School of Clinical Medicine (ETDs)

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    Knowledge, attitudes and practices of clinician management of adults presenting with acetylcholinesterase inhibitor poisoning
    (University of the Witwatersrand, Johannesburg, 2024) Redant, Dean Patrick
    Background: Acetylcholinesterase inhibitor (AChE-I) poisoning is a common cause of deliberate self-harm in South Africa (SA). Whilst there is existing literature on the epidemiology and management of AChE-I poisoning, there is a lack of research on the South African clinician’s knowledge, attitudes and clinical practice when managing these patients. Objectives: To describe the knowledge, attitudes and practices (KAP) of clinicians when managing adult patients with AChE-I poisoning in academic emergency departments (ED) in Southern Johannesburg, Gauteng. To describe the correlation between the clinician’s demographics and experience to their knowledge, attitudes and practices in this setting. Methods: One hundred and forty-five clinicians completed a structured questionnaire used to gather data on clinicians’ knowledge, attitudes and practices (KAP) with regards to their management of patients with AChE-I poisoning. Descriptive and inferential statistics were used to analyse the data and to infer correlation between clinician’s KAP vs clinician’s demographics and experience. Results: One hundred and forty-five questionnaires from 5 EDs were completed and analysed. Of which 86 (59%) of participants were female and 59 (41%) were male. The majority of participants were under the age of 40 (84%) and employed as Grade 1 Medical Officers (39%). Years of experience were divided into <2 years, 2 – 5 years and ≥5 years with each group representing a third of the sampled population. Clinician average knowledge scores on AChE-I poisoning were good (77.9% n= 12.46/16) with scores improving predictably with years of experience (72.5% in <2 years to 83% in ≥5 years). Attitudes towards managing patients with AChE-I poisoning were overall neutral. Clinician practices varied greatly, particularly with adjustment of atropine infusions and adjunctive treatments used. Conclusion: Clinicians had an overall good knowledge of AChE-I poisoning which improved predictably with greater experience managing these patients. Practices were highly varied across all demographic groups despite access to protocols in most departments studied. Attitudes were generally neutral with no clear impacting factors. Clinicians agreed unequivocally that the public health system did not provide sufficient primary preventative care in order to address the underlying factors driving patients to self-harm. This research revealed that the medical and psychosocial management of adult patients with AChE-I poisoning can be improved upon through specific clinician training.
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    A cross-sectional study investigating knowledge, attitudes and health choices in relation to diabetes mellitus among nondiabetic patients attending Chiawelo community practice, Soweto, Republic of South Africa
    (2024) Tshibeya, M. R.
    Background: The knowledge, attitudes and health choices of non-diabetic patients in resourcelimited settings to prevent the onset of diabetes mellitus (DM) are poorly understood. Aim: The aim of this study was to investigate and describe the knowledge, attitudes and health choices of non-diabetic patients in relation to DM at the Chiawelo Community Practice (CCP), Soweto, South Africa. Methods: In this cross-sectional study, a self-reported questionnaire was administered to 165 adult participants attending the CCP from 2nd March to 17th April 2020. Descriptive analysis, Chi square and univariate logistic regression were included in the analysis. Multivariate analysis was done for variables with a p-value <0.25 Results: In total, the study had 165 participants, of whom 112 (68%) were women, 35% were older than 45 years and 16% were younger than 25 years of age. Almost half (49%) of participants had good knowledge of DM, with 60% indicating good attitudes and 52% making good health choices to prevent DM. Participants who received education from clinicians were 4.31 times more likely to develop better attitudes (p=0,003) and 3.34 times more likely to adopt better health choices (p=0.004) towards DM compared to those who obtained information from media or other sources. Conclusion: The study found that poor knowledge of DM does not necessarily translate into poor attitude towards the disease, which is noteworthy. The study also highlighted the important role of healthcare workers in influencing behaviour change