A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfillment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2017 / The Hajj is widely recognized as the world’s largest and globally most diverse kind of mass gathering. This annual five day gathering takes place in the city of Mecca and includes between 2.5 and 3.5 million participants. This poses a great concern by the organizers as the risk for the spread of infectious disease due to overcrowding is greatly increased. These diseases are increasingly being recognized as a potential threat to both local and international public health systems. The lack of understanding of the infectious diseases that originate and disseminate during the Hajj was raised in the Jeddah declaration. Furthermore, despite the protective measures put in place, poor health practices from selective use of the measures by the participants contributes to the increased risks. Exploring the health information needs of the pilgrims attending Hajj, would help in knowing what is required to reduce poor health practices and simplify and improve compliance with protective measures against infectious diseases before, during and after Hajj, and this will help in minimising the spread of infectious diseases in the Hajj. The aim of this study was to explore the health information needs of the pilgrims attending Hajj in order to know what was required to reduce poor health practices and simplify and improve compliance with protective measures against infectious diseases before, during and after Hajj, and this would help in minimizing the spread of infectious diseases in the Hajj. In this study, a qualitative research design was used and focus group discussion using semi-structured questions was conducted. The members were purposely recruited and divided into four groups, two groups of males and two of females. The division of participants into focus groups was in part done in compliance with the Muslim beliefs. Data were collected using a focus group discussion with semistructured questions that was recorded using a tape recorder. These discussions were transcribed verbatim before being analyzed using thematic analysis. The findings of the study showed that pilgrims need a holistic health educational program that addresses their experiences of illnesses and chosen format as educational pamphlets are no longer effective. The findings also revealed that collaboration, surveillance and screening of pilgrims for diseases prior to departure are useful as they help in spreading messages of health and diseases issues with simplicity and yield effective result as well as identifying those at risk of contracting infectious diseases, spreading infectious diseases and exacerbating their diseased conditions. The study recommends the use of digital technology such as an app for phone to send health information to participants and promptly identify and manage individuals who develop illness during mass gathering events like Hajj. It also recommends the incorporation of mass gathering medicine into the curriculum of Nursing program in order to effectively train and equip nurses with better preparation measures against infectious diseases during mass gatherings like Hajj / MT 2019

Abstract INFORMATION NEEDS AND INFORMATION SOURCES OF PATIENTS DIAGNOSED WITH RARE CANCERS By Dana L. Ladd, Ph.D., MS, SLIS BACKGROUND: Approximately 25% of all cancers diagnosed are considered rare. Patients may face many significant challenges including difficulty obtaining information about their rare conditions. Patients often have high information needs and may seek desired information from a variety of informational sources including healthcare providers, media, print, government and non-profit organizations in order to meet their needs. Accessing reliable consumer-level information can be challenging and often information needs are unmet. Dissatisfaction with health information provision can result in negative health-related outcomes and factors including decreased health-related quality of life. METHOD: This cross-sectional design study used validated measures to assess the information needs, information sources, information satisfaction, and health-related quality of life of patients diagnosed with rare cancers (n=113). Adult patients at the VCU Health Massey Cancer Center who had been diagnosed with a rare cancer in the past 12 months were contacted via mail survey. Descriptive statistics were used to summarize patients’ information need and information received levels. Unmet needs were analyzed using a two-sample T-test. Chi-square tests were used to analyze information needs and received by demographics for gender and race and logistic regression analysis was used for age. Descriptive statistics summarized information sources used and preferred. Finally, descriptive statistics were used to summarize information satisfaction. The relationship between information satisfaction and health-related quality of life was assessed using a two-sample T-test. RESULTS: Study participants had high information needs, particularly for information about disease, medical tests, and treatment. Though patients also reported receiving information at high levels, 21 participants (18.9%) reported being unsatisfied with information provision. Unmet needs were found for information about disease and on the item level for information about causes of cancer, whether their cancer was under control, expected benefits of treatment, and financial, insurance, and work-related information. Although participants reported preferring information from their healthcare providers, they most commonly sought information from the Internet more than any other source. CONCLUSION: By identifying patients’ information needs and sources, this study fills an important gap in the information needs and sources literature of patients diagnosed with rare cancers. Identification of these needs allows healthcare providers to tailor information provision to more effectively meet patients’ information needs.

Philosophiae Doctor - PhD / A review of the literature has shown that there is a lack of mental health information on which to base planning of mental health services and decisions concerning programme development for mental health services. Several studies have indicated that the use of an evidence-based health information system (HIS) reduces inappropriate clinical practices and promotes the quality of health care services. This study was aimed at developing a framework for a district-based mental health information management system, utilising the experiences of health care providers and caregivers about a district mental health information system (DMHIS). Activity Theory was used as the philosophical foundation of the information system for the study. A qualitative approach was employed using semi-structured individual interviews, Focus Group Discussions (FGDs), systematic review and document analysis. The intervention research design and development model of Rothman and Thomas (1994) was used to guide the study, which was conducted in the Cape Town Metropole area of the Western Cape. A purposive, convenient sampling method was employed to select study participants. Ethical clearance for the study was obtained from the University of the Western Cape, and permission to use the health facilities from the Department of Health. The data collection process involved 62 individual interview participants, from mental health nurses to district health managers, health information clerks, and patient caregivers/families and persons with stable mental conditions. Thirteen caregivers took part in the FGDs. Document review was conducted at three community mental health centres. The data were analysed manually using content analysis. Core findings of the interviews were lack of standardized information collection tools and contents for mental health, information infrastructure, capacity building, and resources. Information processing in terms of collection, compiling, analysing, feedback, access and sharing information were the major problems. Results from document analysis identified inconsistencies and inaccuracies of information recording and processing, which in turn affected the quality of information for decision making. Results from the systematic review identified five functional elements: organizational structure; information infrastructure; capacity building; inputs, process, output and feedback; and community and stakeholders’ participation in the design and implementation of a mental health information system (MHIS). The study has contributed a framework for a DMHIS based on the findings of the empirical and systematic review. It is recommended that there is a need to establish a HIS committee at district health facility level for effective implementation of the framework and quality information processing. There is a need to ensure that staffs have adequate knowledge and skills required for effective implementation of an information system. It is recommended that higher education institutions include a course on HISs in their curriculum. It is suggested that the South African Mental Health Policy be reviewed to include an MHIS and ensure involvement of the community and stakeholders in this system as well as adequate budget allocation.

Background: The East Tennessee State University Quillen College of Medicine Library has participated for several years in projects to provide rural clinicians with health information resources. Objectives: To determine whether a strategy of hand‐held devices with a best‐evidence point‐of‐care disease tool and a drug database paired with access to a medical library for full‐text articles and training to use the tools would be an affordable way to meet the information needs of rural underserved clinicians. Methods: This study is a mixed‐methods methodology. The first project was evaluated using a randomised controlled trial (RCT) methodology. The second was evaluated qualitatively using interviews and focus groups. Results: The quantitative findings discovered that clinicians equipped with a hand‐held device with evidence‐based software more frequently found answers to clinical questions, found answers more quickly, were more satisfied with information they found and use expensive resources such as continuing medical education, online databases and textbooks less than the group that did not have access to online technology. Qualitative results supported the quantitative findings. Conclusion: Librarians can implement a three‐pronged strategy of the secondary literature via a hand‐held, the primary literature via Loansome Doc and quality training to meet basic information needs of rural clinicians.