Motivating behaviour change in the diabetic patient

No Abstract

The effects of a language barrier in a South African district hospital

The original publication is available at http://www.samj.org.zaCITATION: Schlemmer, A., Mash, B. 2006. The effects of a language barrier in a South African district hospital. South African Medical Journal, 96(10):1080-1087.Background. Communication between health workers and patients at Hottentots Holland Hospital (HHH) is hindered by staff and patients not speaking the same language. HHH is a district hospital in the Cape Town Metropolitan District of the Western Cape where staff mainly speak Afrikaans or English and a large number of patients mainly Xhosa. Objectives. The study aimed to explore the effects of this language barrier on health workers and patients at HHH. Design. Three focus group interviews were held with 21 members of staff and 5 in-depth patient interviews were conducted. Results. The language barrier was found to interfere with working efficiently, create uncertainty about the accuracy of interpretation, be enhanced by a lack of education or training, cause significant ethical dilemmas, negatively influence the attitudes of patients and staff towards each other, decrease the quality of and satisfaction with care, and cause cross-cultural misunderstandings. Conclusion. The effects of the language barrier were considerable and persistent despite an official language policy in the province. The training and employment of professional interpreters as well as teaching of basic Xhosa to staff are recommended.Publisher’s versio

Participatory development of a minimum dataset for the Khayelitsha district

Background. Traditional 'data-led' information systems have created excessive amounts of poor-quality and poorly utilised data. The Health Information Systems Pilot Project (HISPP), a Western Cape project that started in 1996, initiated a process in one of its three pilot sites to model an alternative approach to developing a district health information system.Objective. To develop a minimum dataset for Khayelitsha as part of an action-led district health and management information system in a participatory 'bottom-up' process.Method, The HISPP, in conjunction with health workers in the proposed Khayelitsha district, developed a minimum dataset through a process of defining local goals, targets and indicators. This dataset was integrated with data requirements at regional and provincial levels,Results. A minimum dataset was produced that defined all the data needed according to the frequency of reporting and the level at which it was required.Conclusion, The HISPP has demonstrated an alternative model for defining health information needs at district level. This participatory process has enabled health workers to appraise their own information needs critically and has encouraged local use of information for planning and action

Evaluation of a school-based nutrition and physical activity programme for Grade 4 learners in the Western Cape province

Objective: This study aimed to evaluate the effectiveness of the Making the Difference programme (MTDP), an educationand activity-based intervention for Grade 4 learners at primary schools in the Western Cape.Design: This was a cross-sectional, post-intervention survey of an existing programme, using control schools as a comparator.Setting and subjects: The study involved Western Cape primary schools in the 2009 school year. Schools were randomly sampled from two regions. Four intervention (active in the MTDP) and five control (non-participating) schools (n = 325 learners) were selected.Outcome measures: The following outcome measures were assessed using an administered questionnaire to learners: learners’ knowledge of, attitudes towards, and behaviour in relation to nutrition and physical activity.Results: A small but significant improvement (eating vegetables and taking lunch boxes to school) was demonstrated with regard to self-reported behaviour in relation to nutrition in the intervention group. However, this behaviour was not explained by differences in barriers to healthy eating, self-efficacy or knowledge, which were not different between the groups, or by perceived social support, which was actually significantly increased in the control group. Groups displayed no differences in physical activity or sedentary behaviour. However, the results showed a significant difference between the groups in terms of a reduction in perceived barriers to physical activity and increased physical activity self-efficacy in the active group.Conclusion: While the MTDP only had a modest effect on the self-reported nutrition and physical activity behaviour of the learners, results regarding lower perceived barriers to physical activity and increased physical activity self-efficacy were promising

Mastering your Fellowship

The new series, “Mastering your Fellowship”, provides examples of the question format encountered in the written examination, Part I of the FCFP(SA) examination. Examples of these question types (according to a theme) will be given in each printed edition of the journal. “General adult medicine” is the theme for this edition and model answers will be available online, but not in the printed edition.Keywords: FCFP(SA) examination, registrars, general adult medicin

EDITORIAL: Mastering your Fellowship

No Abstract

Mastering your Fellowship

The new series, “Mastering your Fellowship”, will provide examples of the question format encountered in the written examination, Part I of the FCFP(SA) examination. Examples of these question types (according to a theme) will be given in each printed edition of the journal. Women’s health is the theme for the first article. Model answers will be available online, but not in the printed edition.Keywords: FCFP(SA) examination, registrars, women’s healt

Outcomes for family medicine postgraduate training in South Africa

After 1994, the post-apartheid government decided that primary health care and the district health system would be the cornerstone of their new health policy. As a consequence of this, the academic departments of Family Medicine and primary care recognised the need for a nationally agreed set of training outcomes that were more aligned with these new priorities within the public sector. Thus in 2001, the Family Medicine Education Consortium (FaMEC), representing the eight academic departments of family medicine in South Africa, agreed to a set of outcomes for postgraduate family medicine training. At that time, all departments were running Family Medicine Master’s programmes as part-time training courses for doctors in primary health care. Recognition of the need to move towards full-time registrar training already existed, and because of this steps were taken to register Family Medicine as a speciality with the Health Professions Council of South Africa (HPCSA)

Quality of care for intimate partner violence in South African primary care : a qualitative study

CITATION: Joyner, K. & Mash, B. 2014. Quality of care for intimate partner violence in South African primary care : a qualitative study. Violence and Victims, 29(4):652-669.The original publication is available at http://www.springerpub.com/violence-and-victims.htmlENGLISH SUMMARY : Intimate partner violence (IPV) makes a substantial contribution to the burden of disease in South Africa. This article explores the current quality of care for IPV in public sector primary care facilities within the Western Cape. Only 10% of women attending primary care, while suffering from IPV, were recognized. Case studies, based on in-depth interviews and medical records, were used to reflect on the quality of care received among the women who were recognized. Care tended to be superficial, fragmented, poorly coordinated, and lacking in continuity. The recognition, management, and appropriate documentation of IPV should be prioritized within the training of primary care providers. It may be necessary to appoint IPV champions within primary care to ensure comprehensive care for survivors of IPV.Post prin

Evaluation of a school-based nutrition and physical activity programme for Grade 4 learners in the Western Cape province

Objective: This study aimed to evaluate the effectiveness of the Making the Difference programme (MTDP), an education-and activity-based intervention for Grade 4 learners at primary schools in the Western Cape. Design: This was a cross-sectional, post-intervention survey of an existing programme, using control schools as a comparator. Setting and subjects: The study involved Western Cape primary schools in the 2009 school year. Schools were randomly sampled from two regions. Four intervention (active in the MTDP) and five control (non-participating) schools (n = 325 learners) were selected. Outcome measures: The following outcome measures were assessed using an administered questionnaire to learners: learners' knowledge of, attitudes towards, and behaviour in relation to nutrition and physical activity. Results: A small but significant improvement (eating vegetables and taking lunch boxes to school) was demonstrated with regard to self-reported behaviour in relation to nutrition in the intervention group. However, this behaviour was not explained by differences in barriers to healthy eating, self-efficacy or knowledge, which were not different between the groups, or by perceived social support, which was actually significantly increased in the control group. Groups displayed no differences in physical activity or sedentary behaviour. However, the results showed a significant difference between the groups in terms of a reduction in perceived barriers to physical activity and increased physical activity self-efficacy in the active group. Conclusion: While the MTDP only had a modest effect on the self-reported nutrition and physical activity behaviour of the learners, results regarding lower perceived barriers to physical activity and increased physical activity self-efficacy were promising