Stress and coping mechanisms of officers of the South African Police Service based in Tzaneen, Limpopo province, South Africa.

BACKGROUND: In this study, stress is conceptualised as a psychological syndrome in response to stressors. Stress and inappropriate coping mechanisms constitute a serious problem in police profession. Organisational causes of stress, such as lack of support from management, are additional stressors. The ability to cope with this stress is influenced by marital status, gender, rank, age and years of service. In managing stress, police officers may use adaptive or maladaptive coping mechanisms. AIM: To investigate stress and the coping mechanisms used by police officers. SETTING: The study was set in Tzaneen, Limpopo province, South Africa. METHODS: This cross-sectional study used a self-administered questionnaire based on the Police Stress Inventory (PSI) and Coping Orientation to Problems Experienced (COPE) tools. RESULTS: Of the 104 participants, female police officers had significantly higher stress intensity scores, while constables and captains had statistically significant lower stress scores. The highest ranked stressors were killing someone in the line of duty, a fellow officer killed in the line of duty, and knowledge of and experiencing the death of a fellow officer in the line of duty. The five most frequently occurring stressors were organisational in nature. Respondents were more likely to use coping strategies that were problem-focused. CONCLUSION: Organisational stressors were common, suggesting that the South African Police Services (SAPS) management should provide interventions that reduce the effects of work-related stressors. The majority of respondents used problem-focused coping strategies, indicating that most handle stressors in a positive manner.

The Influence of Family Physicians Within the South African District Health System: A Cross-Sectional Study.

PURPOSE: Evidence of the influence of family physicians on health care is required to assist managers and policy makers with human resource planning in Africa. The international argument for family physicians derives mainly from research in high-income countries, so this study aimed to evaluate the influence of family physicians on the South African district health system. METHODS: We conducted a cross-sectional observational study in 7 South African provinces, comparing 15 district hospitals and 15 community health centers (primary care facilities) with family physicians and the same numbers without family physicians. Facilities with and without family physicians were matched on factors such as province, setting, and size. RESULTS: Among district hospitals, those with family physicians generally scored better on indicators of health system performance and clinical processes, and they had significantly fewer modifiable factors associated with pediatric mortality (mean, 2.2 vs 4.7, P =.049). In contrast, among community health centers, those with family physicians generally scored more poorly on indicators of health system performance and clinical processes, with significantly poorer mean scores for continuity of care (2.79 vs 3.03; P =.03) and coordination of care (3.05 vs 3.51; P =.02). CONCLUSIONS: In this study, having family physicians on staff was associated with better indicators of performance and processes in district hospitals but not in community health centers. The latter was surprising and is inconsistent with the global literature, suggesting that further research is needed on the influence of family physicians at the primary care level.

The perceived impact of family physicians on the district health system in South Africa: a cross-sectional survey.

BACKGROUND: Evidence from first world contexts support the notion that strong primary health care teams contain family physicians (FPs). African leaders are looking for evidence from their own context. The roles and scope of practice of FPs are also contextually defined. The South African family medicine discipline has agreed on six roles. These roles were incorporated into a family physician impact assessment tool, previously validated in the Western Cape Province. METHODS: A cross-sectional study design was used to assess the perceived impact of family physicians across seven South African provinces. All FPs working in the district health system (DHS) of these seven provinces were invited to participate. Sixteen respondents (including the FP) per enrolled FP were asked to complete the validated 360-degree assessment tool. RESULTS: A total number of 52 FPs enrolled for the survey (a response rate of 56.5%) with a total number of 542 respondents. The mean number of respondents per FP was 10.4 (SD = 3.9). The perceived impact made by FPs was high for five of the six roles. Co-workers rated their FP's impact across all six roles as higher, compared to the other doctors at the same facility. The perceived beneficial impact was experienced equally across the whole study setting, with no significant differences when comparing location (rural vs. metropolitan), facility type or training model (graduation before and ≥ 2011). CONCLUSIONS: The findings support the need to increase the deployment of family physicians in the DHS and to increase the number being trained as per the national position paper.

Inpatients' awareness of admission reasons and management plans of their clinical conditions at a tertiary hospital in South Africa.

BACKGROUND: Inpatient awareness of the reason for their admission and the planned management enhances patient compliance and empowers patients to be resourceful in subsequent consultations. The objective of this study was to determine patients' awareness of their clinical conditions while admitted to an academic hospital. METHODS: A survey was conducted at Dr George Mukhari Academic Hospital in Pretoria, from 6 to 17 December 2010, on 264 inpatients drawn from a population of 837 through a systematic sampling method. Data on inpatient awareness were collected using a researcher-administered questionnaire, which was available in English, as well as isiZulu and Setswana. Components of patients' global awareness were clinical diagnosis, necessity for admission, planned management, possible condition cause(s), duration of admission, and planned investigations, operations and procedures. We conducted regression analysis on possible predictors of global awareness: age, marital status, occupation and educational level. The SAS (Release 9.2) was used for data analysis. RESULTS: One hundred and thirty-six inpatients (51.5%) had global awareness of their clinical conditions and management plans. High degrees of awareness were reported on clinical diagnosis 206 (78.0%), reason for admission 203 (76.9%), planned management 206 (78.0%), and current medication 222 (84.1%). Fifty (18.9%) respondents were aware of their estimated admission duration. Patients who were informed of admission duration were likely to be informed of their planned management (p < 0.01). When health care practitioners did not volunteer information, most respondents (>69%) did not seek information. When information was provided, the majority of respondents (>70%) reported understanding the information. The proportion of patients who acknowledged the shared responsibility by the health care practitioner and the patient to raise awareness among the inpatients was significantly more than those who did not (p = 0.03). Patients' age, marital status, occupation and educational level were not predictors of global awareness (p > 0.05). CONCLUSIONS: The proportions of respondents who were aware of the different aspects of health care ranged from 18.9% to 84.1%. About half of respondents had global awareness of their admission reasons and management plans. Raising awareness of patients' clinical conditions should be part of the health care practitioner-patient encounter.

Brain drain in South Africa is affecting health care.

No abstract available.

Using ChatGPT in family medicine and primary health care.

No abstarct available.

Umbilical vein catheterisation for the family physician working in primary health care.

This is part of a series of articles on vascular access in emergencies. The other two articles were on intra osseous lines and central venous lines. These are critical lifesaving emergency skills for the primary care professional. In this article, we will provide an overview of umbilical vein catheterisation highlighting its importance, the indications, contraindications, techniques, complications and nursing considerations. By familiarising healthcare providers with this procedure, we hope to enhance their knowledge and skills, ultimately leading to improved outcomes in the neonatal population.

The exceptional potential in extending primary care exposure for South African medical interns.

No abstract available.

Myriad untold stories unfolding daily: South Africa's pursuit of quality primary health care.

No abstract available.

The role of family medicine and primary health care and its impact on the climate crisis.

No abstract available.

Gender-based violence - An increasing epidemic in South Africa.

No abstract available.

Integration of traditional medicine into the mental healthcare system in Tshwane, South Africa.

BACKGROUND: Mental healthcare providers have a negative attitude towards the integration of traditional health medicine (THM) into the mental health system. The attitude is based on their lack of trust in traditional practices, which are not supported by substantial evidence-based medical research. The study was conducted to determine mental healthcare providers views on the integration of traditional health medicine into the mental healthcare system. METHODS: The study was conducted at a psychiatric hospital in the Tshwane district, Gauteng province, South Africa. A cross-sectional, descriptive research design was conducted on 85 respondents who consented to participate. Data were collected using a survey questionnaire from 23 psychiatrists and 62 psychiatric nurses. Data were analysed using descriptive statistics and presented in the form of graphs, frequencies and percentages. RESULTS: Mental healthcare providers displayed a negative attitude towards integrating THM in psychiatric hospitals. The results showed no significant difference between psychiatrists and psychiatric nurses in their preference for modern mental healthcare practices (p = 0.25). CONCLUSION: There is still doubt among the mental healthcare providers on whether to support integration of the THM into mental health system or not. The doubt is based on the two-health system isolated from each other especially in South Africa.Contribution: This study contributed by showing the need and importance of understanding a patients' cultural background, which supports the integration of a traditional health system into the mental healthcare system, which in turn will lead to the appropriate management of mental illnesses.

Community health workers: essential in ensuring primary health care for equitable universal health coverage, but more knowledge and action is needed.

Community health workers (CHWs) have helped improve access to quality primary health care (PHC). However, knowledge gaps exist in designing and implementing CHW-engaged models needed to ensure quality people-centered PHC. In this collection, we call for papers which bridge this knowledge gap, to build sustainable, resilient and equitable CHW programs.

Central venous pressure line insertion for the primary health care physician.

Central venous access is an important procedure to understand and perform not only in the emergency unit but also for prolonged reliable venous access. All clinicians must be familiar and confident with this procedure. This paper will focus on applied anatomy in respect of common anatomical sites for venous access, the indications, the contraindications, the technique and complications that may arise following the procedure. This article is part of a series on vascular access. We have previously written on the intra osseous procedure and an article on umbilical vein catheterisation will follow.

Intraosseous line insertion for the primary health care physician.

Early rapid access to the vascular system is essential in emergencies and is lifesaving. In this article, we will provide information on the common sites used, the equipment that is required, the indications and contraindications for intraosseous line insertion, how to correctly and safely do the procedure, medication that can be administered, post insertion line management and possible complications. This is a lifesaving procedure and primary healthcare physicians should acquire this skill.

After action review of the COVID-19 pandemic response in North West province, South Africa.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) pandemic with major disruptions globally. Northwest Province Department of Health (NWDoH) in South Africa set up comprehensive epidemiological emergency response plans for preventing, finding, containing and stopping the spread of COVID-19 in accordance with the National Disaster Management Act. Objectives: This After-Action Report (AAR) describes the provincial response to the pandemic from September 2020 to October 2022. Method: The AAR was conducted using the World Health Organization AAR methodology. Focus groups discussed five items: coordination, leadership and governance; epidemiology, surveillance and laboratory; case management and continuity of essential services; risk communication and community engagement and COVID-19 vaccination. Results: The timely establishment and activation of provincial intergovernmental and intersectoral coordinating structures led to effective coordination, resource mobilisation, leadership, decision-making and intervention. The effective communication in the department and other stakeholders resulted in improved surveillance data quality, timelier response and increased ownership of data. Dissemination, training and implementation of case management protocols ensured standardised case management. The multi-channel information dissemination targeting different audiences empowered people with real-time knowledge on the infection and encouraged health-seeking behaviours. Conclusion: The AAR demonstrated the importance of coordinated epidemiological, laboratory and communication response that requires significant public health reserve capacity in peacetime for rapid expansion in an emergency. Contribution: This review contributes to the body of knowledge emerging from the COVID-19 pandemic and provides guidance on enhanced public health response to future emergencies.

Guiding the emerging primary care researcher: A report of research capacity-building workshop.

There is an escalating interest in research capacity building across the globe. Research is an integral part of the continuous improvement process, clinical decision making and health system strengthening and should be embedded into the health system. The South African Family Practice Journal editorial team held a workshop on 19 August 2022 at the 24th National Family Practitioners Congress in Cape Town, with the aim of supporting primary care clinicians in their development from early-career researchers to established clinician-scientists. Small group and plenary discussions yielded valuable insights into the lived experiences of early career researchers and highlighted critical action areas to build the landscape of clinician-led research in the South African context.Contribution: This article contributes to current literature by providing insight into the lived experiences of early-career researchers and explores opportunities for research capacity-building.

Level of patient safety culture among public healthcare professionals in Pretoria.

BACKGROUND: Patient safety culture (PSC) norms set within an organisation prevent harm during medical care. This study assessed the level of PSC among public healthcare professionals (HCPs) in Pretoria, South Africa. METHODS: A multi-centre cross-sectional study conducted in three hospitals and 25 clinics in regions 1 and 2 of Pretoria, using a self-administered questionnaire adapted from the Hospital Survey on Patient Safety Culture. Using the Raosoft online sample size formula, from 1238 public HCPs identified, the sample size was calculated at 294; this expanded to 319 as a result of respondents' willingness to participate in the study. RESULTS: Of the 319 respondents with a mean age of 39.9 years, the minimum and maximum ages were 22 and 66 years, respectively. The age group of 30-39 years had the highest participation rate (17.6%). Most respondents (41.1%) came from the Odi district hospital and there were more women (78.1%) and nurses (49.2%). Positive attitudes were found for all PSC components, with staff education and training scoring highest (98.7%). Patient safety culture received a satisfactory rating from HCPs from the targeted facilities. CONCLUSION: This study showed that public HCPs in Pretoria's regions 1 and 2 have a good PSC, particularly among nurses, professionals with more experience, and at primary care level.Contribution: To maintain or increase awareness of this concept among HCPs, the study advocates a PSC programme as well as ongoing education that can be supported by district and facility managers.

Medical education at the time of the COVID-19 pandemic.

No abstract available.

Social media and health - Is it all good, bad or just ugly?

No abstract available.