Health SA Gesondheid https://www.ajol.info/index.php/hsa <p><em>Health SA Gesondheid - Journal of Interdisciplinary Health Sciences</em> is an open access, peer-reviewed interdisciplinary and interprofessional scholarly journal that aims to promote communication, collaboration and teamwork between professions and disciplines within the health sciences to address problems that cross and affect disciplinary boundaries.</p><p>The journal publishes original articles on issues related to public health, including implications for practical applications and service delivery that are of concern and relevance to Africa and other developing countries. It facilitates the gathering and critical testing of insights and viewpoints on knowledge from different disciplines involved in health service delivery.</p><p>The journal offers the breadth of outlook required to promote health science education, research and professional practice.</p><p>The journal with its interdisciplinary scope attracts interest from a wide audience of scientists and health professionals working in the areas of health care management, health care economics, policy making, nursing, psychology, sociology, ethics and education.</p><p>Unique features distinguishing this journal</p><div><hr align="left" noshade="noshade" size="5" width="100%" /></div><p>The journal has a strong regional focus (South Africa) with abstracts published in English. It offers a nurturing environment for young and novice researchers to showcase their work whilst upholding the standards of health science education, research and professional practice.</p><p> </p><p>The journal explores issues and posits solutions to current challenges existing in health care from an interdisciplinary perspective within Africa and other developing countries, including but not limited to:</p><ul><li>improvement of health safety and service delivery</li><li>management and measurement of health services</li><li>evaluation and assessment of health care needs</li><li>prevention of ill health and health-affecting behaviours</li><li>promotion of healthy lifestyles</li><li>health security, economics, policy and regulations.</li></ul>Other websites associated with this journal: <a title="https://hsag.co.za/index.php/hsag/index" href="https://hsag.co.za/index.php/hsag/index" target="_blank">https://hsag.co.za/index.php/hsag/index</a> en-US Health SA Gesondheid 1025-9848 <p>The author(s) retain copyright on work published by AOSIS unless specified otherwise.</p><p><strong>Licensing and publication rights</strong></p><div align="center"><hr align="center" noshade="noshade" size="5" width="100%" /></div><p>Author(s) of work published by AOSIS are required to grant AOSIS the unlimited rights to publish the definitive work in any format, language and medium, for any lawful purpose. AOSIS requires journal authors to publish their work in open access under the <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank"><strong>Creative Commons Attribution 4.0 International (CC BY 4.0) licence</strong></a>.</p><p>The authors retain the non-exclusive right to do anything they wish with the published article(s), provided attribution is given to the applicable journal with details of the original publication, as set out in the official citation of the article published in the journal. The retained right specifically includes the right to post the article on the authors’ or their institution’s websites or in institutional repositories.</p><p>Previously published work may have been published under a different licence. We advise the community that if they would like to reuse the work to consult the applicable licence at article level.</p><p>Note: If you need to comply with your funding body policy, you can apply for the CC BY license after your manuscript is accepted for publication.</p> Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review https://www.ajol.info/index.php/hsa/article/view/215895 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p>Lesbian, gay, bisexual and transgender (LGBT) individuals are often stigmatised and discriminated against. This population is expected to experience poorer mental health outcomes compared with heterosexual and cis-gendered people, a phenomenon healthcare providers need to take note of and act upon. This study aimed to explore and describe the mental health challenges of LGBT people. An integrative literature search was conducted. The following electronic databases were searched: Academic Search Premier, Africa-Wide Information, Business Source Premier, eBook Collection (EBSCOhost), E-Journals, ERIC, Family &amp; Society Studies Worldwide, Health Source: Nursing/Academic Edition, Humanities Source, MasterFILE Premier, MEDLINE, PsycARTICLES, Social Work Abstracts, TOC Premier, WorldCat.org, Taylor and Francis Journals, Biomed Central and Wiley Online Library. An internet search was also carried out using Google and Google Scholar databases. The following search terms were identified: ‘LGBT’ OR ‘LGBT community’ AND ‘mental health challenges/problems’ OR ‘mental/psychiatric illness’. The reviewed literature comprised research conducted globally between 2010 and 2019. From the 2545 titles, 345 abstracts were examined, resulting in 57 articles. The 57 full-text articles were examined to verify whether they addressed the scope of the literature review, of them, 21 addressed the mental health challenges of LGBT people. Lesbian, gay, bisexual and transgender people experience the following mental health challenges: emotional distress, stigmatisation, victimisation, discrimination and barriers to accessing healthcare services. The results showed that although LGBT has been legalised in many countries, LGBT communities still experience significant mental health challenges. Healthcare providers are in a position to address challenges related to social and healthcare structures and act as advocates in order to promote the mental health of LGBT individuals.</p> </div> </div> </div> </div> Miriam M. Moagi Anna E. van Der Wath Priscilla M. Jiyane Richard S. Rikhotso Copyright (c) 2021-10-12 2021-10-12 26 1 A diabetes peer support intervention: Patient experiences using the Mmogo-method<sup>®</sup> https://www.ajol.info/index.php/hsa/article/view/215898 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Self-management is the backbone of diabetes care. For the patient with type 2 diabetes, this implies making decisions about a healthy diet, regular exercise and taking treatment appropriately. Some patients may experience barriers to the self-management of diabetes, such as lack of support. In this respect, peer support has been identified as a promising strategy in the self-management of diabetes.</p> <p><strong>Aim:</strong> The study aimed to explore the experiences of adults with type 2 diabetes who took part in a diabetes peer support intervention in the Free State, South Africa. Such information may lead to the development of practical methods for diabetes self-management and control.</p> <p><strong>Methods:</strong> Twelve purposively sampled Sesotho-speaking women (aged 51–84 years) participated in the Mmogo-method<sup>®</sup>, a visual-based narrative enquiry. Textual data from audio recordings of discussions, visual data from photographs of constructions and field notes were triangulated and analysed thematically.</p> <p><strong>Results:</strong> Participants described the peer support intervention as very valuable. They regarded community health workers as an important source of support. Three themes emerged from the intervention: positive lifestyle changes, continuous support, and improved confidence and sense of connectedness. This was a significant finding reported in patients with diabetes, as it will contribute to successfully sustaining effective self-management behaviour.</p> <p><strong>Conclusions:</strong> Peer support for patients with type 2 diabetes appeared to be a valued intervention, as participants related well to community health workers, who are ideally positioned in the healthcare system to provide the service.</p> </div> </div> </div> </div> Melanie A. Pienaar Marianne Reid Copyright (c) 2021-10-12 2021-10-12 26 1 Microbial levels on street foods and food preparation surfaces in Mangaung Metropolitan Municipality https://www.ajol.info/index.php/hsa/article/view/215902 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> The street food sector has become an important component of the food distribution system in many cities in both developing and industrialised countries, particularly for midday meals. However, certain street food can pose a significant risk to consumers because of microbiological contamination.</p> <p><strong>Aim:</strong> The aim of this study was to determine the microbial levels of street foods and preparation surfaces in Mangaung Metropolitan Municipality.</p> <p><strong>Setting:</strong> The study selected study setting was vending sites close to taxi ranks where prepared meals were accessible to consumers.</p> <p><strong>Methods:</strong> The study was conducted in Mangaung Metropolitan Municipality during the winter season. Samples were collected through convenience sampling from the representative towns Thaba Nchu, Botshabelo and Bloemfontein. Using swabs, surface samples were collected and quantified from selective media. Eight beef samples were also collected; the microbial load on each sample was quantified and identified using a RapID kit.</p> <p><strong>Results:</strong> The surface swabs obtained in Botshabelo (1.1 × 10<sup>4</sup> cfu/m<sup>2</sup> – 1.1 × 10<sup>6</sup> cfu/m<sup>2</sup>) showed higher microbial counts as compared to those obtained in Bloemfontein (1.1 × 10<sup>4</sup> cfu/m<sup>2</sup> – 1.1 × 10<sup>5</sup> cfu/m<sup>2</sup>) and Thaba Nchu (1.1 × 10<sup>4</sup> cfu/m<sup>2</sup> – 1.1 × 10<sup>5</sup> cfu/m<sup>2</sup>). Higher microbial counts were observed on meat samples sampled in Thaba Nchu (50 cfu/g x 10<sup>5</sup> cfu/g), Bloemfontein (48 cfu/g x 10<sup>4</sup> cfu/g) and Botshabelo (33 cfu/g x 10<sup>5</sup> cfu/g) when compared to international microbiological standards. After assessing the microbial levels, <em>Staphylococcus aureus, Escherichia coli, Candida guilliermondii, Corynebacterium jeikeium, Psychrobacter phenylpyruvicus</em> and <em>Peptostreptococcus tetradius</em> were identified.</p> <p><strong>Conclusion:</strong> This study confirmed contamination of surfaces and food served by vendors in Mangaung Metropolitan Municipality. The identified foodborne bacteria could pose a public health problem in each specific locality.</p> </div> </div> </div> </div> Malerato Moloi Gaofetoge G. Lenetha Ntsoaki J. Malebo Copyright (c) 2021-10-12 2021-10-12 26 1 A practice framework for the cooperative treatment of cancer between traditional health practitioners and radiation oncologists in KwaZulu-Natal province, South Africa https://www.ajol.info/index.php/hsa/article/view/215904 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Cooperative practice between traditional health practitioners (THPs) and radiation oncologists (ROs) is crucial for the continuity of care in the treatment of patients with cancer. However, scant information exists on how to co-ordinate cooperation between these health practitioners without interrupting the treatment of the patients.</p> <p><strong>Aim:</strong> The study aimed to explore the practices of THPs and ROs in cancer treatment and ultimately derive a workable practice framework between these health practitioners in the KwaZulu-Natal (KZN) province.</p> <p><strong>Setting:</strong> The study was conducted in selected districts, namely eThekwini, uThukela, Amajuba, uMkhanyakude, iLembe, uMzinyathi and uMgungundlovu, in KZN.</p> <p><strong>Methods:</strong> A qualitative study by using a descriptive phenomenological approach was conducted to collect data from 28 THPs involved in the treatment of cancer and four ROs from public oncology hospitals. Focus groups and one-on-one semi-structured interviews by using open-ended questions were conducted to collect data from THPs and ROs, respectively. Framework analysis was used for data analysis to identify themes.</p> <p><strong>Results:</strong> The study found that in KZN, THPs and ROs are working in parallel and that there are problems when patients seek cancer treatment from both health practitioners. Furthermore, the THPs and ROs work in an environment where there is no relationship, respect and trust, open communication and referral of patients by ROs to THPs. Both teams indicated that patients consult both traditional medicine (TM) and allopathic medicine (AM) by moving between the two health practitioners, resulting in interruptions in treatment. In addition, the study found that cooperation between THPs and ROs is understood as the provision of continuity care, where the parties work independently but share certain information of the patient on treatment, or as already being treated by each of them. The focus was on the type of relationship, enablers and common grounds for cooperation.</p> <p><strong>Conclusion:</strong> The workable cooperative practice framework could be an inclusive health system where the parties work in parallel, with the patient being the main actor in the collaboration.</p> </div> </div> </div> </div> Pauline B. Nkosi Maureen N. Sibiya Copyright (c) 2021-10-12 2021-10-12 26 1 Midwives’ perceived role in up referral of high-risk pregnancies in primary healthcare settings, eThekwini district, South Africa https://www.ajol.info/index.php/hsa/article/view/215906 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> South African maternal and neonatal mortality rates remain unnecessarily high, which are considered avoidable through timeous identification, treatment and referral. An efficient referral process of high-risk pregnant women is dependent on the midwives’ ability to respond with relevance to the maternal and neonatal healthcare needs. The attainment of improved maternal and neonatal outcomes commences at the primary healthcare level, with the midwife, recognised as the first person responsible and accountable for pregnant women’s healthcare.</p> <p><strong>Aim:</strong> To explore midwives’ perceptions of their role in the referral of high-risk pregnant women from primary health care clinics to expert-centred sites.</p> <p><strong>Methods:</strong> A qualitative, exploratory, descriptive in nature approach, underpinned by a social constructivism paradigm, guided the methodology. Purposive sampling was used to select both the primary health care clinics in the feeder zone and the registered midwives working in these clinics. Data were collected through four focus group discussions and analysed using content analysis. The principles of trustworthiness were observed.</p> <p><strong>Setting:</strong> Department of Health primary health care clinics in the eThekwini district, South Africa.</p> <p><strong>Results:</strong> The midwives understood their role in the up referral of high-risk pregnant women but experienced many interruptions in its execution. Four categories emerged from the data, namely, enhanced by team support in the clinics, restrictions in transfer to expert-centred sites, impeding social determinants and midwifery competence facilitates referral process.</p> <p><strong>Conclusion:</strong> Global initiatives cannot guarantee maternal and neonatal health because of the challenges experienced by the midwives in the execution of their roles as they interface with the healthcare team.</p> </div> </div> </div> </div> Siyabonga W. Ximba Olivia B. Baloyi Mary Ann Jarvis Copyright (c) 2021-10-12 2021-10-12 26 1 Doctors’, nurses’ and clinical associates’ understanding of emergency care practitioners https://www.ajol.info/index.php/hsa/article/view/215908 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Healthcare professionals’ understanding of the knowledge, skills and training of their counterparts from other disciplines cultivates appreciation and respect within the workplace. This, in turn, results in better teamwork and improved patient care. Emergency departments are places where emergency care practitioners (ECPs) engage with doctors, nurses and clinical associates. Whilst the importance of inter-professional communication and teamwork between in-hospital professionals and pre-hospital emergency care providers is acknowledged, no literature could be found describing exactly how much these in-hospital professionals understand about the training and capabilities of their ECP colleagues.</p> <p><strong>Aim:</strong> The aim of this study was to assess the level of understanding that prospective doctors, nurses and clinical associates have regarding the training and capabilities of ECPs.</p> <p><strong>Setting:</strong> The research was conducted in Johannesburg, South Africa, at two universities. Methods: Seventy-seven participants completed a purpose-designed questionnaire assessing their understanding regarding the education and clinical capabilities of ECPs.</p> <p><strong>Results:</strong> In total, 64% of participants demonstrated a poor understanding of the level of education and clinical capabilities of ECPs. The remaining 36% showed only moderate levels of understanding.</p> <p><strong>Conclusion:</strong> Medical, nursing and clinical associate graduates have a generally poor understanding of the education and clinical capabilities of their ECP colleagues who practise predominantly in the pre-hospital environment. This lack of understanding can become a barrier to effective communication between ECPs and in-hospital staff during patient handover in emergency departments.</p> <p><strong>Contribution:</strong> This research highlights a lack of understanding about the role and function of South African ECPs as pre-hospital emergency care providers and the need for more effective inter-professional education.</p> </div> </div> </div> </div> Craig Vincent-Lambert Dirk Kotzé Copyright (c) 2021-10-12 2021-10-12 26 1 Dietary management practices for type 1 diabetes mellitus by dietitians in KwaZulu-Natal https://www.ajol.info/index.php/hsa/article/view/215912 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> In South Africa, 5% – 15% of diabetics have type 1 diabetes mellitus (T1DM). Dietitians are an important part of the diabetes management team; however, there is a lack of published data on the dietary management practices for T1DM by dietitians.</p> <p><strong>Aim:</strong> The aim of this study was to determine the dietary management practices for T1DM by dietitians in KwaZulu-Natal (KZN).</p> <p><strong>Setting:</strong> This study was conducted in KZN.</p> <p><strong>Methods:</strong> A cross-sectional, descriptive study was conducted using a self-administered electronic questionnaire.</p> <p><strong>Results:</strong> Of the 69 dietitians who participated, 58% (<em>n</em> = 40) used the American Diabetes Association (ADA) guidelines to manage T1DM; just under 35% (<em>n</em> = 24) spent over an hour with new cases; and 87% (<em>n</em> = 60) used face-to-face consultations for follow-up. Dietitians used the glycaemic index, portion control using the healthy eating plate, carbohydrate counting using nutritional labels and household measures and carbohydrate awareness to manage T1DM (<em>p</em> &lt; 0.05). Dietitians also used the healthy eating plate (71%; <em>n</em> = 49) (<em>p</em> &lt; 0.05) and household measures (73.9%; <em>n</em> = 51) (<em>p</em> &lt; 0.05) to manage T1DM. Time constraints, the literacy level of the patient, available resources and language barriers all played a role in determining the dietary management practices used (<em>p</em> &lt; 0.05).</p> <p><strong>Conclusion:</strong> Most dietitians in KZN used the ADA dietary guidelines to manage T1DM, which highlights the need for South African dietary guidelines for the management of T1DM. Dietitians used a variety of different dietary methods to manage T1DM in practice. This suggests that dietitians are flexible in how they manage T1DM with no one particular method being used. A variety of factors also influenced which dietary management practices were chosen.</p> </div> </div> </div> </div> Megan E. Dimitriades Kirthee Pillay Copyright (c) 2021-10-12 2021-10-12 26 1 Experiences of language barriers by homoeopathy student interns providing health services at the University of Johannesburg https://www.ajol.info/index.php/hsa/article/view/215913 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> South Africa is a multilingual society, and therefore, the likelihood of healthcare providers (HCPs), including students training to be HCPs, encountering language barriers with patients is high.</p> <p><strong>Aim:</strong> To explore and describe the experiences of homoeopathy student interns regarding language barriers in the delivery of health services and to provide guidance towards overcoming language barriers in homoeopathic practice at the University of Johannesburg (UJ).</p> <p><strong>Setting:</strong> The interviews and focus group discussions were conducted in English and at a private location that was convenient for the participants in Johannesburg, Gauteng.</p> <p><strong>Methods:</strong> This qualitative study used a phenomenological approach. Ten individual interviews were conducted with registered homoeopathy student interns (HSIs) from the UJ. The central question: ‘What has your experience been regarding language barriers between you and your patients at the UJ Homoeopathy clinics?’ was asked and responses were recorded and transcribed for later analysis. The interview results were presented to a focus group for discussion to validate findings that arose from the analysis and to provide an opportunity to add any insight, comment or recommendations that were not expressed in individual interviews and verification of emergent themes.</p> <p><strong>Results:</strong> Participants described how language barriers create challenges in understanding between patients and HSIs. Descriptions of the experiences of the intrapersonal and interpersonal effects that are associated with language barriers were provided. Participants also described the influence of language barriers on the various aspects of the health service process. Finally, participants described the mitigation of language barriers through various strategies.</p> <p><strong>Conclusion:</strong> Participants reported their experiences of language barriers as challenging. Language barriers were found to adversely affect the various aspects of the health service process as well as the practitioner’s personal feelings and the patient–practitioner relationship. Language acquisition and awareness modules introduced early on in the syllabus is a proposed solution to the mitigation of language barriers.</p> </div> </div> </div> </div> Lorna Blackwell Neil T. Gower Reshma Patel Copyright (c) 2021-10-12 2021-10-12 26 1 Body satisfaction of female staff members working in primary schools in Mangaung, Bloemfontein https://www.ajol.info/index.php/hsa/article/view/215914 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> The role of psychosocial determinants of overweight and obesity is receiving attention in South African literature. South Africans tend to exhibit an inaccurate perception of their body weight.</p> <p><strong>Aims:</strong> The purpose of this study was to determine levels of body satisfaction in female staff members working in primary schools in Mangaung, Bloemfontein.</p> <p><strong>Setting:</strong> Mangaung is a peri-urban area in Bloemfontein in the Free State province of South Africa.</p> <p><strong>Methods:</strong> Female staff members over the age of 18 years were invited to participate in the study. Anthropometric measurements of weight and height were measured using standardised techniques to calculate body mass index (BMI). Waist circumference (WC) was measured as an indicator of risk for non-communicable diseases (NCDs). Weight satisfaction was measured using a structured, self-administered body satisfaction questionnaire.</p> <p><strong>Results:</strong> The majority of the staff members (71.3%) were classified as obese (BMI &gt; 30 kg/m<sup>2</sup>); similarly a majority of them were at a high risk of NCDs according to WC. A little over a third (34.8%) of the women perceived themselves to have a normal weight. The majority of the women who had no concern with their body image were obese (59.1%) and only 8.7% of the women in this study were markedly concerned with their body image. Of the 60.9% of women who reported having attempted to lose weight, 38.6% reported using exercise and 30.0% used water as a weight loss method.</p> <p><strong>Conclusion:</strong> Women’s awareness of a healthy weight should be promoted if efforts to achieve weight loss are to be effective.</p> </div> </div> </div> </div> Ntsoaki L. Meko Mariette Nel Copyright (c) 2021-10-12 2021-10-12 26 1 Health and safety risks affecting part-time nursing students https://www.ajol.info/index.php/hsa/article/view/215916 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Professional nurses who are employed full-time can study their postgraduate programmes part-time to add to the basic qualification they obtained through relevant institutions of higher education like universities or colleges. Although there are advantages for part-time study such as improvement of qualifications, enhancement of personal development and increased chance of promotion, there are disadvantages as well, which includes keeping a job, attending to family and social responsibilities, time management to ensure that studying is done after work or in-between work and other activities, attending to assignments and complying with the requirements to acquire the qualification.</p> <p><strong>Aim:</strong> This study aimed to explore health and safety risks faced by nurses who work and study part-time.</p> <p><strong>Setting:</strong> The study was conducted at a university in Gauteng province, South Africa. Nurses who undertake part-time studies at this university were the focus of study.</p> <p><strong>Method:</strong> The research design used in the study was an exploratory, quantitative method that was contextual in nature. Data were collected using a self-administered questionnaire that comprised of demographical and health and safety aspects. Data were analysed by means of descriptive statistics using the Statistics package for Social Sciences version 26.</p> <p><strong>Results:</strong> Research findings indicated that students who study part-time experience health and safety risks such as fatigue (<em>n</em> = 86; 49%), stress (<em>n</em> = 95; 54%), sleep disorders (<em>n</em> = 60; 34%), poor eating habits (<em>n</em> = 123; 70%), abuse of caffeine (<em>n</em> = 91; 52%) and are prone to road accidents (<em>n</em> = 54; 31%).</p> <p><strong>Conclusion:</strong> Nurses who work and study part-time need support from their employers and families. Employers should grant study leave as a way of support.</p> </div> </div> </div> </div> Lorato G. Manyeneng Mogale L. Pilusa Mmataniele S. Mogotlane Copyright (c) 2021-10-12 2021-10-12 26 1 Experiences of parents of an adolescent with intellectual disability in Giyani, Limpopo province, South Africa https://www.ajol.info/index.php/hsa/article/view/215917 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Parents of adolescents with intellectual disability experienced stress caused by challenges that come from having such adolescents. Those challenges affected the parents physically and emotionally, depending on the severity of the adolescent’s intellectual disability. Having an adolescent with an intellectual disability becomes a burden if the challenges were not resolved.</p> <p><strong>Aim:</strong> This study aimed to explore and describe the experiences of parents of adolescents with intellectual disability in Giyani.</p> <p><strong>Setting:</strong> This study was conducted at the participants’ homes in Giyani, Limpopo province, South Africa.</p> <p><strong>Methods:</strong> A qualitative, exploratory, descriptive and contextual design was utilised. The main question was ‘How is it to have an adolescent with intellectual disability?’ Eight purposively sampled parents participated, and data were collected through in-depth interviews, observations and field notes. Data were analysed by means of thematic coding and an independent coder was consulted.</p> <p><strong>Results:</strong> Four themes were identified. The study revealed that parents of adolescents with intellectual disability experienced negative emotional responses. Most parents reported a lack of support from family members and the community. They also reported caring challenges, yet some showed positive coping mechanisms.</p> <p><strong>Conclusion:</strong> Parents of adolescents with intellectual disability experienced various challenges in caring for these children. A collaborative approach from relevant stakeholders could have a positive impact in supporting the parents of adolescents with intellectual disabilities.</p> </div> </div> </div> </div> Nompumelelo Ntshingila Chris P.H. Myburgh Marie Poggenpoel Tsakani Chauke Copyright (c) 2021-10-12 2021-10-12 26 1 The lived experiences of men who have sex with men when accessing HIV care services in Zimbabwe https://www.ajol.info/index.php/hsa/article/view/215919 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Key populations such as men who have sex with men are disproportionately affected by human immunodeficiency virus (HIV), yet they are underserved. This vulnerable group also faces stigma and discrimination when utilising the healthcare services. However, to achieve the HIV epidemic control, it is important for them to have access to HIV care services.</p> <p><strong>Aim:</strong> The aim of this study was to explore and describe the experiences of men who have sex with men (MSM) as they accessed HIV care services in healthcare settings in Bulawayo, Zimbabwe.</p> <p><strong>Setting:</strong> The study setting was healthcare facilities (state and private owned) in Bulawayo, Zimbabwe, that offer HIV care services.</p> <p><strong>Methods:</strong> The study used a descriptive phenomenological design targeting self-identified MSM living with HIV. Data were gathered by using in-depth individual interviews that were audio recorded. Data saturation determined sample size. Data were transcribed verbatim and later analysed thematically.</p> <p><strong>Results:</strong> The study revealed that counselling given to MSM was generalised and not individualised. Some clients faced stigma and discrimination after disclosure. Peer and family support were important in the journey to access HIV care services.</p> <p><strong>Conclusion:</strong> An enabling environment was not provided for MSM clients to access HIV care services in the majority of health facilities. This calls for sensitisation and competency clinical training of service providers so that the diverse needs of MSM are met. Peer and family support for MSM needs to be strengthened.</p> </div> </div> </div> </div> Idah Moyo Margaret Macherera Azwihangwisi H. Mavhandu-Mudzusi Copyright (c) 2021-10-12 2021-10-12 26 1 Paramedic students’ confidence and satisfaction with clinical simulations of an emergency medical care programme in South Africa: A cross-sectional study https://www.ajol.info/index.php/hsa/article/view/215920 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> There has been an increase in the use of clinical simulations as instructional tools in healthcare education. This is because of their role in ensuring patients’ safety and quality-care provision.</p> <p><strong>Aim:</strong> This study investigated the paramedic students’ satisfaction and self-confidence in the clinical simulation of an emergency medical care programme.</p> <p><strong>Setting:</strong> The study was conducted at the Durban University of Technology in the KwaZulu-Natal Province of South Africa. The paramedic students’ satisfaction and self-confidence in the clinical simulation of an emergency medical care programme were the focus of the study.</p> <p><strong>Methods:</strong> The study used a cross-sectional research design. A convenience sampling method was used to select the 83-paramedic students who participated in the study. Data were collected between July and September 2017 using a structured questionnaire. Descriptive statistics (frequencies and percentages and Spearman’s rank-order correlation coefficient) and an inferential test, ordinal logistic regression analysis, were used for data analysis.</p> <p><strong>Results:</strong> High levels of paramedic students’ satisfaction and self-confidence in simulation activities were reported. Generally, the paramedic students’ demographics were associated with the satisfaction and self-confidence variables with <em>p</em>-values ≤ 0.04. Emergency medical care training undertaken by the paramedic students was significantly associated with self-confidence (<em>p</em> = 0.00).</p> <p><strong>Conclusion:</strong> Clinical simulation can bridge the theory-practice gap for paramedic students. It is a hands-on approach that promotes students learning of clinical skills through reflection.</p> </div> </div> </div> </div> Peter T. Sandy John T. Meyer Oluwaseun S. Oduniyi Azwihangwisi H. Mavhandu-Mudzusi Copyright (c) 2021-10-12 2021-10-12 26 1 Factors related to functional exercise capacity amongst people with HIV in Durban, South Africa https://www.ajol.info/index.php/hsa/article/view/215921 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> People with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.</p> <p><strong>Aim:</strong> To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.</p> <p><strong>Setting:</strong> Respondents (<em>N</em> = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.</p> <p><strong>Methods:</strong> Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent’s medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m<sup>2</sup>); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).</p> <p><strong>Results:</strong> On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.</p> <p><strong>Conclusion:</strong> South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.</p> </div> </div> </div> </div> Penelope M. Orton Dudu G. Sokhela Kathleen M. Nokes Joseph D. Perazzo Allison R. Webel Copyright (c) 2021-10-12 2021-10-12 26 1 Perspectives on waiting times in an antenatal clinic: A case study in the Western Cape https://www.ajol.info/index.php/hsa/article/view/215922 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Antenatal care (ANC) is vital in reducing maternal and neonatal morbidity and mortality. Globally, 85% of women had one ANC visit with a skilled birth attendant and only 58% received the recommended four ANC visits. Long waiting times (LWTs) in the antenatal clinic affects the utilisation of the service. Long waiting times are viewed as a significant barrier to ANC utilisation and needs further investigation.</p> <p><strong>Aim:</strong> The aim of this study was to explore and describe the contextual realities within the antenatal clinic that influenced waiting times (WTs).</p> <p><strong>Setting:</strong> This study was conducted in an antenatal clinic, within a Midwife Obstetric Unit (MOU), Western Cape, South Africa.</p> <p><strong>Methods:</strong> This study utilised a qualitative methodology with a single case study design with three embedded units of analysis. Purposive sampling was used to recruit the participants. Data were collected through unstructured observation and semi-structured interviews with pregnant women and midwives. Interviews were audio recorded, transcribed and analysed using the framework method.</p> <p><strong>Results:</strong> The antenatal clinics had LWTs. The barriers to WTs were related to staff factors, patient factors, operational factors, communication, equipment and infrastructure and other research participant recruitment.</p> <p><strong>Conclusion:</strong> The factors that influenced WTs are multifaceted and interrelated. Many of the factors influencing the WTs could be remedied by implementing appropriate workflow strategies, improving communication and increasing equipment availability. The findings can be used to develop waiting time guidelines and improve WTs in the antenatal clinic.</p> </div> </div> </div> </div> Justine C. Baron Doreen Kaura Copyright (c) 2021-10-12 2021-10-12 26 1 Antibiotic use amongst pregnant women in a public hospital in KwaZulu-Natal https://www.ajol.info/index.php/hsa/article/view/215923 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Antibiotics are amongst the more frequently prescribed medicines in pregnant women and the use of antibiotics is increasing. However, with limited studies available in this population, the safe use of antibiotics in pregnancy remains a concern.</p> <p><strong>Aim:</strong> To evaluate the use of antibiotics amongst pregnant women attending a public health care facility. The main objective of this study was to quantify the types of antibiotics used in pregnant women.</p> <p><strong>Setting:</strong> A public hospital classified as a referral hospital located in Durban, KwaZulu-Natal.</p> <p><strong>Methods:</strong> Demographic and treatment information of women were collected retrospectively from January 2019 to July 2019. A total of 184 pregnant patients, who received antibiotic therapy, were included in this study. Descriptive and analytical measures were used to analyse both patient demographics and treatment variables.</p> <p><strong>Results:</strong> A total of 416 antibiotic prescriptions, issued to 184 patients, were reviewed. Penicillins (39.7%), macrolides (13.0%) and combination penicillin- and beta-lactam inhibitors (12.3%) were reported as the most commonly prescribed antibiotics. Rifamycin (2.9%), hydrazides (2.2%) and aminoglycosides (1.9%) were less frequently prescribed. Most antibiotics were prescribed for diseases of the circulatory system (36.1%).</p> <p><strong>Conclusion:</strong> Several classes of antibiotics were used in pregnancy despite the lack of available safety data and clinical evidence. Informing women of the potential side effects and keeping abreast with new information played an important role in the safe, rational and effective use of medicines that contributed to improving maternal health.</p> </div> </div> </div> </div> Sasha Naidoo Varsha Bangalee Frasia Oosthuizen Copyright (c) 2021-10-12 2021-10-12 26 1 Experience of midwives in providing care to labouring women in varied healthcare settings: A qualitative study https://www.ajol.info/index.php/hsa/article/view/215924 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Midwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care.</p> <p><strong>Aim:</strong> This research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings.</p> <p><strong>Setting:</strong> Midwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital.</p> <p><strong>Methods:</strong> A convenience sample of midwives (N = 10) were interviewed. An exploratory and descriptive design, with individual semi-structured interviews conducted, asked a primary question: ‘How is it for you to be a midwife in South Africa?’ Transcribed interviews were analysed using thematic coding.</p> <p><strong>Results:</strong> Five themes were found: proud to be a midwife, regulations and independent function, resource availability, work burden and image of the midwife.</p> <p><strong>Conclusion:</strong> Midwives struggle within systems that fail to allow independent functioning, disallowing a voice in making decisions and creating change. Regardless of practice setting, midwives expressed frustration with policies that prevented utilisation consistent with scope of practice, as well as an inability to practice the midwifery model of care. Those in public settings expressed concern with restricted resource appropriation. Similarly, there is clear need to upscale midwifery education and to establish care competencies to be met in providing clinical services.</p> <p><strong>Contribution:</strong> This research provides evidence of the midwifery experience with implications for needed health policy change.</p> </div> </div> </div> </div> Marie Hastings-Tolsma Annie Temane Oslinah B. Tagutanazvo Sanele Lukhele Anna G. Nolte Copyright (c) 2021-10-12 2021-10-12 26 1 Overcoming communication barriers in a multicultural radiography setting https://www.ajol.info/index.php/hsa/article/view/215925 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Effective communication between the patients and radiographers can be a daunting task in a multicultural, multilingual environment. With 11 official languages, South Africans experience language barriers amongst themselves, which pose unique communication challenges on a daily basis. It is thus important to explore how radiographers overcome such challenges to provide an effective service to their patients.</p> <p><strong>Aim:</strong> The aim of this study was to explore and describe the experiences of radiographers in Gauteng province in communicating with patients in a multilingual, multicultural healthcare setting and make recommendations towards overcoming such barriers.</p> <p><strong>Setting:</strong> The focus group discussions were conducted in English and at a private location that was convenient for the participants in Gauteng.</p> <p><strong>Method:</strong> The study employed a qualitative phenomenological approach using focus group interviews (FGIs) to solicit the experiences of participants and gain an in-depth understanding of the phenomenon.</p> <p><strong>Results:</strong> The findings showed that patient–radiographer cross-cultural communication is ineffective whilst language barriers are encountered daily. Participants subsequently offered a number of recommendations to enhance communication with patients from different cultural and linguistic backgrounds. These included workshops or short courses to improve language skills, posters to allow for non-verbal communication, the use of professional interpreters or mobile translation technology, employment of a diverse workforce and a focus on cultural sensitivity and learning an additional language at tertiary level.</p> <p><strong>Conclusion:</strong> Although a variety of communication strategies are available, the most appropriate combination should be explored for individual radiology practices in order to serve their respective diverse patient base. Recommendations that emanated from this study can, therefore, be used as a guide to radiology practices to facilitate effective patient–radiographer communication.</p> </div> </div> </div> </div> Cherise Janse van Vuuren Barbara van Dyk Padidi L. Mokoena Copyright (c) 2021-10-12 2021-10-12 26 1 Perceptions of mental health nurses about psychosocial management of depression in adolescents, North West province, South Africa https://www.ajol.info/index.php/hsa/article/view/215926 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p><strong>Background:</strong> Depression in adolescents is a multifactorial global public health concern, with devastating consequences on the sufferer. The prevalence of depression amongst this age group is on the rise, and thus there is the need for greater attention.</p> <p><strong>Aim:</strong> To explore and describe the perceptions of mental health nurses regarding the psychosocial management of depression in adolescents in North West province, South Africa.</p> <p><strong>Setting:</strong> The study was conducted in two mental healthcare institutions and two mental healthcare units within two general hospitals in North West province, South Africa.</p> <p><strong>Method:</strong> A qualitative, explorative, descriptive and contextual research design was used in conducting this study. Data were collected through focus group discussions from four groups of mental health nurses from each of the mental healthcare institutions and mental healthcare units with 18 mental health nurses. Data were analysed using Tesch’s open coding method.</p> <p><strong>Results:</strong> Two themes emerged from the study: comprehensive psychosocial management and involvement of different stakeholders.</p> <p><strong>Conclusion:</strong> The findings revealed clear psychosocial management for depression in adolescents. Adopting the findings of this study could improve depressive symptoms and curtail the prevalence of depression amongst adolescents in the North West province, South Africa.</p> </div> </div> </div> </div> Precious C. Chukwuere Leepile A. Sehularo Mofatiki E. Manyedi Copyright (c) 2021-10-12 2021-10-12 26 1 Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review https://www.ajol.info/index.php/hsa/article/view/215927 <div class="page" title="Page 1"> <div class="section"> <div class="layoutArea"> <div class="column"> <p>Lesbian, gay, bisexual and transgender (LGBT) individuals are often stigmatised and discriminated against. This population is expected to experience poorer mental health outcomes compared with heterosexual and cis-gendered people, a phenomenon healthcare providers need to take note of and act upon. This study aimed to explore and describe the mental health challenges of LGBT people. An integrative literature search was conducted. The following electronic databases were searched: Academic Search Premier, Africa-Wide Information, Business Source Premier, eBook Collection (EBSCOhost), E-Journals, ERIC, Family &amp; Society Studies Worldwide, Health Source: Nursing/Academic Edition, Humanities Source, MasterFILE Premier, MEDLINE, PsycARTICLES, Social Work Abstracts, TOC Premier, WorldCat.org, Taylor and Francis Journals, Biomed Central and Wiley Online Library. An internet search was also carried out using Google and Google Scholar databases. The following search terms were identified: ‘LGBT’ OR ‘LGBT community’ AND ‘mental health challenges/problems’ OR ‘mental/psychiatric illness’. The reviewed literature comprised research conducted globally between 2010 and 2019. From the 2545 titles, 345 abstracts were examined, resulting in 57 articles. The 57 full-text articles were examined to verify whether they addressed the scope of the literature review, of them, 21 addressed the mental health challenges of LGBT people. Lesbian, gay, bisexual and transgender people experience the following mental health challenges: emotional distress, stigmatisation, victimisation, discrimination and barriers to accessing healthcare services. The results showed that although LGBT has been legalised in many countries, LGBT communities still experience significant mental health challenges. Healthcare providers are in a position to address challenges related to social and healthcare structures and act as advocates in order to promote the mental health of LGBT individuals.</p> </div> </div> </div> </div> Miriam M. Moagi Anna E. van Der Wath Priscilla M. Jiyane Richard S. Rikhotso Copyright (c) 2021-10-12 2021-10-12 26 1