3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Intensive care nurses’ knowledge about endotracheal suctioning guidelines in one major academic hospitals in Johannesburg(2024) Ntelele, Clive TebogoBackground: Critically ill patients in Intensive care units are often placed on mechanical ventilation which requires endotracheal suctioning to promote adequate gaseous exchange and manage any underlying progressive condition. However, endotracheal suctioning has been associated with life-threatening complications and increasing hospital stays. Evidence have suggests that poor practice has detrimental effects without appropriate evidence-based knowledge and adherence to recent evidence-based guidelines. Therefore, this South African study investigated intensive care unit (ICU) nurses’ knowledge and practice of evidencebased guidelines for endotracheal suctioning. Purpose: This study aimed to determine intensive care unit nurses’ knowledge of the American Association of Respiratory Care (AARC, 2010) evidence-based guidelines on the endotracheal suctioning technique in one major hospital in Johannesburg. Setting: The study was conducted in five ICUs which include Trauma ICU, Cardiothoracic ICU, Coronary Care ICU, Neurosurgery ICU and General ICU of one major public sector hospital in Johannesburg. Methods: A non-experimental, descriptive and quantitative design was utilised in this study. The sample size comprised 130 (n = 130) nurse respondents. A non-probability convenience sampling method was utilised and the data was collected using a validated questionnaire (Negro et al., 2014). The Questionnaire lists ten (10) strategical questions with each containing 4 options to select, and the respondents had to select the correct one from the listed options. Descriptive statistics were used to analyse the data. Statistical tests included the Chi-square test of association, and the strength of association was estimated using Cramer V tests. Testing was done on the 5% (p<0.05) was found in three of the ten domains. In addition, It was also revealed that respondents with diploma-level training performed better on average in terms of endotracheal suctioning knowledge than those with degrees (381 vs 178, respectively). Although, the diploma nurses outperformed their counterparts in eight of ten domains, the association in this domain was rather weak. Conclusions: This study concluded that endotracheal suctioning remains a difficult procedure to perform according to guidelines for nurses in these ICUs. Hence it can be concluded that some nursing practices may be outdated and potentially threaten patient safety and the quality of care in these ICUs. This highlighted the need for change in practice to ensure adherence to recommendations of the current clinical guidelines and ensure practice-informed education of ICU nursesItem Understanding oral hygiene knowledge and curriculum issues at training institutions in South Africa.(2015-05-07) Vergotine, GlynnisHigher Education is influenced by society and workplace demands, which affects the structure of curricula. The literature review exposed a lack of understanding of knowledge in the Oral Hygiene occupational field. This led to a call to understand which knowledge is most valued by the Oral Hygienist and how it affects professional development. This necessitated the examination of knowledge located in curricula. The aim of this study was to study the perceptions of South African Oral Hygiene lecturers and the organisation of knowledge in curricula, in order to learn about current attempts to professionalise the field. The study makes use of a qualitative descriptive design. The study population is based at two universities, consisted of full-time lecturers teaching Oral Hygiene. Data collection and analysis comprised three methods: semi-structured questionnaires to examine the lecturers’ perceptions about knowledge; curriculum analysis gathering information about the curricula making use of a knowledge type analysis tool developed from the conceptual framework; and examination question analysis to assess the recontextualisation of knowledge from concepts or everyday knowledge of practice. The results show a comparison of lecturers’ perceptions and the organisation of knowledge in the curriculum suggest that although it is clear that the lecturers aspire to professionalise the field, the curricula and their own research identities promote the preparation of practitioners with technical skills. This is shown (inter alia) in the following findings about both curricula: ‘clinical applied knowledge’ is highly valued (UNIV1-73% and UNIV2-53%) with a small amount of time spent on ‘pure’ knowledge (UNIV1-8% and UNIV2-12%). The point to be made here is, that an emphasis on ‘Clinical Applied knowledge’ suggests that a large amount of time is spent on covering procedures for practice, which in turn is an indication that the two curricula are inclined towards preparing students for an occupational model of practice. The lecturers’ research identity focuses on knowledge borrowed from clinical practice. Lecturers use a unifying concept for practice and believe they are experts in clinical teaching. In conclusion, examining South African lecturers’ current views of the Oral Hygiene knowledge base and studying its organisation within different curricula reveal that the knowledge most valued in the field is Clinical Applied knowledge with less emphasis on pure knowledge and knowledge applied from the sciences. This study highlights that lecturers aspire to professionalise the field, even though curricula promote the preparation of practitioners with technical skills.Item Knowledge translation in dysphagia : a South African study.(2014-01-10) Seedat, JaishikaBackground: Knowledge translation models to address existing knowledge gaps in different areas of speech-language pathology practice are providing researchers and clinicians the opportunity to improve efficiency and effectiveness of service delivery. As a developing context, public health care in South Africa can scarce afford the luxury of wasting resources and finances on interventions that are inefficient or without proven benefit given the increasing prevalence of chronic burden of disease such as stroke and traumatic related injury, both of which has dysphagia as a symptom. The outcome of the manner, efficiency and consistency of traditional models of dysphagia management currently being implemented in this context were compared to a pre-existing theoretically proven free water protocol for dysphagia management. Method: The primary aim of the current study was to enable knowledge-to-action translation in dysphagia management by determining the feasibility of using a free water protocol for stroke or traumatic brain injured patients presenting with dysphagia in an acute government hospital setting in Gauteng, South Africa. A mouth care training protocol was developed for nurses as a component of the free water protocol. Nurse perceptions on the training and implementation of mouth care were explored. The quantitative aims investigated if there was a difference between traditional and free water management in terms of a) the occurrence of aspiration pneumonia, b) amount of water intake and c) length of hospitalisation. 139 Nurses and 46 patients with dysphagia were participants. A mixed method design was used. The study was conducted in two phases, phase one comprised the ethnography and the nurse training component. Phase two was quantitative and comprised implementation of the free water protocol by the researcher. Thematic content analysis was used for the qualitative data. Quantitative data was analysed using inferential statistics. Results: The mouth care training protocol for nurses was efficient and effective for the current context. Nurses engaged positively with the study by implementing mouth care successfully when necessary for the dysphagic patients. This combined with consistent daily management of dysphagia with patient involvement, facilitated patient compliance, adequate levels of water intake, with no cases of dehydration, and no incidence of aspiration pneumonia at the end of the intervention period. The comparison group in contrast who received the traditional model of dysphagia management showed longer period of hospitalisation and higher consumption of liquids despite recommendations for liquid restricted diets. There were seven cases of aspiration pneumonia at the end of the intervention period in the comparison group. Conclusions & Implications: Despite no statistically significant differences between the study and comparison groups on the specified outcome measures, clinically significant differences were noted. The method employed in the study seemed to facilitate knowledge translation of the free water protocol to a public hospital context in South Africa. The findings of the study suggested that a collaborative partnership between the speech-language pathologist and nurse was attainable and this seemed to have multifaceted mutual benefits to the patient, institution and the respective professions. Improved monitoring of service provision, implementation of protocols based on contextual evidence, importance of knowledge translation in a developing context and an expanded role of the speech-language pathologist responsive to the needs of the context and patient population were some of the implications that arose from the study.Item Attitudes,knowledge and relationship behaviour relating to HIV and AIDS in contact sport.(2007-02-26T12:45:13Z) Germanos, VeniseThe Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) epidemic has spread throughout the world and its prevalence in sport has received increasing attention. The aim of this exploratory study was to examine the knowledge, attitudes and relationship behaviour with respect to HIV and AIDS among athletes participating in contact sport. In addition, this study included a preliminary investigation into whether sport participation facilitates the development of life skills which would act as a buffer against the risky behaviours that increases vulnerability to infection. A self-report questionnaire was specifically constructed to address the aims of the study. The sample comprised of 38 male athletes between the ages of 18 and 30, from the following codes of contact sport: boxing, rugby, and taekwondo in Gauteng. Content analysis and descriptive statistics were used to analyse the participants’ responses. The findings indicated that the athletes had a good level of knowledge, but some misconceptions still remain. Attitudes of the athletes appeared to be in favour of mandatory testing and disclosure of one’s status. Positions on the participation of HIV-positive athletes in sport alternated between exclusion on the basis of safety and inclusion so as not to facilitate the proliferation of stigma. Few athletes reported continued involvement in high-risk behaviour, but it was encouraging that the largest part of participants declared exhibiting preventative behaviour. Sport participation was found to have some biopsychosocial impact on participants, which may extend to enhance health-seeking behaviour. Research findings may be fundamental in directing future AIDS prevention efforts within and beyond the sports arena.Item The knowledge, attitudes,practices and prevalence of alcohol and cannabis use amongst South African diamond miners(2006-11-17T08:16:46Z) Onwukwe, Victor NnannaThe causative association between alcohol, cannabis use and accidents in the workplace have been shown in some studies. The adverse effects of these on employee’s health, work performance, public and industrial safety have also been researched internationally. But there still remains a paucity of information on the knowledge, attitudes, practices and prevalence of alcohol and cannabis use on diamond mines in South Africa even though anecdotal evidence suggests widespread use that is on the rise. As a result of this, effective intervention strategies to stem the rise have not been developed. This study assessed the knowledge, attitudes, practices and prevalence of alcohol and cannabis use amongst South African diamond miners. It was a cross-sectional analytical study which ascertained the knowledge, attitudes and practices of the miners in relation to alcohol and cannabis use through face to face structured interviews. The prevalence of alcohol was ascertained through breathalyser testing and that of cannabis through urine tests. The study site was a large diamond mine located in the northern part of South Africa. Individual written informed consent was obtained from each of the participants before questionnaire interviews, breathalyser and urine tests were carried out. All the interviews and tests were anonymous and unlinked. None of the test methods were invasive. The questionnaire was tested in a pilot survey. This research was commissioned by the Safety in Mines Research and Advisory Committee (SIMRAC). vii The reported prevalence for alcohol was 44% whilst the tested prevalence was 1.4%.For cannabis, the reported prevalence was 2.0% whilst the tested prevalence was 2.8%.The significant factors associated with alcohol use were higher educational qualification and type of work. Full time employees were more likely to have ever used alcohol. Reported users of alcohol and cannabis started before starting work on the mines. An overwhelming majority of the participants reported that alcohol and cannabis use could lead to accidents on the mines. A large majority reported that intervention strategies such as education, regular testing of employees and entertainment will decrease the use of alcohol and cannabis. Possible explanations for the patterns observed in the use of these substances have been given and suggestions on how to influence the use of these substances have been made.