3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Factors associated with the health and wellbeing of older people in a rural African setting(2015-03-27) Gomez-Olive, Francesc XavierBackground South Africa is experiencing a massive HIV epidemic that together with the new epidemic of non-communicable diseases is directly affecting the health and wellbeing of older people. For policy makers, there is a crucial need for information on how this dual epidemic is evolving and how this may affect older people's health, mortality and health care needs. 2. Aims To better understand factors that influence the health, wellbeing and survival of older people, and their need for care in rural South Africa at a time of a growing dual epidemic of chronic diseases (non-communicable and communicable). To provide information which may assist in the planning of health services for older people. 3. Methods Applying the WHO Study on Global Ageing and Adult Health (SAGE) and a study on HIV and non-communicable diseases (NCD), we investigated the health, wellbeing and mortality of the population 50 years and older in the Agincourt sub-district in north-east South Africa which is underpinned by health and demographic surveillance. A random sample of the population 50 years and older was selected for the SAGE survey. A random sample of the population 15 years and older was selected for the HIV and NCD study. All available adults 50 plus were invited to participate in the SAGE module in the 2006 census round. We assessed self-reported health, anthropometric measures, blood pressure and HIV status using dried blood spots. Statistical analysis included simple frequencies, univariate and multivariate analysis and Cox proportional hazard models. 4. Findings The usual pattern of mortality, of increasing death rates with age, is not observed in this population, where those in their 50s have higher mortality compared to older age groups. The high prevalence of HIV in this age group (50 to 59) appears to be the main explanation for the observed pattern. Hypertension affects two thirds of this older population and, although there are no differences by gender, women are more aware of their condition. This is reflected in more women attending primary health care services. Reporting lower quality of life and greater disability are associated with higher likelihood of death. We observed gender differences in the process of ageing with women reporting higher prevalence of mortality risk factors but living longer than men, a phenomenon known as the "survival paradox".Item "Deep down and very superficial": an investigation of self-concept in children with learning difficulties(2008-09-22T13:25:29Z) Smith, MelanieAbstract will not load on to DSpaceItem A Validation study of the sense of coherence scale using two South African samples(2007-03-01T11:05:14Z) Randall, Susan JaneThis study undertook to investigate the validity of the Sense of Coherence Scale (SOC Scale) for use in South Africa. The scale was developed by Antonovsky (1987) and is widely used in stress and health research. It measures three components: meaningfulness, comprehensibility, and manageability, which Antonovsky posited as being central to a person’s sense of coherence (SOC), which in turn facilitates coping and personal resilience. The current research utilised two samples, namely a group of disabled individuals and a group of undergraduate psychology students. It found that while the SOC Scale is indeed a useful psychometric instrument within a South African context, it would be advisable to develop a modified version of the scale for local use. Factor analysis suggested that a three-factor solution is more appropriate than a one-factor solution, a finding which is congruent with Antonovsky’s theory. Suggestions are made for modifications to some of the original 29 items, as well as the subscales, of the SOC Scale.Item Factors associated with drug shortages in PHC facilities in the Mopani district of the Limpopo province(2006-11-10T11:58:10Z) Matse, Patrick MuziMost leading causes of death and disability in developing countries can be prevented, treated, or at least alleviated with cost effective essential drugs. However, hundreds of millions of people do not have regular access to essential drugs despite the fact that essential drugs can prevent many deaths. The aim of this study was to determine factors associated with essential drugs shortages in Primary Health Care (PHC) facilities (i.e. clinics and community health centres) in Mopani District in the Limpopo Province. Forty-five facilities were selected by means of stratified (by sub-district) random sampling. Forty-five professional nurses, who were in charge of the facility on the day of the interviews, were interviewed. A structured questionnaire was used for the data collection. Six pharmacists, from the six hospitals that supply drugs to the PHC facilities, were interviewed using a structured questionnaire. A one-on-one informal interview was held with 2 Hospital Superintendents and the Acting Provincial Chief Pharmaceutical Director. The study was both a retrospective and prospective observational study based on review of historical data, interviews with key players and direct observation of current practice. The tools used to collect and analyse the data were based on those developed by the World Health Organisation (WHO) and the Health Systems Trust (HST) with some adjustments and adaptation. The District STI Quality of Care (DISCA) Tool was used in the other thirty-six facilities, at which the structured questionnaire was not administered, to test prescribing indicators in relation to diagnosis, the correctness of and dosage of drugs dispensed and also drugs availability.