Psychosocial challenges of children with disabilities in Sekhukhune District, Limpopo province of South Africa: Towards a responsive integrated disability strategy

Disability, and everything it encompasses, presents major challenges to individuals, families and communities worldwide. Children with disabilities (CWD) are marginalised and excluded in most societies. Discrimination and prejudice towards CWD are compounded by poverty, lack of essential services and support and sometimes a hostile and inaccessible environment. Objectives: The study sought to examine the psychosocial challenges experienced by CWD in the Sekhukhune district of Limpopo province, South Africa. Based on the identified, articulated and expressed challenges, the study sought to recommend improvement of the existing Integrated National Disability Strategy (INDS) for greater responsiveness to the needs of CWD at both provincial and local levels. Method: The interpretivist qualitative mode of enquiry was the chosen methodology for this study. Phenomenology and descriptive research designs guided the study. Purposive sampling was employed, and data were collected from 36 participants using three triangulated methods: individual in-depth interviews, focus group discussions and key informant interviews. Thematic data analysis was used to analyze data. Results: The findings revealed that CWD in Sekhukhune experienced numerous challenges which affected their social functioning, development and general well-being. Aggravating factors included stigma, labelling and discrimination; disability-specific discrimination and bullying; exclusive education; sexual exploitation; lack of governmental support and poor implementation of disability-specific policies, amongst others. Conclusion: The provisions of the INDS to promote inclusion, integration, mainstreaming and equitable access to resources and services remained an ideal rather than a reality for CWD in Sekhukhune.

The professionalism of psychiatry registrars as perceived by patients and various health practitioners at Weskoppies Psychiatric Hospital, Pretoria

Objectives: Amidst calls for improved professionalism, this study examined the professionalism of psychiatry registrars at Weskoppies Hospital as evaluated by their patients, themselves, their consultants and other health practitioners. The second objective was to examine the perceived importance of aspects of professionalism and compare these descriptively among the various health practitioners and patients. Method: Participants completed the Professionalism Mini-Evaluation Exercise Questionnaire in evaluating the professionalism of the registrar. The number of questionnaires completed by patients, allied health practitioners, consultant psychiatrists and psychiatry registrars were, respectively, 100, 50, 25 and 20; thus, 195 in total. This previously validated questionnaire consists of 21 items that enquire about doctor-patient relationship skills, reflective skills, time management and interprofessional relationship skills. Participants also ranked the three items of the questionnaire that they considered most important. Results: Highly statistically significant differences among four groups emerged for both the total and all four subscale scores, with patients generally rating the professionalism of registrars as lower, and not meeting with expectations. All four groups ranked 'listened actively to patient' and 'showed interest in patient as person' highly. Patients and allied health practitioners ranked the attribute 'was on time' highly, while consultants and registrars did not. Conclusion: Improving professionalism requires that the attributes 'listening actively to patient' and 'recognising and meeting patient needs' are taken seriously. Doing so requires that patients also evaluate the professionalism of registrars, rather than relying merely on the evaluation by consultants as being sufficien

Medical students' views on the use of video technology in the teaching of isizulu communication; language skills and cultural competence

The role of communicator has been included as a key competency for health science students in South Africa. Owing to the population's diverse language and cultural backgrounds; communication between patients and healthcare professionals is challenging. In this study; the Attention; generation; Emotion and Spacing (AGES) neurocognitive model of learning was used as a framework to create videos for language teaching for the vocational needs of students. Objectives. To explore students' views on the use of videos of simulated clinical scenarios for isiZulu communication and language teaching and the development of cultural awareness. Methods. Videos were developed using first- and second-language isiZulu speakers with scripts (verified by the university's Language Board) based on authentic clinical settings. Videos were shown to a target group of students; who were then interviewed in focus group discussions. Audio recordings from the discussions were transcribed and analysed thematically in three categories; i.e. communication; language skills; and cultural awareness; using deductive coding based on the objectives of the research. Results. Students affirmed numerous benefits of the videos and commented on their use and further development. Benefits described related well to the AGES model of learning and fulfilled the learning requirements of communication teaching; language acquisition and cultural awareness. Conclusion. The videos represent an innovative teaching method for the resource-constrained environment in which we work and are relevant to the 21st century learner. Further evaluation and development of the tool using different scenarios and African languages is recommended

An exploration into the awareness and perceptions of medical students of the psychosociocultural factors which influence the consultation: implications for teaching and learning of health professionals

Background. South African society is undergoing rapid changes; and includes people from different cultures; beliefs and social backgrounds. Research suggests that these contextual influences have an important bearing on how patients present and relate to healthcare providers. Medical students; too; have a life-world based on their own backgrounds and cultures; and may find relating to a patient with a different life-world challenging. Objectives. To explore students' awareness and perceptions of how psychosociocultural factors in a multicultural society influence the consultation; and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient; and completed a self-reflection learning task. Audio recordings were transcribed and analysed thematically. Results. Exposure to patients in the clinical years had made students aware of the challenges of cultural diversity; although they felt under-prepared to deal with this. Students alluded to the influences of their own cultures; of cultural similarities as well as differences; the roles and behaviours of doctors and patients in cross-cultural consultations; the potential knowledge and experience gap that exists across cultures; and an awareness of the need for patient-centredness. Conclusion. Students should be assisted to improve their cultural competence. Recommendations are made for using various methods; including critical incidents and visual learning to provide opportunities for reflexive practice and transformative learning. Educators must be equipped to address learning objectives relating to cultural competence

Environmental isolation of Cryptococcus neoformans var. neoformans from Vellore.

We have isolated C. neoformans from various environmental niches, including our hospital environment. Twenty one samples of weathered pigeon droppings and 86 samples of Eucalyptus bark and debris were collected from various sites around the hospital and college. C. neoformans var. neoformans was isolated from 14 of the 21 (67%) samples of weathered droppings of pigeons collected from the ledges of windows of wards and departmental buildings in the hospital. C. neoformans was not isolated from any of the Eucalyptus samples. These findings document for the first time the presence of C. neoformans var. neoformans in the hospital environment. Although ubiquitous in the environment, its presence in hospital surroundings stresses the need for systematic cleaning of sites inhabited by pigeons. However, we failed to isolate C. neoformans from the limited number of Eucalyptus samples examined.