Thesis (M.S.)--University of Michigan, 1996. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1989.

Background Evidence-based medicine (EBM) involves the care of patients using the best available evidence from the results of good quality clinical research to guide clinical decision making 1 – 3. By incorporating the principles of Evidence-based Medicine (EBM), the family practitioner would be able to treat a patient according to the best clinical research available. This principle is implemented widely in the USA, Canada, the United Kingdom and Europe. In South Africa, however, EBM is not yet as widely incorporated into family practice. This is so despite the plethora of websites available to practitioners and the relative ease with which applicable research evidence can be found. Very few published studies are available regarding EBM or Evidence–based Practice (EBP) in the South African context. The findings of this study would thus highlight reasons and/ or barriers preventing family practitioners from implementing EBM in their respective practices. This could also lead to further research into possible methods of implementation of EBM into South African family practices. Aim: The aim of the study was to describe the perceptions, knowledge and attitudes of private practitioners regarding evidence based practice and to identify the barriers encountered in evidence based practice. Methods A questionnaire survey of general practitioners in Gauteng, South Africa, was conducted. Questionnaires were distributed to a random sample of practitioners in the Gauteng region. Two hundred and twenty one (221) practitioners participated in the survey and responded to questionnaires mailed to them. The questionnaire was mailed, faxed or e-mailed to the practitioners, which they then completed and returned for statistical analysis. Study design The study design is that of quantitative, statistical analysis (descriptive cross-sectional survey). Setting General practitioners were randomly selected from a list of practitioners in the Gauteng Province. Doing a nationwide survey would have been a mammoth undertaking. It was therefore decided to limit the research to one province and therefore it was only concentrated on practitioners practicing in the Gauteng area. Results It is interesting to note that of the two hundred and twenty one participants in this study; only 10% of the practitioners were against using EBM in their practices. This, however, stands in stark contrast to the 56% of practitioners who do not implement EBM in their practices or make use of the EBM principle at all. The major barriers preventing practitioners from implementing EBM is depicted in the following graph: Lack of time and the training in aspects of Evidence-based medicine were the main barriers preventing the full scale implementation of EBM in family practices in Gauteng. Conclusion Participating Gauteng doctors were in principle, very positive towards the implementation of EBM in their respective practices. Most of the participants agreed that EBM would benefit their patients’ care and treatment. Very few of the participants, however, make use of EBM in practice. A lack of training and time constraints were the main barriers with regards to the implementation of EBM. Proper training of medical students at undergraduate level at faculties of health sciences, would go a long way assisting prospective doctors in mastering the concept of EBM and increasing their overall awareness of EBM. Further definitive research would assist in establishing whether such awareness would be associated with improved implementation of evidence in the form of evidence based guidelines in practice.

0107750D Masters Research - Faculty of Health sciences / The prescription habits of general practitioners are continually under the scrutiny of ethical critics. There are numerous factors that influence a practitioner’s decision as to which antihypertensive agents to prescribe for the treatment of hypertension. As outlined in various international and national guidelines for the management of hypertension, the recommended treatment depends on ethnicity, current life-style, diet, smoking, age, gender, family history and possible underlying or secondary conditions such as diabetes mellitus, heart failure, isolated systolic hypertension, myocardial infarction, pregnancy, and evidence of coronary artery disease (CAD), stroke or peripheral vascular disease. Currently the control of blood pressure in patients with hypertension is far from optimal with over 70% of hypertensive patients being reported as having imperfect control. A number of factors related to the patient, the practitioner or the medication may explain the high incidence of inadequate blood pressure control. One possible explanation for the poor control of blood pressure may be that practitioners fail to comply with the guidelines. Hence the aim of my study was firstly to determine whether a practitioner’s decision as to which medication to prescribe in the treatment of hypertension is influenced by the Southern African Hypertension Society Guidelines. Secondly, in an attempt to assess the validity of the results of the primary analysis, the actual prescription habits (MediCross® database) were assessed and compared to the general practitioner’s recall of their prescription habits. Questionnaires were distributed to 320 MediCross® practitioners and prescription habits were identified and substantiated by the screening of an existing MediCross® database. I chose as my sample MediCross® general practitioners, as they are demographically representative of all major urban areas in South Africa; likely to be open-minded to supporting research and answering questionnaires (as MediCross® is part of a Clinical Research Site Management Organisation); and I had access to the database of the prescriptions made by MediCross® practitioners hence enabling me to fulfil my second objective. However, it must be kept in mind that these practitioners are representative of general practitioners in urban areas only (as the title of my research report indicates). My results show that 33.1% adhere to the guidelines (when a non-conservative definition of diuretics is used); 27% have heard of the guidelines and have a copy of them. When asked to give their own opinion however, 39% thought they adhered to the guidelines. The results also show that ACE inhibitors are the most commonly prescribed drug class for uncomplicated hypertension but a comparison to a MediCross® database, of which the quality is questionable, does not support this. As the response rate to the questionnaires was only 24.7%, these results are only a pilot study; however they suggest that few general practitioners use the guidelines or even have a copy of the guidelines. This pilot study suggests that the guidelines need to be distributed more widely. Furthermore the general practitioners that responded to the questionnaire indicated that the management of hypertension is difficult in that there is no single treatment regimen appropriate for all populations and each different - 5 - patient. It was also their view that clinical guidelines for the management of hypertension should more accurately reflect the uncertainty of when to initiate treatment and individual variation if they are going to take these guidelines seriously and comply with them.

Thesis (MPH)--University of Limpopo, 2010. / The management of tuberculosis has undergone a lot of changes from fixed dose tuberculosis regimen, directly observed therapy short-course strategy (DOTS) to the introduction of international standards to tuberculosis care (ISTC) in order to reduce the burden of tuberculosis. The study investigated and described the experiences of private general practitioners regarding the knowledge of diagnosis and management of tuberculosis in Tshwane, Gauteng Province. The purpose of the research was addressed within a quantitative approach applying descriptive designs. A self-administered questionnaire was used to collect the data that fit the objectives of the research. In this study, the population applied to ninety-nine doctors of the Private General (Medical) Practitioners’ profession in a specific urban area, namely the municipal area Tshwane, Gauteng Province, with the following inclusive criteria as study units: practicing as a General Practitioner in Tshwane, which includes the city centre (Pretoria Central), Atteridgeville, Pretoria suburbs, Atteridgeville, Mamelodi, Eersterus, Garankuwa, Mabopane, Odi and Soshanguve and sessions appointment at public hospitals. The researcher drew a representative sample of the private medical practitioners with a random selection process whereby the first general practice in each area was selected randomly, and from there onwards the first three practice rooms, skipping the fourth practice room throughout the Guateng area where 90 private medical practitioners was reached. A total of 90 questionnaires were distributed to General Practitioners in the identified areas of Tshwane, Gauteng Province. A response of 59/90 (66%) was obtained, which compares favourably with the experience of other researchers. The study reveals that national TB guidelines are not properly followed by the respondents and that there is a need for public-private partnership in order to improve and enhance the diagnosis and management of tuberculosis in Tshwane, Gauteng Province.

This study of an Indonesian company, Telkom Indonesia, identifies how human resource development (HRD) practitioners view or define HRD, what factors they consider critical for HRD practice, and specific issues related to training. Interviews with 20 practitioners in the company's Training Division were used as the primary vehicle for gathering information, while observations and documents supplemented the interviews. The practitioners essentially equate HRD with training and development (T&D), but the company's practice reflects the presence of considerable attention not only to training and development but also to organization development (OD) and career development (CD). The practitioners' comments about critical factors for HRD can be categorized into four broad groups: corporate, workplace, supplier, and internal; and the company's training interventions are classified into three major clusters: telecommunications technology, business management, and leadership. This study also underscores the presence of some forces that lead HRD practice to stick around the training area and some other forces that promote a movement toward a more strategic HRD orientation.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

No description available.

This study of an Indonesian company, Telkom Indonesia, identifies how human resource development (HRD) practitioners view or define HRD, what factors they consider critical for HRD practice, and specific issues related to training. Interviews with 20 practitioners in the company's Training Division were used as the primary vehicle for gathering information, while observations and documents supplemented the interviews. The practitioners essentially equate HRD with training and development (T&D), but the company's practice reflects the presence of considerable attention not only to training and development but also to organization development (OD) and career development (CD). The practitioners' comments about critical factors for HRD can be categorized into four broad groups: corporate, workplace, supplier, and internal; and the company's training interventions are classified into three major clusters: telecommunications technology, business management, and leadership. This study also underscores the presence of some forces that lead HRD practice to stick around the training area and some other forces that promote a movement toward a more strategic HRD orientation.