3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Genetic knowledge, opinions and practices amongst general practitioners(2003) Trenton, Kelly L. MargaretABSTRACT Medical Genetics is playing a greater role in healthcare than ever before. The question arises though, as to whether these scientific advances are moving swiftly enough from the field of science to the practices of general practitioners (GPs) of medicine. In general, since the introduction of genetic services in South Africa (SA) in 1971 (Jenkins, 1990), knowledge and attitudes regarding the utilization of these services have often been confused. Medical institutions and practicing doctors are sometimes unaware of the important intricacies of genetics that may impact on their patients. Genetic counselling is underutilized and many genetic conditions are neither recognised nor diagnosed. Medical Genetics is an important part of complete patient care, but in SA it has lagged far behind in areas such as health service and education. The aims of this study were to assess and analyze the current genetic knowledge and attitudes that are in place amongst GPs in the Gauteng province of SA, and to obtain a clearer understanding of their opinions towards genetic counselling. A researcher-designed questionnaire was posted to 1091 GPs in the Gauteng area. Approximately 6.7% of this target group replied. Fifty-one face-to-face interviews using the same questionnaire were also conducted by the researcher so that first hand responses could be recorded. The findings from all data collected show that there are many areas where knowledge could be improved. Whilst genetics and genetic counselling is held in high regard, and deemed important in the primary care context by GPs, it is generally viewed to be out of their area of expertise. Genetic education programs aimed at improving GP awareness and knowledge are thus recommended to enhance the quality of patient care.Item Ethical issues identified by General Practitioners in private practice in the Johannesburg area as challenges to the successful implementation of the proposed National Health Insurance(2017) Jacovides, AndrewIntroduction National Health Insurance (NHI) has been proposed in South Africa to ensure that everyone has access to appropriate, efficient and quality health services. Involving the private healthcare sector is essential for this to occur because of its resources. Significant changes to the private healthcare structure are anticipated for its incorporation into the NHI plan. This study examines the perceptions of General Practitioners (GPs) from the private sector in the Johannesburg area on the NHI. It examines the challenges they foresee that will impact on their willingness to participate in the NHI and how these might manifest as ethical concerns. These findings will yield effective ways these concerns are addressed with regard to their acceptance of the NHI and any ethical issues they may have regarding the effective delivery thereof. Study design The study took the form of an exploratory-descriptive empirical method using semi-structured interviews. Method The qualitative data was analysed using thematic content analyses. Results The general perception of the NHI by the General Practitioners was negative. The NHI was perceived by the doctors in this study to be an extension of the current public health sector. The current perception of the public health sector is one of inferior care; an over worked and understaffed facility; a poorly maintained system with inadequate supervision; and one that is rampant with corruption. The key ethical concerns arising from this study is the quality of care for the patients, basic working conditions in government facilities; corruption in, and a general mistrust of the government. Concerns were raised about quality of patient care in the public sector and the possibility of “downgrading” private health care. These factors impose on the patients’ right to dignity, equality and freedom as poor quality of health care infringes these rights. Conclusion and recommendations To gain “buy-in” from GPs, the establishment of trust, improved communication and an end to mismanagement and corruption are essential for the NHI to be successfully implemented.