Patients' informational needs while undergoing brachytherapy for cervical cancer.

OBJECTIVE: To identify informational needs of South African women receiving intracavitary brachytherapy for locally advanced cervical cancer as part of a process to develop guidelines for quality patient-centred care. DESIGN: A prospective, qualitative study with a phenomenological approach. SETTING: Brachytherapy Unit, Department Oncology, Universitas Hospital, Bloemfontein, South Africa. PARTICIPANTS: Purposive sampling was utilized to recruit patients undergoing brachytherapy for cervical cancer from July to December 2012. MAIN OUTCOME MEASURES: Semi-structured, one-to-one interviews were conducted, guided by a theme list. Audio-recorded interviews were conducted in Sesotho, Afrikaans and English by an unaffiliated, multilingual interviewer. The interviews were transcribed, translated and thematic analysis performed. RESULTS: Data saturation was achieved having interviewed 28 participants, aged 30-73 years. Four themes with sub-themes were identified: (i) informational needs, (ii) patient disposition towards treatment, (iii) psychological experience and (iv) physical experience. Findings on patients' informational needs were the overarching theme and form the focus of this article. These informational needs included: providing patients with disease- and treatment-related information in their home language; adequate information concerning possible side-effects, sexual intercourse and pre-treatment preparation; and providing patients with informative material as standard procedure. CONCLUSION: The article has identified women's informational needs providing a focus for patient-centred care. Providing patients with sufficient and understandable information could lessen feelings of fear and anxiety towards treatment delivery. Guidelines with a patient-centred approach could thus be developed to be used as a tool to assist members of multidisciplinary teams in providing quality care to this group of women.

Interest in and willingness to use complementary, alternative and traditional medicine among academic and administrative university staff in Bloemfontein, South Africa.

BACKGROUND: Healthcare systems worldwide are changing and the use of complementary, alternative and traditional medicine (CAM) form part of this transformation. South Africa has a large number of CAM practitioners, but they are not included in the official healthcare system. The aim of this study was to determine the perception and usage of CAM among the academic and administrative staff of the University of the Free State (UFS) in Bloemfontein, South Africa. METHODS: A questionnaire was compiled and sent electronically to all the academic and administrative staff of the UFS who had a university email address, to be completed online. RESULTS: The response rate was 5.5%, with most of the respondents from the Faculty of Health Sciences. The respondents (n=165) were mainly women of 41-60 years of age with more than one tertiary qualification. Most of the respondents were in good health and considered CAM as moderately helpful and mostly safe. Most of the CAM recommendations were not from a medical physician. The respondents wanted alternatives to certain medications, such as antibiotics. They also had good previous experience with CAM and felt that conventional treatment was not always effective to treat their problems. They identified a need for CAM in the health system. CONCLUSION: The study has limitations due to the data collection method and the low response rate. The results showed that the respondents favored a more integrated healthcare system including different CAM therapies, and that conventional doctors should be better informed about these therapies and its uses.

The profile of adult nephrology patients admitted to the Renal Unit of the Universitas Tertiary Hospital in Bloemfontein, South Africa from 1997 to 2006.

BACKGROUND: This paper reports a retrospective audit of new patients referred to the Renal Unit at Universitas Academic Hospital in Bloemfontein, South Africa for the decade 1997-2006. METHODS: All the files kept in the Renal Unit were reviewed for the main clinical presentation, a definitive pathological diagnosis (if obtained), age, race and gender of the patients. No consultations from other disciplines were included. RESULTS: One thousand two hundred and sixteen patients were included in the study. The main clinical presentations were as follows: chronic renal failure (CRF), 461 (37.9%); nephrotic syndrome, 203 (16.7%); hypertension, 161 (13.2%); and abnormal urinary findings, 128 (10.5%). The nephrotic syndrome was the most common indication for renal biopsy, and histological investigation revealed focal segmental glomerulosclerosis in 46 (3.8%) patients, minimal change in 23 (1.9%), membranoproliferative disease in 36 (3.0%) and membranous glomerular disease (MN) in 28 (2.3%). In CRF, hypertension was suspected in 236/461 (51.2%) cases but was proven histologically in only 13 (2.8%) patients. CONCLUSIONS: Socio-political factors impacting on access to healthcare most likely had an influence on the referral pattern of patients during this period. The largest group of patients were referred to our institution late in their disease with CRF, often requiring renal replacement therapy, and a definitive diagnosis was seldom possible at that stage. With the limited availability of dialysis facilities, the need for early detection and preventative measures with regard to renal disease in this community is evident.

Development of a framework with specific reference to exit-level outcomes for the education and training of South African undergraduate physiotherapy students.

The aim of the study was to develop a framework for undergraduate programmes for the education and training of physiotherapists in South Africa. The research comprised a literature survey, interviews with United Kingdom physiotherapy educators and departmental workshops in South Africa. The Delphi technique was employed as research method to evaluate the proposed framework. The measuring instrument was a questionnaire comprising of amongst others, statements related to exit-level outcomes, which were rated on a five-point rating scale. Two rounds of the Delphi technique were required before acceptable consensus was reached and a framework for the development of a physiotherapy education and training programme was compiled. The framework has been designed as a benchmark for the development of innovative physiotherapy curricula in South Africa. This paper provides information of the exit-level outcomes specified in the framework.