Exploring the collaborative care of patients with pelvic fractures in Tshwane, South Africa.

BACKGROUND: Pelvic fractures are complex injuries that lead to long-term disabilities and poor health-related quality of life (HRQoL). Even though pelvic fractures are known to be challenging to manage, there is limited information on guidelines and protocols to ensure that patients receive comprehensive and collaborative healthcare. METHODS: A qualitative descriptive phenomenological approach was utilised to explore current practices and innovations of healthcare professionals (HPs) in Tshwane academic hospitals in the collaborative management and rehabilitation of patients with pelvic fractures, using semi-structured interviews. Thematic analysis was used to analyse data. RESULTS: Six overarching themes were identified from the interviews with HPs: The biopsychosocial lens of the patient, limitations in approaches to care, contextual impediments to care, the team challenge; the biopsychosocial aspects of care and forging forward to improve care. CONCLUSION: A multidisciplinary approach is encouraged for the comprehensive management of pelvic fractures. However, a poor understanding of roles and poor referral structures challenge this approach. Further barriers to caring include staff shortages and limited resources. Healthcare professionals recommended interprofessional education and collaborative practice, student training and using standardised outcome measurement tools to improve care for patients with pelvic fractures.Contribution: This study lays a foundation to initiate conversations about the development of an interprofessional model of care for patients with pelvic fractures. Findings might inform health policies on the management of pelvic fractures. Healthcare professionals might apply strategies that enhance the quality of healthcare provided. Patients with pelvic fractures might receive quality interprofessional healthcare that promotes quality of life, post pelvic fractures.

Participation patterns of children with cerebral palsy: A caregiver's perspective.

Background: Participation in activities of daily living (ADL), education, leisure and play in children living with cerebral palsy (CP) may be affected by various factors, as outlined in the International Classification of Functioning, Disability and Health Framework (ICF). The aim of this study was to describe the participation patterns of a group of these children. Objectives: This study aimed to describe participation patterns in ADL, education, leisure and play activities of children living with CP in Modimolle. Method: An exploratory-descriptive qualitative (EDQ) study design was used. A researcher-constructed bio-demographic data sheet and a semi-structured interview schedule were used to collect data from the primary caregivers of children (5-17 years) living with CP in Modimolle. Interviews were transcribed verbatim, translated from Sepedi to English and analysed using the content analysis approach and NVivo software. Results: The findings of this study indicated that children living with CP in Modimolle require set-up and assistance to participate in various ADL such as self-care, family and community activities. They also participate in formal and informal educational programmes as well as active and passive leisure and play activities. However, at the moment, they have limited opportunities to participate because of resource constraints and inaccessible infrastructure. Conclusion: Although children with CP in Modimolle perform some ADL, and participate in educational, leisure and play activities, they are not fully integrated into their community. Legislative support and policy implementation are required to improve participation and integration of children living with CP. Further studies on community-specific integrative strategies to enhance participation among children living with disabilities are recommended. Contribution: This paper provides valuable information on the participation patterns of children with CP living in a rural area of South Africa. The findings can assist with development and implementation of community-specific, integrative health and social care strategies to enhance participation among children living with disabilities.

Quality of life and physical activity among older adults living in institutions compared to the community.

BACKGROUND: The environment of older adults plays an important role in their well-being. It influences their quality of life and physical activity level. In South Africa, there is a dearth of literature concerning this issue. METHODS: An analytic cross-sectional sample of 80 older adults living in old age homes and the community was compared in terms of level of physical activity and quality of life. The study was conducted in Soweto, Johannesburg. A computer-generated random sample of older adults aged 60 years and above participated. The Physical Activity Scale for the Elderly (PASE) and RAND 36 questionnaires were used for data collection. Descriptive statistics were used to describe the sample. Unpaired t-tests, Pearson's correlation coefficient and chi-squared test explored the differences and associations between institutionalised and community living older adults. RESULTS: Quality of life in old age home dwellers (M = 68.53 ± 19.55) was significantly lower (p = 0.025) than in community dwellers (M = 77.74 ± 16.25). The mean physical activity score was also significantly (p = 0.000) lower in old age home dwellers (M = 20.18 ± 24.52) compared with community dwellers (M = 190.31 ± 82.81). CONCLUSION: Older adults who live in the community have a higher quality of life and physical activity levels compared with those who live in institutions (old age homes).