Existing and evolving in two minds : beliefs in relation to health and illness expressed by older South Africans

The aim of the study was to illuminate beliefs in relation to health and illness expressed by older Africans within the context of a society in transition, namely South Africa. An ethnographic research approach influenced by the interpretive phenomenological tradition was selected to gain an understanding of the participants’ experiences. A focused ethnographic design was employed, using group and individual in-depth interviews and participant observations. Sixteen elderly persons (ten females and six males) from Hammanskraal, a rural area north of Pretoria, were involved in the research. The findings illuminate a world understanding where body and mind are inseparable and relationships provide the foundation for improving and maintaining health and being cured from illness. The ongoing transition that the elderly in South Africa experience influences health and illness beliefs, with a need to adapt to existing parallel health care systems, Western biomedicine and African traditional medicine. As the study draws attention to the importance of caring for the elderly to be contextualised, it is recommended that the care of the elderly be applied to the unique needs of the individual involved. Failure to do so may otherwise have severe consequences such as an apparent high risk of developing stereotypes, which can lead to cultural misunderstandings, prejudice and discrimination.The research was funded by grants from the Nordic Africa Institute, Uppsala, Sweden and Blekinge Institute of Technology, Sweden.http://www.unisa.ac.za/Default.asp?Cmd=ViewContent&ContentID=24782http://reference.sabinet.co.za/sa_epublication/ajnmam201

Primary healthcare nurses' experiences of physical activity referrals: an interview study.

Aim The aim of this study is to illuminate primary health care (PHC) nurses' experiences of physical activity referrals (PARs)

Public health care nurses' views of mothers' mental health in paediatric healthcare services: a qualitative study.

Aim To investigate public health nurses' perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services

Older individuals’ need for knowledge and follow-up about their chronic atrial fibrillation, lifelong medical treatment and medical controls

Older individuals with chronic atrial fibrillation (AF) often experience physical symptoms and feel psychologically unwell. In addition, these persons are prescribed lifelong medical treatment that requires regular monitoring. Through 11 individual interviews, this interpretive description study aimed to explore and describe lifelong medical treatment and the need for medical controls as experienced from the perspective of older individuals living with chronic AF. The interviews were performed during 2014–2015; furthermore, they were recorded, transcribed verbatim and analysed for thematic patterns using thematic analysis inspired by Braun and Clarke. Ethical standards were followed throughout the study. The findings revealed one main theme: ‘ambivalence in the need of knowledge’ showing that lifelong medical treatment and the need for medical controls, in general, meant experiencing feelings of ‘it doesn't matter, but it does matter’ and ‘being in the hands of the healthcare system’. The older persons lacked knowledge about their condition, which generated poor insight into their medical treatment and this in turn affected their daily life. They had thoughts and questions about their medication, but did not have an opportunity to ask the questions because of lack of follow-up from the healthcare system. The findings underscore the negative impact chronic AF has on older people's life and emphasises the need for follow-up and providing information from health care to these individuals

"We clean our houses, prepare for weddings and go to funerals" : daily lives of elderly Africans in Majaneng, South Africa

This ethnographic study aims to identify and describe how a group of elderly African people in South Africa experience their daily life and related concerns and interests. Data were collected through group interviews involving 16 elderly persons and complementary field observations. The data were analysed using a qualitative content analysis. From the analysis following sub-themes emerged: 1. Lack of basic resources; 2. Routines in daily life; 3. Experience of unsafe conditions; 4. “The disease”HIV/AIDS. The results have been discussed according to the following themes: keeping normality and changing society. The study illuminates the varied experiences in daily life, including lack of basic resources, experience of unsafe conditions, and the HIV/AIDS pandemic and its consequences for the elderly as contributors to the extended family.The research and work on this manuscript was supported by grants from the Nordic Africa Institute, Uppsala, Sweden. The authors gratefully acknowledge the assistance of Dorricha Peu, lecturer at the University of Pretoria, and of Alan Crozier for revising the English

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

Purpose: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom®. Methods: Two hundred elderly persons aged 66–93 years were recruited from the Swedish National Study on Aging and Care in 2010–2013, and data were collected via wireless LTR ECG-BodyKom. Results: Screening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60–80 years) and older (≥80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it. Conclusion: The increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment

Prevalence and Incidence of Atrial Fibrillation and Other Arrhythmias in the General Older Population : Findings From the Swedish National Study on Aging and Care

Aim: To study the prevalence and cumulative incidence of arrhythmias in the general population of adults aged 60 and older over a 6-year period. Study Design and Setting: Data were taken from the Swedish National Study on Aging and Care (SNAC), a national, longitudinal, multidisciplinary study of the general elderly population (defined as 60 years of age or older). A 12-lead resting electrocardiography (ECG) was performed at baseline and 6-year follow-up. Results: The baseline prevalence of atrial fibrillation (AF) was 4.9% (95% confidence interval [CI] = [4.5%, 5.5%]), and other arrhythmias including ventricular premature complexes (VPCs), supraventricular tachycardia (SVT), and supraventricular extrasystole (SVES) were seen in 8.4% (7.7%, 9.0%) of the population. A first- or second-degree atrioventricular (AV) block was found in 7.1% of the population (95% CI = [6.5%, 7.7%]), and there were no significant differences between men and women in baseline arrhythmia prevalence. The 6-year cumulative incidence of AF was 4.1% (95% CI = [3.5%, 4.9%]), or 6.9/1,000 person-years (py; 95% CI = [5.7, 8.0]). The incidence of AF, other arrhythmias, AV block, and pacemaker-induced rhythm was significantly higher in men in all cohorts except for the oldest. Conclusion: Our data highlight the prevalence and incidence of arrhythmias, which rapidly increase with advancing age in the general population