Seyi Ladele Amosun

Perceived images of disability: The reflections of two undergraduate medical students in a university in South Africa on life in a wheelchair

Purpose. The purpose of this manuscript is to document the experiences of two undergraduate medical students at the University of Cape Town, South Africa, who registered for a 4-week special study module titled “Images of Disability”, as part of the medical training programme. The objective of the module was to foster the development of positive attitudes toward persons with physical disability through role-playing. Method. The special study module required that the students assumed they had mobility impairments and were physically confined to wheelchairs. The students were required to document their personal experiences of life in a wheelchair for five consecutive working days. Results. The students had to deal with their perceptions of the attitudes of individuals they interacted with, which resulted in feeling of inferiority and lowered self-esteem. The students also identified obstacles in the environment which hindered integration. Conclusions. The students reported significant positive changes in their attitudes towards persons with disabilities.

Health promotion needs of physically disabled individuals with lower limb amputation in Rwanda

Purpose. The objectives of the study were to identify the health-related behaviors among physically disabled individuals with lower limb amputation resident in Rwanda, the factors that influenced these behaviors, and the major issues that should be targeted in health promotion programs for physically disabled individuals with lower limb amputation. Method. A cross-sectional survey, utilizing a self-administered questionnaire, was carried out among 334 lower limb amputees who volunteered to take part in the study. In addition, a sub-sample of 15 participants was purposively selected for in-depth face-to-face interviews. Results. Many participants did not engage in physical exercises (64.7%). Others abused alcohol on daily basis (14.4%), smoked 11 – 20 cigarettes daily (13.2%), and used recreational drugs such as marijuana, opium and cocaine (9.6%). There were significant associations between the age group of the participants and participation in exercises (P = 0.001), and consuming alcohol, tobacco and recreational drugs (P = 0.001). In-depth interviews revealed factors influencing the behavior of participants. Conclusions. Participants were found to be at risk of secondary complications because of poor lifestyle choices. There is a need to develop and promote wellness-enhancing behaviors in order to enhance the health status of physically disabled individuals in Rwanda who have lower limb amputations.

Effectiveness of a home-based pulmonary rehabilitation programme in pulmonary function and health related quality of life for patients with pulmonary tuberculosis: a pilot study

BACKGROUND Patients with Pulmonary Tuberculosis (PTB) often develop impairment in pulmonary function due to anatomical changes secondary to the illness. Physiotherapy in the form of pulmonary rehabilitation has been advocated. OBJECTIVE The aim of the study was to determine whether adherence to a six-week home-based pulmonary rehabilitation programme (PRP) improved the baseline measurements of lung function, exercise tolerance and health-related quality of life (HRQoL) in patients receiving out-patient treatment for PTB. METHOD A single blinded randomized control study design was used to assess the effects of a six-week home- based PRP in patients receiving treatment for PTB at a local clinic in Khayelitsha, Western Cape. We evaluated lung function by spirometry (MINATO AUTOSPIRO-model no. AZ-505), exercise tolerance using the 6-min-walk test (6MWT), the Borg exercise exertion scale and HRQoL using the EQ-5 D questionnaire in an intervention group (n=34) and a control group (n=33). The trend of the effects of the PRP on lung function was towards increases, but there was no statistical difference between the intervention and control groups at the end of the sixth week in the values of FVC (p=0.2; 95% CI -0.9 to 0.51) as well as FEV1 (p=0.1; 95% CI -0.07 to 0.51). Similar trend was observed for exercise tolerance, and there was no significant difference in HRQoL (p=0.789). CONCLUSION The outcome of the study provides motivation for further consideration and implementation of a pulmonary rehabilitation programme for patients with PTB.

Perception of risk of HIV and sexual risk behaviours among students in the United States, Turkey and South Africa

The aim of this study was to examine HIV sexual risk behaviours and perception of HIV risk among 1 095 students from the United States of America (US), Turkey and South Africa. Randomly selected students who were enrolled in general education courses completed a structured questionnaire. Results revealed statistically significant differences in specific HIV-related sexual behaviours among students from the three countries and among male and female students in each country. A higher percentage of US and South African students engage in HIV risky sexual behaviours compared with their Turkish counterparts, and a higher percentage of female students in the US and South Africa engage in HIV sexual risk behaviours compared with their male colleagues. A higher proportion of Turkish male students engaged in sexual risk behaviours compared with their female counterparts. The perception of HIV risk was low among US and Turkish students, and high among South African students. There was no agreement between engaging in risky sexual behaviour and self-perception of HIV risk among South African female students, while agreement was poor for US male and female students, Turkish male and female students, and South African male students. The observed optimistic bias needs to be considered in the design and implementation of HIV prevention programmes for these populations.

Retrieving physiotherapy patient records in selected health care facilities in South Africa--is record keeping compromised?

Purpose: The purpose of this study was to evaluate the process and feasibility of retrieving patient records in a variety of physiotherapy care settings in the Gauteng province in the Republic of South Africa. Methods: Thirteen public and private health care facilities providing physiotherapy services were studied. Multiple methods of data collection (facility walk-through observation aided by a researcher designed checklist, in-depth interviews and attempting to retrieve physiotherapy records) were employed to evaluate the process of retrieving physiotherapy patient records, determine physiotherapy record retrieval rates and to determine the factors that were influencing record retrieval. Results: The process of retrieving physiotherapy records was arduous and multi-faceted, with some health care facilities allowing patients to take their records home. A final retrieval rate of 46% (36.3% – 100%) was obtained. An odds ratio calculation revealed that it was 13.09 (CI: 8.99 – 19.13; p < 0.001) times more possible to retrieve records of patients treated in private physiotherapy care settings (87.4% retrieval rate) than in public sector physiotherapy care settings (34.67% retrieval rate). Conclusions: This study concludes that the process of retrieving physiotherapy records was arduous and lacked uniformity in public sector hospitals. Further a low physiotherapy record retrieval rate was obtained.

Identifying strategies to improve research publication output in health and rehabilitation sciences: a review of the literature

The health research community in South Africa annually produces fair numbers of research papers in national and international health and related journals. Unfortunately the proportion of the papers produced by authors in Health and Rehabilitation Sciences is insignificant compared to other disciplines. In order to identify strategies to increase the number of publications in South Africa, this article reports on a review of published papers into the effectiveness of interventions designed to promote research publication among academics and clinicians in Health and Rehabilitation Sciences programs. Seven of the papers reported on interventions for academics, and six of the papers reported on the interventions for academics in the nursing profession. The most common interventions were “writing support groups”, “writing retreats”, and “writing courses” that lasted for anything from 3 days to 5 years. The interventions were designed to meet the needs of the participants for structured time, motivation, improved writing skills and peer support. All the interventions produced significant research output relating to submission or publication of academic papers. The implementation of these interventions by South African tertiary institutions where Health and Rehabilitation Sciences are offered may improve the number of papers published by the health research community.

Readability and test-retest reliability of a psychometric instrument designed to assess HIV/AIDS attitudes, beliefs, behaviours and sources of HIV prevention information of young adults

Objective: This comparative study evaluated the readability and test-retest reliability of a questionnaire designed to assess the attitudes, beliefs behaviours and sources of information about HIV/AIDS among young adults recruited from universities in the United States of America (USA), Turkey and South Africa. Design/Setting: The instrument was administered on two occasions, within a two week interval, to 219 university students in the USA (n = 66), Turkey (n = 53) and South Africa (n = 100). Method: The psychometric instrument developed has five major subscales: demographic, HIV/AIDS attitudes and beliefs, HIV risk sexual behaviour, alcohol and drug use, and HIV sources of information. Results: The instrument’s readability evaluation revealed a Flesch-Kincaid score (literacy difficulty level of the questionnaire) of 8.4, indicating that respondents would need an eighth grade reading level to understand the survey. The overall test-retest reliability coefficients for the items on the demographic subscale were generally high (0.893–0.997). Similarly, high test-retest reliability was obtained for the HIV risk sexual behaviour (0.738–0.996) and the alcohol and drug use (0.562–1.000) subscales. Much lower test-retest reliability was obtained for the HIV/AIDS attitudes and beliefs (0.32–0.80), and sources of information about HIV/AIDS (0.370–0.892) subscales. Conclusion: We found no discernible difference in the reliability data among the respondents from the three countries. The instrument should be of interest to clinicians and researchers investigating the HIV risk behaviours of young adults and older age groups with an eighth grade reading level. The availability of this instrument may enhance HIV population and intervention studies internationally.

HIV/AIDS knowledge, perception of knowledge and sources of information among university students in USA, Turkey, South Africa and Nigeria:

Objective: To examine HIV/AIDS knowledge, perceptions of knowledge and sources of HIV information among university students in four countries with different HIV prevalence rates. Methods: A survey was completed by 2,570 randomly selected university students from the USA, Turkey, South Africa and Nigeria. Logistic regression analysis was used to identify the association between accurate HIV/AIDS knowledge, demographic characteristics and frequency of exposure to information sources. Results: Compared to US students, the HIV/AIDS knowledge of Turkish students was more likely to be inaccurate and the knowledge of South African and Nigerian students was more likely to be accurate. South African students were the most exposed to HIV/AIDS information and Turkish students were the least exposed (p < .001). Men were more likely to demonstrate accurate HIV knowledge than women. A higher percentage of students from South Africa and Nigeria (countries with high HIV prevalence) incorrectly perceived themselves as being very knowledgeable about HIV/AIDS. Marital status, year of university education and type of study (part time or full time) were associated with level of knowledge. Frequency of exposure to HIV/AIDS information was not associated with knowledge. Conclusion: More students in countries with higher HIV prevalence had accurate HIV/AIDS knowledge and poorer perception of their level of knowledge than students in countries with low prevalence. Governments in the countries studied should ensure that young people receive accurate HIV/AIDS information, with special attention paid to educating young women.

Processes in widening access to undergraduate allied health sciences education in South Africa

The purpose of this manuscript is to describe the processes followed in initiating and managing widening access to allied health sciences education at the University of Cape Town, South Africa. In response to national higher education policy imperatives in South Africa and in anticipation of the first cohort of Outcome Based Education (OBE) school leavers entering tertiary education, the School of Health and Rehabilitation Sciences at the university launched an extensive intra- and cross-programme transformation project in 2004. The project afforded four undergraduate professional programmes, namely audiology, occupational therapy, physiotherapy and speech therapy, an opportunity to address common educational and contextual drivers. These included, among others, the need for increased access and throughput of historically under-represented students in higher education. An advisory task team, named the curriculum review management team (CRMT), was engaged in envisaging, navigating and containing a complex sociopolitical process involving many stakeholders with disparate ideas, practice approaches, and focal concerns. The use of the Gale and Grant model of change management, augmented by the Community of Practice conceptual framework, to assist with these processes is described.

Widening student access and participation in Allied Health Sciences: A critical reflection

ABSTRACT Widening of access and participation has become a paramount agenda for Allied Health Sciences education in South Africa. In response to the need the Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town introduced the Intervention Programme (IP) in 2009 as a strategy for widening of access and participation student. This study reflects on the design and implementation of IP, the complexities of the diversity of students entering the IP, and the implications for curriculum restructuring in the first year of study and beyond. The authors drew on Mezirow’s (1990) theory of transformative learning to explain the multifaceted challenges encountered through our own reflection as programme designers and facilitators, as well as organisers of and participants in curricular reviews using data from student interviews, student performance in first and subsequent years of study, and review documentation . The study shows that curriculum restructuring for a diversifying student body across multiple programmes is a complex process with interrelated and influential factors. Our critical reflections revealed the complexities of aligning intentions that are significantly flawed by presuppositions relating needs and outcomes.