3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Pre-hospital emergency care student experience with paediatric emergency cases in Johannesburg, Gauteng(2011-03-18) Stein, Christopher Owen AlexanderAdequate exposure to paediatric pre-hospital emergency cases for students undertaking clinical learning is a key component of preparation for independent practise. Both clinical reasoning and psychomotor skills require practise in a realistic environment in order to best equip the qualifying practitioner for demands of the real world of pre-hospital emergency care. The aim of this study was to retrospectively describe the exposure of pre-hospital emergency care students in the University of Johannesburg‟s National Diploma in Emergency Medical Care programme to emergencies involving paediatric patients in the Greater Johannesburg Metropolitan area over a continuous eight year period, between 1 January 2001 and 31 December 2008. Patient care records contained in an electronic clinical learning management information system entered over the eight-year study period were analysed in order to characterise the exposure of students to paediatric emergency cases in general, and clinical skills performed during this exposure. Results showed that, with the exception of infants and children seen by first year students, median exposure to paediatric emergency cases for students in all academic years was below 50%. Exposure to emergencies involving younger patients was generally lower than that for older patients, however the acuity of patients increased with decreasing age. Exposure to most clinical skills also decreased with decreasing patient age. Opportunities for students to practise critical or invasive skills were relatively rare. Suggestions for the improvement of student exposure to paediatric emergency cases and clinical skills include a period of internship and greater utilisation of hospital-based clinical skills exposure and practice.Item The Role of Social Support in the Relationship between Exposure to Traumatic Stressors and Posttraumatic Stress Symptoms in a Sample of Emergency Care Practitioners(2007-02-22T12:54:15Z) Basedau, Natascha TanyaThe present study served to investigate the way in which continuous exposure to potentially traumatic incidents impacts on the South African Emergency Care Practitioner (ECP). The study sought to investigate the presence of symptoms of posttraumatic stress (PTS) in the sample and the events which appear to pose the greatest threat to these ECPs’ mental health. The notion that individuals exposed to the same traumatic stressors can present with very different posttraumatic responses has led to the acknowledgement that the relationship between exposure and PTS is a complex one. Studies have examined a multitude of variables believed to impact in some way on this relationship, with particular emphasis on individual appraisals and coping styles. Less attention has been afforded the role of social phenomena in the development of posttraumatic stress disorder (PTSD). The attention that has been afforded these phenomena has tended to examine social support as a unidimensional construct, and studies have often measured different social support conceptualisations. Utilising a recognised psychosocial framework, the present study sought to investigate the impact of social support in the relationship between exposure and PTS. It sought to examine three distinct facets of social support, namely: the appraisal of being supported, the perception of available supportive behaviours from family and friends, and an individual’s orientation towards utilising support. The study used a cross-sectional, correlational design to investigate the relationships between exposure, PTSD symptoms and social support. The procedure involved the anonymous completion of several standardised self-report measures by 107 ECPs from Netcare 911, a private South African emergency care organisation. These measures included a revised version of the Paramedic Work Exposure Checklist (PWEC), the Revised Impact of Event Scale (RIES), the Social Support Appraisals Scale (SS-A), the Social Support Behaviours Scale (SS-B) and the Network Orientation Scale (NOS). The events that tended to be rated as having the most negative emotional impact among respondents involved assisting abused or injured children, witnessing the death or injury of a coworker, assisting victims of sexual assault, dealing with equipment failure or the incompetence of others and receiving inadequate or incorrect information when dispatched on a call. The correlational analyses revealed that exposure to events rated as having a negative emotional impact was significantly and positively associated with symptoms of PTSD in the sample. Correlational analyses also revealed that each of the facets of social support measured was significantly negatively associated with symptoms of PTSD. The results indicate that the mode and source of support most significantly associated with symptoms of PTSD in the sample was the perception of available emotional support from friends. In spite of the direct relationships observed between symptoms of PTSD and the facets of social support examined, none of the social support facets investigated emerged as a significant buffer in the relationship between exposure and PTSD. The study highlights the need for additional research, including longitudinal investigation, into the role of multiple facets of social support in the relationship between exposure and PTSD. Some suggestions for future research and the practical application of the findings of the research are offered.