder-na-bo-benadering nodig is; spesifiek een wat sameloping tussen beleid, teorie en praktyk sal fasiliteer, en wat gegrond is op navorsing.

Thesis (MBA)--Stellenbosch University, 2006. / ENGLISH ABSTRACT: South Africa's healthcare industry is at a crossroad as pressure in both the public and private sectors is increasing. The extent of change in the industry is overwhelming and it is seen as a very turbulent and unstable environment. Healthcare professionals must reconsider their position in the industry and adapt in this ever-changing environment. The physiotherapy profession forms a small part of the healthcare value chain, but it fulfils an important role in the healthcare system. Unfortunately the profession shows no clear direction and purpose. There also exists a mismatch between the current healthcare environment demands and the physiotherapy service delivery. If they do not adapt in this environment which is in turmoil and have a clear strategy for the way forward, they will be pushed out of the healthcare value chain and become obsolete. The aim of this research report was then to do an in depth analysis of the private healthcare industry in which physiotherapy is operating, to analyse the external physiotherapy industry and an internal analysis of the profession so as to construct a generic strategy for the physiotherapy profession in the private healthcare sector in South Africa. To achieve this aim, it was determined that qualitative, investigative research would be conducted. The research methodology used in this research report was a combination of primary and secondary research. Firstly, secondary research in the form of a literature review was conducted to provide a comprehensive insight into the provision of health care in South Africa. Thereafter, primary research was conducted through semi-structured, in-depth interviews with a purposive sample of physiotherapy industry experts to analyse the external physiotherapy Industry as well as the internal profession environment. Main findings include that the physiotherapy industry is becoming less attractive as competitive forces in the physiotherapy and private healthcare industry are moderate to strong. Deconstruction of the healthcare value chain in the private sector is increasing intra- and inter-professional competition. Government plays a major role in the attractiveness of the industry as they are restricting competitive and market forces and minimising profits through legislation. Medical schemes are trying to contain costs and managed healthcare is coming to the forefront. The physiotherapy market is stagnating and the clients' needs and requirements are changing. Opportunities that were identified we~e the expansion into new markets, involvement in other industries and broadening the scope of practice. Threats are mainly from governmental legislation and policies, vertical integration from the hospital and medical scheme industries and the threat of substitutes, especially alternative health. From the internal profession analysis a current strategy was identified and a strategic intent was formulated as the physiotherapy profession wants to be the preferred and relevant health care service provider in prevention, management and rehabilitation of potential and actual movement impairments of individuals. Strengths to help build this vision included their high regard and profile, quality training, increase in research and evidence and their whole service package. Weaknesses that must be overcome include poor business, managerial and marketing skills, limited role models and leaders and the high levels of intra-professional competition leading to the demise of the profession. Having completed the analysis, major strategic thrusts with a focussed differentiated approach for the profession could then be formulated: • Define physiotherapy and the scope of practice. • Reinstate physiotherapy in the healthcare system. • Develop leadership. • Cooperate within the profession. • Maintain professional autonomy. • Develop business skills. / AFRIKAANSE OPSOMMING: Gesondheidsprofessies moet hul posisie in die industrie herevalueer en aanpas in hierdie steeds wisselende omgewing. Die fisioterapie professie beslaan 'n klein deeltjie van die gesondheidsorg waardeketting, maar dit vervul 'n baie belangrike rol in die gesondheidsorg stelsel. Ongelukkig blyk dit asof die professie geen rigting en doeleindes het waarna dit beweeg en streef nie. Verder bestaan daar ook 'n wanbelyning tussen die huidige gesondheidsorg omgewingvereistes en die dienste wat fisioterapie verrig. Indien die fisioterapie professie nie aanpas in hierdie onstuimige omgewing nie en 'n duidelike strategie ontwikkel vir die toekoms nie, staan dit in gevaar om te verval uit die gesondheidsorg-waardeketting en te vergaan. Die doel van hierdie navorsingswerkstuk is dan om 'n in diepte analise te doen van die privaat gesondheidsorgindustrie waarin fisiolerapeute funksioneer, om die eksterne fisioterapie-industrie sowel as die interne professie te analiseer; ten einde 'n generiese strategie vir die fisiolerapie-professie in privaat gesondheid in Suid Afrika te ontwikkel. Om hierdie doelwitte te bereik is daar besluit om kwalitatiewe navorsing te doen. Die navorsingsmetodologie wat gebruik is bestaan uit 'n kombinasie van primere en sekondere navorsing. Sekondere navorsing is gedoen in die vorm van 'n literatuuroorsig om 'n omvattende oorsig te gee van die gesondheidsorg dienslewering in Suid Afrika. Daarna is primere navorsing gedoen in die vorm van gedeeltelike gestruktureerde, in diepte onderhoude met 'n doelbewuste steekproef van fisioterapie-kundiges om die eksterne omgewing en interne professie te evalueer. Hoof bevindings uit die analise is dat die fisioterapie-industrie se aantreklikheid besig is om te verminder as gevolg van gemiddelde tot sterk kompeterende kragte. Dekonstruksie van die gesondheidsorg-waardeketting in die privaatsektor lei tot verhoogde intra- en inter-professionele kompetisie. Die regering speel ook 'n groot rol in die aantreklikheid van die industrie en hulle beperk natuurlike kompetisie en markkragte en minimaliseer winste deur middel van wetgewing. Mediese fondse probeer kostes beperk en besturende gesondheidsorg begin ontluik. Die huidige fisioterapiemark is besig om te stagneer en kliente se behoeftes en vereistes is besig om te verander. Geleenthede wat geidentifiseer is sluit in die uitbreiding na nuwe markte, betrokkenheid by ander industrie; en die verbreding van fisioterapie se bestek van praktyk. Bedreigings bestaan hoofsaaklik vanaf regeringswetgewing en regulasies, vertikale integrasie van die hospitaal en mediese fonds industriee en die bedreiging van plaasvervangers, veral alternatiewe gesondheid. Vanaf die interne professie-analise is daar 'n huidige strategie geidentifiseer en 'n strategiese intensie kon geformuleer word. Hierdie intensie is dat die fisioterapieprofessie die gewenste en relevante gesondheidsorg diensverskaffer sal wees in die voorkoming, bestuur en rehabilitasie van potensiele en werklike bewegingsaantastings van individue. Sterkpunte in die professie wat hierdie intensie kan ondersteun, sluit in hul goeie profiel en agting, kwaliteit opleiding, toename in navorsing en hul volledige dienspakket. Swakpunte wat oorkom moet word is swak besigheids-, bestuur - en bemarkingsvaardighede, beperkte rolmodelle en leiers en die intra-professionele kompetisie wat die professie as 'n geheel ondermyn. Nadat die analise gedoen is kon daar hoof strategiese rigtings geformuleer word met 'n gefokusde differensiasie benadering: • Definieer fisioterapie en bestek van praktyk. • Hervestig fisioterapie in die gesondheidsorgstelsel. • Ontwikkel leierskap. • Samewerking in die professie. • Behou professionele outonomiteit. • Ontwikkel besigheidsvaardighede.

Submitted in fulfillment of the requirements for the degree of Master of Technology: Environmental Health, Durban University of Technology, Durban, South Africa, 2016. / South Africa, like many other developed countries, is challenged by the under attendance and delay in initiation of antenatal care (ANC) services among pregnant adolescents. Adolescents are more vulnerable to pregnancy related complications, which may contribute to maternal and child mortality and morbidity. This study aimed at evaluating the under attendance and/or delay in initiation of ANC services among young pregnant adolescents (13-16 years old) as a risk for adverse maternal and birth outcomes. The research was based at a district hospital on the North Coast of Kwazulu-Natal. A retrospective review of all young adolescent (13-16 years old) maternity case records for the period from 2011-2013 was conducted. Data collected included ANC trends in attendance, obstetric and perinatal outcomes. A total of 314 pregnancies were recorded among young adolescents at this single hospital over a period of 3 years. Adolescent pregnancy was associated with a risk of late ANC booking and reduced ANC visits. The prevalence of anaemia (32%) was relatively high among the girls. Fifty percent of all adolescents received episiotomies while, 45(14%) experienced perineal tears. Logistic regression models found that the condition of perineum was significantly associated with HIV status (OR= 0.36; 95% CI=0.16; 0.84; p<0.05). HIV positive mothers were more likely to have an intact perineum post-delivery. However, HIV positive adolescents were twice as likely to be diagnosed with anaemia compared HIV negative mothers (results not significant). Underutilisation of ANC (i.e less than 4 visits) was significantly associated with lower gestational age (< 37 weeks) (OR=2.64; 95% CI=1.04; 6.74; p<0.05). Fifteen percent of young mothers delivered early (< 37 weeks), 10% delivered babies with a low birth weight (< 2500g) and 15% of the neonates suffered fetal distress. Low birth weight, low Apgar scores as well as the incidence of maternal anaemia and Pregnancy Induced Hypertension (PIH) were found to be related to late ANC booking. Qualitative findings highlighted the perceived barriers of ANC by pregnant adolescents. Interviews identified the following as factors that hindered access of care; financial barriers, attitudes of Health Care Workers (HCW), system barriers and fear of HIV testing. Urgent population based strategies are required to encourage timeous initiation of ANC among adolescents. Strengthening of health education programs on the benefits of ANC attendance among adolescents can be utilized as part of an approach to address the current public health concern. / M

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The overall objective of this study was to ascertain whether lay counsellors offer psychosocial counselling to clients at antiretroviral therapy clinics. The study was conducted at two clinics in the Greater Tzaneen municipality, Limpopo province, South Africa. The sample of 14 consisted of seven female lay counsellors and seven HIV positive clients, three females and four males, at Xihlovo and Nyeleti antiretroviral clinics. They were interviewed using 11-item and 12-item interview guides, respectively. Interviews were conducted in the local languages. Qualitative data were collected for the study. The data were audiotaped, translated, transcribed and then categorised into a thematic framework. HIV positive participants were found to be suffering from psychosocial consequences of living with HIV, such as shock, denial, anger and blame, fear of death, fear of disclosure, and intimate-partner violence. However, lay counsellors did not offer effective counselling that could relieve the psychosocial consequences. They instead used religion to console clients, discouraged clients from expressing their feelings, and minimised their clients’ concerns. It is recommended that lay counsellors be taught basic counselling theories as part of their training so that they are better able to screen their clients for psychosocial problems and provide basic counselling. / AFRIKAANSE OPSOMMING: Die algehele doelwit van dié studie is om te bepaal of leke-beraders psigo-sosiale berading aan kliënte by die die anti-retrovale terapie klinieke bied. Kwalitatiewe data is vir dié studie versamel. Die studie is by twee klinieke in die groter Tzaneenmunisipaliteit in Limpopo provinsie in Suid‐Afrika gedoen. Die eksperimentele groep van 14 het bestaan uit sewe vroulike leke-beraders en sewe MIV-positiewe kliënte: drie vrouens en vier mans, by Xihlovo en Nyeleti anti-retrovale klinieke. Daar was onderskeidelike onderhoude met hulle gevoer en die 11-item en 12-item onderhoudriglyne is toegepas. Onderhoude is in inheemse tale gevoer. Die data was opgeneem, vertaal, getranskribeer en in 'n tematiese raamwerk vasgevang. Daar is gevind dat die MIV-positiewe persone negatiewe psigo-sosiale gevolge ervaar: skok, ontkenning, woede, blaam, vrees vir die dood, vrees dat hul status openbaar sal word, asook geweld binne hul verhoudings. Leke-beraders het egter nie doeltreffende berading gegee om bogenoemde psigo-sosiale gevolge te verlig nie. Hulle het eerder godsdiens gebruik in 'n poging om hul kliënte te vertroos, nie die kliënte aangemoedig om hul gevoelens uit te druk nie en hul gevoelens en kommer afgemaak. Daar word aanbeveel dat leke-beraders basiese beradingsteorie as deel van hul opleiding ontvang sodat hulle psigo-sosiale probleme in hul kliente kan uitken en beter basiese berading kan verskaf.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The objectives of this study were to explore patients’ experiences about long waiting time at the Vanguard Community Health Care Centre in the Western Cape and to explore possible solutions for this problem from the patients’ perspective. A qualitative research approach was applied. A sample size of (n=12) was drawn from a total population of 2829 (N=2829) using a non-random convenient sampling technique. A semi-structured interview guide was designed based on the objectives of the study and validated by experts in the field before data collection took place. Approval for the study was obtained from the Ethics Committee at the faculty of Health Sciences, Stellenbosch University and from the facility manager of health centre where the study was to be undertaken. The presentation of the results was categorised into themes and sub-themes that emerged from the data analysis. According to the findings in chapter 4 the themes that emerged were: Causes of long waiting time Areas of concern where waiting occurs most Emotions experienced when waiting long for service Possible solutions to waiting long for service The findings support the conceptual framework developed for the purpose of this study which includes the Patient’s Bill of Rights, the Principles of Batho Pele, Quality Care, Patients’ Representation and Patient satisfaction. The results of the study suggests that the conceptual framework needs to be implemented as a guideline to address the problems of long waiting time with the input from the participants’ opinions about possible solutions to be incorporated to the problem of long waiting time at the community health centre. / AFRIKAANSE OPSOMMING: Die doelwitte van die studie was om pasiente se gevoelens oor lang wagtye by Vanguard Gemeenskapsgesondheidsentrum in die Wes-Kaap te ondersoek en om moontlike oplossings vir hierdie probleem vanaf die pasient se perspektief te bepaal ‘n Kwalitatiewe navorsingsbenadering is gebruik. ‘n Steekproefgrootte van (n=12) is verkry vanaf ‘n totale bevolking van 2829 (N= 2829) deur die gebruik van ‘n nie-ewekansige gerieflike steekproefneming tegniek. ‘n Semi-gestruktureerde onderhoudgids is ontwerp gebaseer op die doelwitte van die studie. Die onderhoudgids is geldig bevind deur spesialiste in die gebied voor data insameling plaasgevind het. Goedkeuring vir die studie is verkry van die Etiese Komitee by die Fakulteit Gesondheidswetenskappe, Stellenbosch Universiteit en van die bestuurder van die gesondheidsentrum waar die studie uitgevoer sou word. Resultate is rangskik in temas en subtemas wat afgelei is van die data analise. Die volgende temas is bepaal vanuit Hoofstuk 4 se bevindinge: Redes vir lang wagtye Areas waar lang wagtye voorkom Emosies ondervind wanneer lank gewag moet word vir diens Moontlike oplossings vir lang wagtye Die bevindinge ondersteun die konseptuele raamwerk ontwikkel vir die doel van die studie wat die Handves van Regte vir pasiente, die beginsels van Batho Pele, Kwaliteitsorg, Pasient verteenwoordiging en Pasienttevredenheid insluit. Die bevindinge van die studie dui aan dat die konseptuele raamwerk geimplementeer moet word as riglyn om die probleme wat ervaar word met lang wagtye aan te spreek. Die deelnemers se menings oor moontlike oplossings moet deel moet wees van die aanspreek van die probleem van lang wagtye in die gemeenskapsgesondheidsentrum.

Thesis (MScFisio)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Objective: To describe the baseline data of a surgical ICU in South Africa before the implementation of an evidence-based physiotherapy practice protocol. Design: Prospective cohort observational study Setting: Ten-bed closed surgical unit in a university affiliated tertiary hospital. Patients: All adult ICU admissions from 16 June - 30 September 2003. Measurements: The patient’s clinical data including demographic information, admission diagnosis, surgery classification and co-morbidities were recorded on admission to the unit. APACHE II score was calculated. The physiotherapy techniques, positions and functional activities used, the frequency and duration of physiotherapy treatment sessions, the provision of after-hours service and the diagnosis of pulmonary complications were also recorded daily. The time of mechanical ventilation was calculated and the number of re-intubations documented. The ICU length of stay or mortality was recorded. Results: 160 patients were admitted. Patients were 49 +/- 19.95 years of age. The mean APACHE II score was 12.3 +/ 7.19 and a 12.3% mortality was observed. Thirty seven percent of patients were admitted to the unit following elective surgery. Patients stayed in the unit for 5.94 +/- 6.55 days. Hypertension was the most frequent co-morbidity found in this cohort (42%), and 21% of patients tested, tested positive for HIV. Co-morbidities had no significant association with ICU LOS or mortality. Nine hundred and twenty seven physiotherapy records were obtained. Students were responsible for 39% (n=366) of treatment sessions, the unit therapist for 34% (n=311) and the on-call therapists for 27% (n=250). Despite routine daily physiotherapy for all patients in the unit, 39% (n=62) developed excessive secretions, 30% (n=48) of patients developed pneumonia and 27% (n=43) of patients were diagnosed with basal atelectasis. Nineteen patients (12%) died in the ICU. Patients spent a mean of 5.94 (SD 6.55) days in the unit. One hundred patients (63%) were ventilated. Almost a third of ventilated patients (31%) were intubated more than once. The patients spent a mean time of 3.8 days (SD 6.30) on the ventilator every time they were re-intubated. The development of pulmonary complications significantly increased the time on the ventilator and the LOS. Conclusions: This baseline study of a surgical ICU presents a picture of a unit providing care comparable to first world environments. The picture of the physiotherapy service provided in this unit is of a “traditional” service based neither on the available evidence regarding the prevention or management of pulmonary complications, nor on the incorporation of early rehabilitation into the management of mechanically ventilated adult patients in ICU. / AFRIKAANSE OPSOMMING: Doel: Om die basis lyn van ‘n chirurgiese intensiewe sorg eenheid in Suid Afrika te beskryf voor die implementering van ‘n bewysgesteunde fisioterapie protokol in die eenheid. Studie struktuur: Prospektiewe kohort observerende studie. Eenheid: Tien bed geslote eenheid in ‘n tertiêre opleidingshospitaal. Pasiënte: Alle volwasse pasiënte opgeneem in die eenheid tussen 16 Junie en 30 September 2003. Meetings: Demografiese data, diagnose met opname, chirurgie klassifikasie en ko-morbiditeite is aangeteken by opname. APACHE II is bereken. Die fisioterapie tegnieke, pasiënt posisies en funksionele aktiwiteite gebruik in behandelingssessies, die frekwensie en duur van behandelingssessies, die verskaffing van na-ure diens aan die eenheid asook die komplikasies gediagnoseer is daagliks aangeteken. Die tyd wat pasiënte geventileer is asook die aantal kere geher-intubeer is bereken. Die tydsduur van eenheid verblyf asook mortaliteit is aangeteken. Results: 160 pasiënte is opgeneem, met ‘n gemiddelde ouderdom van 49 +/- 19.95. Die gemiddelde APACHE II telling was 12.3 +/ 7.19 en die mortaliteit was 12.3%. Sewe en dertig persent van pasiënte is opgeneem na elektiewe chirurgie. Pasiënte bly in die eenheid gemiddeld vir 5.94 +/- 6.55 dae. Hipertensie was die mees algemene ko-morbiditeit (42%), en 21% van die pasiënte wat getoets is, het positief getoets vir HIV. Ko-morbiditeite het geen beduidende verband getoon met die tyd in die eenheid of mortaliteit nie. 927 Fisioterapie rekords is aangeteken. Studente was verantwoordelik vir 39% (n=366) van die behandelingssessies, die eenheid terapeut vir 34% (n=311) en die op-roep fisioterapeute vir 27% (n=250). Ten spyte van daaglikse roetine fisioterapie behandeling van alle pasiënte in die eenheid het 39% (n=62) oormatige sekresies ontwikkel, 30% (n=48) is met pneumonie gediagnoseer en 27% (n=43) met basale atelektase. Negentien pasiënte (12%) is dood in die eenheid. Die tydsduur van eenheid verblyf was 5.94 (SD 6.55) dae. Een honderd pasiënte (63%) is geventileer. Byna een derde (31%) van pasiënte is geher-intubeer. Met elke her-intubasie het die pasiënte gemiddeld 3.8 (SD 6.30) dae langer op die ventilator gebly. Pulmonale komplikasies het beide die tydsduur in die eenheid as op die ventilator betekenisvol verleng. Gevolgtrekkings: Hierdie basislyn studie beskryf ‘n eenheid waar pasiënte mediese sorg ontvang soortgelyk aan eerste wêreld lande. Die fisioterapeutiese diens wat gelewer word is egter nie gebasseer op die nuutste bewyse in die literatuur nie. Nog, in die voorkoming of in die behandeling van pulmonale komplikasies, nog in die vroëere inkorporasie van rehabilitasie in die hantering van volwasse pasiënte in ‘n intensiewe sorg eenheid.