Profile of registrars and reasons for specialisation

Introduction The shortage of general practitioners is a worldwide phenomenon and occurs in countries such as Canada, the United States of America and Saudi Arabia. Increasingly fewer students are interested in general practice as an occupation. Choosing a speciality is a complex process and is dependent on a wide range of intrinsic and extrinsic factors, including preference at the start of studies, experience during undergraduate training, and environmental factors such as cultural and socio-economic background. The aim of this study was to determine the profile of registrars at the Faculty of Health Sciences (University of the Free State), as well as their reasons for specialisation.MethodAll departments were contacted and the first author circulated questionnaires and informed consent forms during the academic afternoons. Questionnaires and informed consent forms were available in Afrikaans and English.ResultsOf the 150 questionnaires handed out, 109 were used for analysis (122 were received, of which 13 were incomplete). Most of the respondents were Afrikaans speaking (81.7%), male (68.8%), with a median age of 31 years (range 26 to 50 years), and married (67.6%). Only 13.8% of the respondents' fathers were medical doctors, 54.5% of which were general practitioners. Few respondents (13.8%) had needed to repeat any of their undergraduate studies, while 23.9% had received academic prizes. Most (91.7%) had completed family medicine during rotation in undergraduate training. The main specialisation areas were internal medicine, obstetrics and gynaecology, and radiology. Many respondents (76.9%) had worked in general practice or primary care for a median of two years (range 0.25 to 18 years). The main reasons for leaving primary care were overwork, wanting to function at a higher level, and that they saw no pathologies. Half of the respondents (49.9%) had never considered private practice as an occupation and the main reasons given were type of work and patient, no future for general practitioners, legislation, and inconvenient hours.ConclusionThis study provides some indicators as to why fewer doctors are willing to work as general practitioners or primaryhealthcare physicians. An excessive workload in the primary healthcare setting was indicated by 31.3% of the respondents as the major reason why they chose not to stay.For full text, click here:SA Fam Pract 2006;48(4):15-15

Is pregnancy termination being used as a family planning method in the Free State?

Background: This study determined the profile of women seeking termination of pregnancy (TOP) in the Free State and whether TOP was used as a family planning method. Methods: Seven hundred and fifty women (15-47 years old) seeking TOP at the Reproductive Health Unit of the National Hospital in Bloemfontein were included in this cross-sectional study. The women who gave verbal consent completed a questionnaire during counselling. Results: The median age of the participants was 24 years and 77.3% were single. Most participants (73.3%) were not using any family planning method at the time of the study. One-fifth (19.1%) had previously had at least one TOP, while for 80.9% of the participants it was their first visit. Some participants (16.6%) considered TOP a family planning method, 39.7% were unsure and 43.7% indicated that TOP is not a family planning method. Thirty-nine women failed to answer this question. When asked the reason for TOP, 3.5% chose the option “contraceptive method”. Conclusions: The relatively high percentage of participants who consider TOP a contraceptive method or are unsure, associated with the fact that most were young, single, not using contraception and had applied for induced abortion just because the conception represented an unwanted pregnancy, implies that some of our population is not aware that termination of pregnancy is not a family planning method. Keywords: termination of pregnancy, family planning methodSouth African Family Practice Vol. 47(5) 2005: 52-5

Knowledge of sexually transmitted diseases and HIV/AIDS symptoms of women receiving termination of pregnancy, Bloemfontein

In 2002, we conducted a cross-sectional study to determine the profile of women seeking termination of pregnancy (TOP) in the Free State and to find out whether TOP was being used as a family planning method. The participants' contraceptive use and termination of pregnancy profile have been described elsewhere.1 This letter describes the knowledge of STD and HIV/AIDS symptoms of women seeking TOP. Seven hundred and fifty consecutive women between 15 and 47 years of age who visited the Reproductive Health Unit at National Hospital (Bloemfontein) for the purpose of termination of pregnancy (TOP) from April to November 2002 were included in this study. A nurse opened a file for each woman arriving at the Reproductive Health Unit before the doctor's examination during which the gestational age was determined.For full text, click here:SA Fam Pract 2006;48(3):17-1

Injuries in children and adolescents seen during 2006 at the emergency department of the National District Hospital, Bloemfontein

Background: Most children and adolescents recover fully from injuries. However, permanent disabilities may occur. The objective of the study was to investigate the prevalence and profile of injuries in children and adolescents five to 19 years of age seen at the emergency department of the National District Hospital in Bloemfontein.Methods: A retrospective descriptive study was conducted. Demographic and injury-specific information obtained from hospital records of 2006 was entered into a data-capturing form. Data were analysed by using descriptive statistics. Results: The prevalence of injuries in this age group was 20.3%. Two hundred and nine records were investigated. The majority of cases were male (68.3%). The median age was 15 years, and 43.5% of injuries occurred in the age group 15 to 19 years. Approximately half (51.7%) were Afrikaans-speaking and resided in suburban areas (50%). Most injuries occurred at home (40.2%) between 12h00 and 17h00 (38.7%). Falls (33.7%) were the most common cause of injury. Soft tissue injuries (35.9%) occurred most commonly, fol lowed by lacerations (33.0%) and fractures (16.7%). Upper limb injuries (42.1%) were seen more than lower limb injuries (27.8%). Facial injuries occurred in 12% of cases. X-rays were performed in 57.9% of cases. Most patients (93.3%) received medication, while 22% were referred for specialist treatment. All cases except one were discharged from the emergency department. Parents accompanied patients in 65.6% of cases.Conclusions: Optimal treatment should be given to the injured child or adolescent to avoid possible long-term injuryrelated sequelae. Preventive strategies should be formulated, enforced and evaluated.Keywords: injuries; children; adolescents; prevalence; preventio

Use of traditional medicine versus use of the community-based primary health care clinic by the San community at Platfontein

Introduction: Working amongst a San community led to the observation that, despite the availability of modern healthcare, high mortality and morbidity associated with disease, such as dehydration, malnutrition and tuberculosis, still prevailed.This study aimed to determine how traditional beliefs and customs influenced the utilisation of Western medicine. Methods: An observational-descriptive study was conducted. Consenting patients, facilitated by interpreters, completed questionnaires during consultations conducted by nurses and the principal investigator at the Platfontein primary healthcare (PHC) clinic. Results: Of the 113 participants, two-thirds were female. The median age was 40 years; 56.7% lacked formal education; 42.5% conversed only in their native tongue. The initial use of the PHC facility was high (71.4%), even though 37% of the participants visited a traditional healer in the preceding year. Circumcision was the condition for which traditional healers were consulted most commonly (28.8%). Conditions preferably requiring clinic visitation were coughing (51.4%), pain (35.1%) and diarrhoea (34.2%). Of the participants leading mostly a traditional lifestyle (n = 48), 30.6 % indicated that they did not use traditional medicine or healers; 72.9% indicated that illness could be caused by a spell. Of the participantsnot leading a traditional lifestyle (n = 41), 85.4% indicated that they did not use traditional medicine; 41.4% indicated that illness could be caused by a spell.Conclusion: The assumption that the mortality and morbidity observed for certain conditions were due to the preference for traditional medicine in this community could not be confirmed. Doctors working amongst isolated communities or in multicultural environments, however, should recognise that traditional medicine still plays a role in the health care of their patients.Keywords: assumptions; perceptions; modern medicine; Western medicine; traditional healers; San community; Khoisa

The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students’ clinical skills training programme. The aim of this study was to assess the students’ perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process.Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire.Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations.Conclusion: Students were positive about practising immunisation techniques on their peers.SA Fam Pract 2005;47(4): 54-5

The prevalence and perception of obesity and its association with the lifestyle of women at the Mangaung University Community Partnership Project healthcare centre, Bloemfontein

Background: This investigation was prompted by the increase of obesity in developing countries with the simultaneous increased risk of preventable noncommunicable diseases. We aimed to determine the prevalence of obesity among women serving a predominantly black peri-urban community, who visited a healthcare centre in Bloemfontein. We also wanted to establish their perceived weight status, and any correlation between obesity, level of education, employment status and monthly income. Method: A cross-sectional analytical design was used. In June 2007, clinic-attending women aged 18-50 years were selected by a systematic sampling method to participate in the study. A self-administered questionnaire investigated participants’ socio-economic status, body image perception, psychological well-being, self-reported health status and physical activity. Body mass indices (BMIs) were calculated from weight and height measurements. Results: A total of 304 women completed the study, of whom 98 (32.2%) were overweight and 134 (44.1%) were obese, with a mean BMI of 30.1 kg/m2 [standard deviation (SD) 6.9 kg/m2]. More than half (53.4%) of the obese women perceived themselves as not obese. Approximately 84% of the participants were educated to secondary level, or higher. A significant difference in the employment status of the obese and non-obese participants (26.9% and 16.5% employed, respectively) was noted (p-value = 0.0013). The obese participants reported significantly less low self-esteem (29.5%) than the nonobese participants (42.4%) (p-value = 0.0250). Conclusion: The high prevalence of overweight and obesity, and the fact that 53.4% of the obese participants did not perceive themselves as such, poses a challenge for healthcare providers. Health-promotion strategies should aim to inform women about the health risks of overweight and obesity, and address misconceptions regarding perceived weight status.Keywords: overweight, obesity, women, socio-economic status, perceived weight statu

High school students\' attitudes, practices and knowledge of contraception in Jozini, KwaZulu-Natal

This study assessed the knowledge, attitudes and practices of contraception and sexual awareness amongst high school pupils in rural KwaZulu-Natal. Two hundred males and 200 females from five high schools in the Jozini district completed confidential, self-administered questionnaires in isiZulu