Faculty of Health Sciences (ETDs)
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Item Caregiver's oral health knowledge, attitudes and practices towards children with special health care needs in Harare Province, Zimbabwe(University of the Witwatersrand, Johannesburg, 2023-11) Mashanda, Vimbai; Tootla, Saidah; Malauy, CathrineBackground: Children with Special Health Care Needs (CSHCN) are prone to oral diseases such as dental caries and periodontal disease. This is due to limitations in oral hygiene practices because of their debilitating conditions. Therefore, caregivers play a major role in the maintenance of CSHCN’s oral health. As a result, caregiver’s oral health knowledge and attitudes are important to ensure that the oral health of CSHCN is maintained. Aim and Objectives: The aim of this study was to describe the caregiver’s oral health knowledge, attitudes, and practices (KAP) towards CSHCN. The objectives of the study were to determine the caregiver’s demographic profile, to assess the caregiver’s oral health KAP towards CSHCN and to assess whether there is a relationship between the caregiver’s level of education, demographic characteristics, and oral health KAP and factors related to oral health practices. Methods: A quantitative cross-sectional study design and convenience sampling method was utilised. Caregivers above 18 years of CSHCN who attended support group meetings in Harare Province, Zimbabwe and were willing to participate, took part in the study. A modified self-administered questionnaire (SAQ) was used for data collection. The SAQ comprised of a demographics section for the caregiver, child’s disability type and oral health KAP questions. Two sample t-tests and Analysis of Variance (ANOVA) was used to compare the means of caregivers KAP. Multiple linear regression model was used to assess the association between caregivers’ KAP and demographic characteristics. Only the variables with p<0.15 in the univariate model were included in the multiple linear and multivariate logistic regression models. Multivariable logistic regression was used to assess the association between caregivers’ oral health practice and demographic characteristics. Apriori variables such as age, level of education, knowledge and attitude were selected for all multivariable logistic models. All variables with p<0.05 were considered to be statistically significant and statistical analysis were performed using Stata. Results: The response rate was 76.8% n=295). Almost 90% (89.2%, n=263) of the caregivers were females and nearly three quarters (72.5%, n=214) were mothers. A third (33.6%, n=99) of the caregivers were aged between 31-40 years. Fifty-three percent (n=157) of the caregivers were unemployed and 61.7% (n=182) were educated up to high school level. Forty-six percent (n=135) of the CSHCN had cerebral palsy. Out of the 295 caregivers, 45.4% (n=134) had fair oral health knowledge, 79.7% (n=235) had a good attitude towards oral health and 62% (n=183) had fair oral health practices. Conclusions: Most of the caregivers had good oral health attitude, however their knowledge and practices were fair. Factors associated with caregivers’ attitude were their knowledge and level of education, and the caregivers’ practices were associated with knowledge and attitude.Item The Utilisation of Genetic Counselling Services Amongst Prenatal Healthcare Providers in Gauteng, South Africa(University of the Witwatersrand, Johannesburg, 2024) Duvenhage, MeganCongenital anomalies and disorders, many being genetic, continue to have high prevalence and mortality rates globally. Prenatal healthcare providers possess the necessary skills to identify these cases before birth and refer patients for genetic counselling. This study aimed to establish the utilisation of genetic counselling services and insights into the perceptions of genetic counselling amongst prenatal healthcare providers in Gauteng, South Africa. By assessing the utilisation of genetic counselling, barriers and facilitators to referrals were highlighted, and recommendations to improve service provisions in the prenatal sector were made. An electronic survey adapted from Thom and Haw (2021) was sent to prenatal healthcare providers in both the public and private healthcare sectors. A total of 54 participants were included in this study. Results show that roughly 74% of participants are able to refer to genetic counselling services, but only 57% had made use of the service. None of the participants were able to identify all appropriate reasons for referral to genetic counselling correctly, and only 24% of participants understood the responsibilities of a genetic counsellor. Misconceptions regarding the scope of practice of genetic counsellors and uncertainties surrounding the referral process were the most significant barriers to referrals. The study revealed that although prenatal healthcare providers in Gauteng are using genetic counselling services, they are not fully utilising the service due to a lack of knowledge surrounding the profession's services. Therefore, there is a need for educational resources to bridge the knowledge gap and improve prenatal healthcare in Gauteng, South AfricaItem Knowledge, attitudes and practices of clinician management of adults presenting with acetylcholinesterase inhibitor poisoning(University of the Witwatersrand, Johannesburg, 2024) Redant, Dean PatrickBackground: Acetylcholinesterase inhibitor (AChE-I) poisoning is a common cause of deliberate self-harm in South Africa (SA). Whilst there is existing literature on the epidemiology and management of AChE-I poisoning, there is a lack of research on the South African clinician’s knowledge, attitudes and clinical practice when managing these patients. Objectives: To describe the knowledge, attitudes and practices (KAP) of clinicians when managing adult patients with AChE-I poisoning in academic emergency departments (ED) in Southern Johannesburg, Gauteng. To describe the correlation between the clinician’s demographics and experience to their knowledge, attitudes and practices in this setting. Methods: One hundred and forty-five clinicians completed a structured questionnaire used to gather data on clinicians’ knowledge, attitudes and practices (KAP) with regards to their management of patients with AChE-I poisoning. Descriptive and inferential statistics were used to analyse the data and to infer correlation between clinician’s KAP vs clinician’s demographics and experience. Results: One hundred and forty-five questionnaires from 5 EDs were completed and analysed. Of which 86 (59%) of participants were female and 59 (41%) were male. The majority of participants were under the age of 40 (84%) and employed as Grade 1 Medical Officers (39%). Years of experience were divided into <2 years, 2 – 5 years and ≥5 years with each group representing a third of the sampled population. Clinician average knowledge scores on AChE-I poisoning were good (77.9% n= 12.46/16) with scores improving predictably with years of experience (72.5% in <2 years to 83% in ≥5 years). Attitudes towards managing patients with AChE-I poisoning were overall neutral. Clinician practices varied greatly, particularly with adjustment of atropine infusions and adjunctive treatments used. Conclusion: Clinicians had an overall good knowledge of AChE-I poisoning which improved predictably with greater experience managing these patients. Practices were highly varied across all demographic groups despite access to protocols in most departments studied. Attitudes were generally neutral with no clear impacting factors. Clinicians agreed unequivocally that the public health system did not provide sufficient primary preventative care in order to address the underlying factors driving patients to self-harm. This research revealed that the medical and psychosocial management of adult patients with AChE-I poisoning can be improved upon through specific clinician training.Item A cross-sectional study investigating knowledge, attitudes and health choices in relation to diabetes mellitus among nondiabetic patients attending Chiawelo community practice, Soweto, Republic of South Africa(2024) Tshibeya, M. R.Background: The knowledge, attitudes and health choices of non-diabetic patients in resourcelimited settings to prevent the onset of diabetes mellitus (DM) are poorly understood. Aim: The aim of this study was to investigate and describe the knowledge, attitudes and health choices of non-diabetic patients in relation to DM at the Chiawelo Community Practice (CCP), Soweto, South Africa. Methods: In this cross-sectional study, a self-reported questionnaire was administered to 165 adult participants attending the CCP from 2nd March to 17th April 2020. Descriptive analysis, Chi square and univariate logistic regression were included in the analysis. Multivariate analysis was done for variables with a p-value <0.25 Results: In total, the study had 165 participants, of whom 112 (68%) were women, 35% were older than 45 years and 16% were younger than 25 years of age. Almost half (49%) of participants had good knowledge of DM, with 60% indicating good attitudes and 52% making good health choices to prevent DM. Participants who received education from clinicians were 4.31 times more likely to develop better attitudes (p=0,003) and 3.34 times more likely to adopt better health choices (p=0.004) towards DM compared to those who obtained information from media or other sources. Conclusion: The study found that poor knowledge of DM does not necessarily translate into poor attitude towards the disease, which is noteworthy. The study also highlighted the important role of healthcare workers in influencing behaviour change