4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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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 Exploring attitudes, aetiology and help-seeking behaviours for Mental illness in the community of Diepsloot(University of the Witwatersrand, Johannesburg, 2023-02) Mkhize, Sandile Dionne; Laher, SumayaMental illness is a serious nation-wide health concern, with many individuals suffering from mental disorders. This study explored the attitudes of Diepsloot community members towards mental illness, their beliefs about the aetiology of mental illness and their help-seeking behaviours. Further the study explored whether attitudes and aetiology beliefs predict help-seeking behaviours in Diepsloot community members. Furthermore, issues of stigma and poverty were explored as factors contributing to understanding of and help-seeking behaviours for mental illnesses. A convenience sample of 154 community members in Diepsloot completed a questionnaire consisting of a demographics section, the Living Standards Measure, the Public Perceptions of Mental Illness questionnaire and two open ended questions asking about the factors that contribute to mental illness and the kind of advice the participants would give to a person who has mental illness. Quantitative data were analysed using descriptive statistics and multiple regression analyses. The open-ended questions were analysed qualitatively using thematic analysis. The results indicated that the participants had more neutral attitudes towards mental illness overall but an item-by-item analysis of the attitudes scale indicated negative attitudes. The participants perceived mental illness to be caused by biological and stress related causes but did identify other causes in their responses to the open ended question. In particular, psychological factors, substance use, social components/aspects in their community, financial challenges, biological influences and cultural influences were all identified. Among the participants, there was an endorsement of help-seeking behaviours that were aligned with western medicine, hospitalization, consulting with family and friends, and religion in both the quantitative and qualitative analyses. Seeking help from traditional healers was less dominant in the responses to the open ended question. The multiple regression results, with regard to predicting attitudes towards mental illness, suggested that the participants had positive attitudes towards mental illness if their level of knowledge was higher. A variety of predictors were revealed regarding the various help-seeking behaviours. An overlap was observed among the stress aetiology and the cultural beliefs aetiology as predictors. These results are discussed within the broader context of access to mental healthcare in South Africa as well as the need for more collaborative interventions.Item Determining a Relationship Between Attitude Towards E Learning and Academic Stress Levels in Higher Education Students(University of the Witwatersrand, Johannesburg, 2023-08) Persello, Byron Franco; Pitman, MichaelE-learning has become more prevalent in higher education institutes, partly due to the COVID-19 pandemic that necessitated social distancing as well as the rise in technology application to education. With stress being an important factor in the academic experience, this research report explores the relationship between the experience of stress and attitudes towards e-learning factors in students. The sample was 79 undergraduate students from the University of Witwatersrand who had undergone e-learning during the 2021 academic year. To gather the data, the Student-life Stress Inventory and Scale of Student Attitude towards E-learning was used. The results showed there was no correlation between experienced stress and attitudes towards the e-learning factors, results r = -.178, n = 75, p = .317. Descriptive analysis of the two measure’s items indicates that participants recognised the benefits of e-learning but challenges using the e-learning medium were still relevant to their experience. The overall stress was beyond normal management for 86.11% of the participants, even though social support appeared available.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 changeItem The perceived impact of leadership coaching by branch managers at the First National Bank of Botswana(2021) Otukile, Maureen UdahThis research examines the perceived impact of leadership coaching on the branch managers at the First National Bank of Botswana. It provides the foundation to investigate and understand whether coaching affects sustained behaviour change. It explores behaviour, attitudes and leadership effectiveness strategies and how the leadership coaching impacts them. In this, the researcher aimed at determining the perceived impact of leadership coaching on behaviour and attitudes; determining whether leadership coaching can impact leadership practices and establishing whether leadership coaching promotes leadership effectiveness strategies at the First National Bank of Botswana. The research used a qualitative research method to understand a phenomenon guided by the Theory of Planned Behaviour. Qualitative methods were chosen because of its nature of having a small sample size. The research adapted a case study since it is an empirical inquiry and case studies provide in-depth information that gives a detailed description of the phenomena. The main tool of data collection was a guided interview. The findings showed that leadership coaching positively impacts behaviour and attitude change needed for achieving their organisations’ objectives. Findings also showed that leaders who undergo leadership coaching are more likely to significantly contribute to better leadership practices like building adaptable cohesive teams, motivating team members to be engaged and maximizing the strengths and minimizing the weaknesses of subordinates. The research also found that leaders who complete a leadership coaching programme have better application of the leadership effectiveness strategies to help their teams achieve higher levels of self-efficacy