3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item The knowledge, attitudes and perceptions of organ procurement and donation among medical doctors in critical care settings in academic hospitals in Johannesburg, South Africa(2017) Solomon, CleoBackground: Statistics for the Johannesburg region demonstrate a low level of cadaveric organ donation within the public health care sector. The reasons for this are not clear. Information gathered in a previous study suggest that urban dwelling South Africans have a good attitude towards donation. It was hypothesized that knowledge, attitudes and perceptions of organ donation within the medical community may be contributing to this, and thus may be identified as a potential target for future intervention in order to effect an increase in donation rates. Methods: A self-administered questionnaire was completed by 105 of a total population of 190 doctors working in critical care, trauma, and accident and emergency departments in three academic hospitals in Johannesburg, South Africa. This cross sectional descriptive survey aimed to determine attitudes, knowledge and perceptions of doctors working in these settings towards organ donation and donor recruitment. Results: 65/105 (61.9%) of respondents had a positive attitude towards donation. This was reflected in their own willingness to donate organs after brain death (95% CI: 51.9-71.2%). The majority (65.7%) were unaware of the presence of protocols for organ donor identification and referrall. Only 46.7% of the respondents knew who to contact from an organ procurement organisation, once a donor is identified. Of the total respondents, 39% had ever managed a donor or contacted the transplant co-ordination team, and 39% knew the criteria for brain death.There was a significant association between a positive answer in the questions relating to experience questions and actual knowledge of the criteria for brain death. 90/105 (85.7%) agreed that organ donation could assist the family of the donor with the grieving process. The presence of an organ procurement team was felt to be the best option for improving organ donation rates. Conclusion: Doctors in critical care settings demonstrate similar levels of positive attitude towards donation as urban dwelling laypersons. Potential areas of intervention to improve donation rates include clearly defined protocols for donor identification and management, education regarding brain death criteria, and external support for family counselling.Item Knowledge, attitudes and practices of nurses and pharmacists towards adverse drug reaction reporting in the Private Sector(2018) Bogolubova, SophiaBackground: Pharmacovigilance is an important tool not only in protecting patients from potentially harmful effects of medicines, but it plays a role in providing good quality of care and monitoring efficacy of drug products within a population. Spontaneous reporting is a system of reporting adverse drug reactions (ADRs) practiced worldwide as part of the WHO Programme for International Drug Monitoring. Unfortunately, the major drawback of this system is the underreporting of ADRs. Methodology: A cross-sectional questionnaire-based survey was conducted amongst pharmacists and nurses in six private hospitals in Gauteng. A pre-designed and structured multiple choice questionnaire containing 20 close-ended questions was used to assess demographics (four questions), knowledge (six questions), attitudes (five questions) and practices (five questions) of participants. E-mail and manual questionnaires were provided to target as many nurses and pharmacists as possible. Electronic responses were captured as they were submitted, while manual responses were collected by the principle investigator from a contact person identified within each hospital. The data obtained was analysed using appropriate statistical analysis through Microsoft Excel 2010 and Google Forms software. Results: A total of 233 healthcare professionals participated in the study. Although three quarters of participants believed ADR reporting to be important, most had received no previous pharmacovigilance training and did not know how to report an ADR. 87.1% of participants believed that all ADRs should be reported, with 75.5% of participants believing they would report all ADRs they encountered in the future provided they had sufficient training and knowledge. The major factors discouraging participants from reporting was a lack of awareness with respect to the process of reporting as well as a lack of access to the ADR reporting form. Conclusion: This study indicates that the majority of participants require further training regarding ADR reporting. Although the knowledge of most participants was acceptable, the transition into practice needs to be improved.Item Evaluating the knowledge, attitudes and practices of healthcare workers towards adverse drug reaction reporting in a Public Tertiary Hospital(2018) Gordhon, YashmayBackground Spontaneous reporting of adverse drug reactions (ADRs) is a method of monitoring the safety of drugs post-marketing, providing a way to discover new, rare or unnoticed ADRs. Despite its importance, there is widespread underreporting of ADRs by health care professionals in South Africa. Objectives The study assessed the knowledge, attitudes and practices (KAP) of health care professionals on ADR reporting at a public hospital. Methods The questionnaire consisted of 21 questions (5 demographics; 7 knowledge; 1 attitude; 7 practices of the participant). Hard copies of the questionnaire were completed by doctors, nurses and pharmacists. The results were captured on Microsoft Excel™, and imported onto Stata® 14 to conduct Pearson chi-squared and Fishers tests. Results 297 health care professionals (87.87%) responded to the questionnaire. 50.17% had knowledge of reporting, and pharmacists were the most likely professionals to know how to report (82.61%) (p< 0.001). 96.88% of participants who had previously received ADR training knew how to report ADRs. 90.24% stated they would report an ADR based on the seriousness of the reaction. Lack of knowledge; managing the patient being more important than reporting; and reporting being time-consuming were some discouraging factors. 58.59% of participants had encountered an ADR before but only 16.50% had reported (p< 0.001). Conclusions Doctors, nurses and pharmacists were aware of the presence of ADRs, but were unlikely to report them. Health care professionals should be made aware of the benefits of reporting, and perhaps a culture of reporting can be adopted given an awareness of pharmacovigilance.Item Knowledge, attitude and practices of caregivers (KAP) on management of childhood diarrhoes amond children aged between 0-5 years attending child welfare clinic (CWC) in Mogoditshane Village, Botswana(2018) Mosweu, Gofaone JessicaBackground: Diarrheoa continues to plague on Botswana children, resulting in high mortality of children below five years. In 2015 childhood diarrheoa accounted for 6 percent of deaths of children in Botswana. Good knowledge, attitude and practices of caregivers is pivotal to protection, prevention and treatment of childhood diarrhoea, hence reduce mortality thereof. Study aim: The aim of the study was to determine the level of Knowledge, Attitudes and Practices (KAP) of caregivers on management of childhood diarrhoea among children between 0 to 5 years attending childwelfare clinics in Mogoditshane village, Botswana. Methodiology: A cross-sectional survey with a convenience sampling was used to select participants. A structured questionaire was used to collect data from 84 respondants regarding demography, knowledge, attitudes and practices on management of dirrhoea in children. Data was analyzed using Epi Info software. Descriptive statistis included measures and frequency tabulations and and inferential statistics included cross-tabulations to investigate statistical associations with KAP were used for analysis. Multiple logistic regression models were used to determine factors associated with KAP. Results: The study found inadequate KAP among caregivers that was significantly associated with gender and level of education. Gender was significantly associatedwith level of knowledge (p<0.001) and level of practice (p= 0.04) while level of caregivers education was significant with level of attitude. (p= 0.015). There was no statistical significant relationship found between KAP variables. Practice and knowledge (p-value close to 1), practice and attitude (p=0.70), attitude and knowledge (p=0.66). Mean age was 30 years (SD=8.38). 26 (32%) had good knowledge and 58 (68%) had moderate knowledge. The mean score of respondents’ attitudes was 14.33 (SD= 3,178) with 36 (43%) having good attitudes towards the prevention and treatment of diarrhoea while 48 (57%) had poor attitudes. 28(57%) of caregivers had good practices and (71%) had poor practices. Conclusion: Existing public health programs targeting prevention of diarrhoea and dehydration should consider gender, level of education, perceptions and beliefs of caregivers when planning for interventions.Item Knowledge, attitudes and practices of students in matric regarding smoking(2003-06-06) Mokonoto, Maggie DimakatsoSmoking is a preventable cause of death. Young people start smoking at an early age due to certain external influences such as peer pressure, advertising etc. Once they start smoking, they often remain smokers forever because of the addictive effects of nicotine. The international studies show that the high morbidity and mortality rates caused by cigarette smoking can be reduced if health promotion strategies target school going children. The aim of the study was to investigate knowledge, attitudes and practices of students in matric as regards smoking in the Greater Tshwane Metropolitan area (Pretoria). This will inform the health promotion programmes, in particular health education, dealing with tobacco smoking prevention and control in schoolsItem Knowledge, attitudes and infection control practices of oral health students when managing patients with HIV/AIDS in Johannesburg, South Africa(2016) Joosab, Zorayda .M.SOral care for patients with HIV/AIDS plays a vital role in improving their nutritional intake, medication tolerance and effectiveness, treatment success rate, as well as quality of life. As the number of people living with HIV/AIDS increases, the possibility of oral healthcare professionals treating more patients with HIV/AIDS will increase and this will result in an increased risk of cross contamination in the dental setting. Aim was to determine the knowledge, attitude and infection control practices of undergraduate dental and oral hygiene students when managing patients with HIV/AIDS. This KAP survey was of a cross-sectional design with an analytical component conducted among 108 dental and oral hygiene students. A validated questionnaire was utilized as a study instrument of choice. A convenience sampling technique was utilized and all students in the target population formed the study sample. Results: The study sample had a mean age of 21 (20 - 23) years, with the majority being females 82 (75.93%) as opposed to 26 (24.07%) males. The average knowledge level of students regarding HIV/AIDS was approximately 55% with a standard deviation of 0.15; the median was 0.55 with a min-max value of (0.2-1.0). [Table2]. Twenty nine per cent of the students (31) had a moderate knowledge level regarding the management of HIV/AIDS patients. Just over half of the cohort, 60(55.56%) of the students had a positive attitude, 44(40.74%) had a passive attitude and 4(3.70%) students had a negative attitude. The infection control practices were of a good quality among the clinical students, with an average of 78.87% (std: 15.61%). Three quarters 53 (76%) of these students had good infection control practice and 17(24%) students had excellent infection control practices. Conclusion: The dental curriculum needs to be appropriately modified, existing learning activities and practical skills should be adapted to ensure future dental practitioners have the clinical competence, in combination with relevant knowledge to provide excellent and appropriate care to patients with HIV/AIDS or any other common transmissible diseases.Item Knowledge attitudes and practices of emergency care practitioners towards intimate partner violence(2016) Hindle, Lucy ElizabethObjective Intimate partner violence (IPV) is a significant social and health concern in South Africa, with far reaching consequences. One in three South African women will experience IPV, and many of the survivors of IPV will have contact with Emergency Care Practitioners (ECPs), either for treatment related to the direct sequelae of the abuse or for other health issues. ECPs already play a role in identifying and managing IPV but current knowledge, attitudes and practices were not known. The aim of the study therefore was to describe current levels of knowledge, attitudes and practices regarding IPV amongst ECPs, including doctors, nurses and paramedics in South Africa and to describe differences according to the respondent's reported prior training and profession. Methods A prospective, cross sectional study was performed using an online survey administered anonymously to ECPs in South Africa. Information regarding demographic data, qualification, prior IPV training, knowledge, attitudes and practices towards IPV were obtained. Results One hundred and fifty three respondents completed the survey. Of those 56% were doctors, 33% paramedics and 9.8% nurses. In total 65% reporting having received no training on IPV. There was a significant association between respondents reporting having received any IPV training and improved self-reported knowledge (p=0.0001), and actual knowledge (p=0.011). Of the respondents in clinical practice 75% had diagnosed IPV in the last six months, although the frequency of diagnoses being made is lower than would be suggested by the South African prevalence rates. Those respondents who reported any prior training on IPV were more likely to have diagnosed IPV in the last 6 months (p= 0.0076) Most of the ECPs who diagnosed IPV counselled the patients on options and/or referred to police and/or social workers. Conclusion Although ECPs are diagnosing and managing IPV, training in this important health concern is inadequate. Any reported training on IPV for ECPs improves self-reported knowledge, actual knowledge and practices regarding IPV.Item Consumer knowledge, attitudes and perceptions, towards generic medicines - a perspective from the Northern Suburbs of Johannesburg, South Africa(2015-04-17) Zigomo, TinasheIn South Africa’s current healthcare structure, about 8.3% of GDP is spent on healthcare. This is well above the WHO recommended 5% of GDP spend. Despite the heavy spending, health outcomes remain poor when compared to similar middle-income countries. Solutions need to be found to cut back on healthcare costs. Approximately half (4.1%) of the healthcare spend is consumed by the private sector which benefits a very small segment (16%) of the population. This segment is largely on medical schemes. Using generic medicines can aid in cutting back on drug costs but are generics being adequately assimilated by the consumers of healthcare in the private sector? The objective of the study was to evaluate the perceptions attitudes and knowledge of the consumers of healthcare in the Northern suburbs of Johannesburg towards generic medicines. A survey was conducted on a sample of 402 respondents across 9 randomly selected pharmacies in the Johannesburg north region between November 2012 and February 2013. A researcher administered questionnaire was the sole data collection tool. Questions asked covered the research objectives and also included demographic data and other explanatory variables. Data analysis was carried out in SAS. The 5% significance level was used throughout, unless specified otherwise. The chi-squared (Χ2 ) test was used to assess the relationships between categorical variables. Fisher’s exact test was used for 2 x 2 tables or where the requirements for the Χ2 test could not be met. The strength of the associations was measured by Cramer’s V and the phi coefficient respectively. Key results on respondent demographics included high representation of the higher income earning groups (78% >R10 000); furthermore 44% had completed tertiary education, 60% were comprehensively insured, 61% regularly visited a pharmacy, 38% were on prescription medication and 24% on chronic medicine. On knowledge, 5% of respondents were able to most accurately define generic medicines. On attitudes, 78% had used generics however the level of agreement was lower for the highest education category (p<0.0001; Cramer’s V=0.18). Trends favoured brands over generics with increasing severity of illness as generics were chosen by 10% in major illness and 5% in chronic illness. 80% perceived generics as safe while 95% perceived brands as safe. 75% of respondents felt that generic medicines were as effective as branded medicines. 15% indicated that branded medicines have fewer side effects. 64% showed positive perceptions of quality of generics compared to 93% for brands. Bowker’s test of symmetry was significant (p<0.0001) showing a shift towards slightly more negative perceptions towards generic medicines amongst those who thought highly of brand quality. Knowledge of generics was overall low. Perceptions regarding safety, quality, efficacy, and side effects of generic medicines were generally positive but responses proved more positive for brands. Attitudes towards generic medicines were mostly positive however willingness to use generics lessened with increasing severity of illness. Household income, health insurance (medical aid) status, level of education, experience with medicines and racial demographics played a key role in explaining consumer beliefs and behaviours. Pharmacists and Doctors had a positive influence on generic use patterns amongst other factors.