Abstract Minor and major forms of depression are the most common mental disorders seen in primary health care. The number of disability pensions granted for major depression multiplied in Finland during the years 1987 and 1995. Over half of the client visits in health care centres are conducted by nurses. In most cases, practice nurses, health visitors, midwifes and school nurses are the first contact the patient or client has in a primary health care. However, there is no published literature in Finland concerning the role of primary care nurses in the recognition and treatment of depression. The purpose of this study was to describe and analyse the notions of primary care nurses concerning the recognition and treatment of depression in primary health care. The first phase of the study was part of a primary health care depression project organized by the National Research and Development Center for Welfare and Health (STAKES). The data was collected with three questionnaires from the nurses in four health care centers (n = 281). The data were partly compared with the data from 58 doctors working in same health care centres. The intervention was a three-day training program on depression held in four health care centres. The first questionnair was filled by 68 % of the nurses, the second by 48% of the nurses and the third by 30% of the nurses. In the second phase of the study 13 nurses from five health care centres were interviewed. The interview material was analysed using a phenomenographic method. The most essential themes in the study were: Prevalence and recognition of depression in primary health care patients, symptoms of depression, abilities and resources of nurses and their co-workers in treating depressive patients, management of depression, multiprofessional co-operation and nurses personal experiences of depression. The nurses felt that depression is most common in the working aged population and the frequent attenders, but most difficult to recognize in children and elderly people. The most essential symptoms they mentioned were sleeping disturbances, thoughts of death, sadness,lack of pleasure and physical symptoms. In the nurses opinion, the most common reasons for depression were concrete or emotional losses and the female predisposition to depressiveness. They found it very difficult to arrange psychotherapy for their depressive patients and to get the patients families involved in the treatment. All of the interviewed nurses considered the doctors are too busy and drug-centred in their management of depression but yet doctors were the most important co-workers for nurses. After the training program the nurses opinions of the possibilities to treat depressive patients in health centres were more positive than before the training-program. On the basis of the notions of the interviewed nurses five different treatment orientations emerged. The treatment orientations reflect different attitudes in the willingness to treat depressive patients and to ask direct questions with psychological content, in assessing one's own ability to treat depressive patients and in assessing one's own tendency to get depressed. All of the interviewed nurses felt it their duty to help depressive patients, but most of them mentioned a lack of time, a lack of confidence in one's own abilities and a fear of responsibility as restraints to do more in helping depressive people. Nursing education should give more practical and theoretical knowledge and encouragement in the recognition and treatment of mental disorders, especially mild mood disorders. The multiprofessional co-operation and intervention models in in the treatment of depressive disorders at the primary health care level should be improved and the possibilities to preventive work increased. Preventive interventions should also include the recognition of nurses exhaustion before it develops into depression.

Magister Public Health - MPH / Background: Point of Care Testing (POCT) refers to qualitative or quantitative tests done in health facilities where the patient is being attended to (on-site), and not in the conventional hospital laboratory setting. As a consequence of many developing countries not having access to conventional laboratory services (with trained laboratory personnel), diagnostic testing often relies on the availability of valid POC tests. All pregnant women attending antenatal care clinics in the Sedibeng District Primary Health Care (PHC) centres should be screened for syphilis, anaemia and HIV. This can be done by means of POC testing, which is easy to perform. These POC tests provide results promptly allowing treatment to be commenced immediately, if required. Despite this highly desirable benefit of POCT, there is circumstantial evidence which suggests that staff is choosing to send specimens to the laboratory for testing, instead of doing POCT themselves. The extent to which this happens and the factors contributing to this practice are not clear. Aim: The aim of this study was to assess the prevalence of screening for syphilis, anaemia, and HIV amongst pregnant women during their first antenatal care visit to PHC facilities in the Sedibeng District, and to establish the factors affecting the prevalence of appropriately using POCT for screening tests. Methodology: Study design: A quantitative, analytical, cross-sectional study was conducted. Study Population and Sample: Patient registers, staff expected to perform POCT and facility managers. 33 District’s health care workers expected to perform POCT on pregnant women during the first ANC visit and 30 facility managers from these facilities; 360 patient records (these were collected from a total of 7 200 patients’ records). The data was collected over a six month period (from 1st July 2012 to 31st December 2012). Data collection: Data was collected from 360 patient records to determine the rate, appropriateness and mechanism of screening for syphilis, anaemia and, HIV in pregnant women on their first antenatal visit. Interviewer-administered closed-ended questions was asked from 30 antenatal care clinic staff tasked with performing POC tests and from 30 PHC facility managers to determine the factors affecting the rate of conducting POCT. Data analysis: Data was analysed using univariate, bivariate and multivariate analyses. Ethical considerations: No harm was anticipated to anyone participating in the study or from the findings of the study. A major benefit of the study was that clarity on the factors affecting the rate of screening and the use of POCT was gained. This will hopefully facilitate the implementation of evidence–based interventions to improve POCT uptake if required.

Magister Scientiae (Nutrition Management) - MSc(NM) / Globally, health workers play a critical role in the establishment and sustenance of breastfeeding due to their frequent contacts with mothers at the antenatal clinics, maternity/birthing units, Primary Health Care Centres (PHC) and postpartum clinics. Their knowledge and attitude regarding breastfeeding will affect the quality of information about infant and young child feeding practices passed along to mothers who visit their health facilities.

A national survey conducted in Lithuania indicates the tendecency, that the first contact with drugs is earlier from year to year. Also that more children and adolescents participate in substance abuse programs, who also suffer from severe conditions related with the usage of psychoactive substances. Aim of the study.Evaluating the organization of help offered in Lithuanian mental health care centres connected with the control of youth substance abuse. Objectives. 1. To overlook prevention and treatment system of youth substance abuse at primary mental heath care level. 2. To evaluate the organization of activities at mental heath care centres to control youth substance abuse. 3. To evaluate whether mental heath care centres cooperate with other institutions to provide better services for youth addicts especially to cope with related problems occuring. Methods. The analysis of Lithuanian law documents, anonymous questionaire sent to the directors of mental health care centres, statistic program SPSS 10.0 version. Results. In Lithuania prevention and treatment of substance abuse is being performed at 65 mental health care centres and is based on existing youth mental health care law. In Lithuania, no similar study has ever analyzed the situation for youth drug addicts and compared their needs for treatment and rehabilitation with offered services in mental health care centres. The survey showed that one third of the health care centres offer services that meet the... [to full text]

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.