Knowledge of non-communicable diseases among adolescents in Uasin Gishu County, Kenya.

Introduction: Exposure to risk factors of non-communicable diseases (NCDs) begins early especially during adolescence while morbidity and mortality occurs mainly in adulthood. Objective: To assess the level of knowledge of major NCDs (cardiovascular disease, cancer, and diabetes) and risk factors among adolescents in a semi-urban setting. Methods: A descriptive cross-sectional survey was used to collect data. The study targeted students attending mixed secondary schools in Uasin Gishu County in Kenya. An adapted knowledge assessment questionnaire relating to chronic diseases of lifestyle was used for data collection. Data was analysed using SPSS version 25. Results: A total of 1,281 students participated in the study. The results revealed that most of the participants (62.1%) had low levels of knowledge about NCD risk factors. Very few students in the present study recognized the role of family history and genetic predisposition as potential risk factors of hypertension (18%) and diabetes (24.7%) as well as the normal blood pressure (35.9%) and blood glucose levels (20.5%). Although most of the students identified alcohol and smoking as risk factors for cancer, half (51.6%) of them did not have the knowledge that regular physical activity reduces the risk of getting cancer. Conclusion: Many of the adolescents in Uasin Gishu County, Kenya had low level of knowledge regarding NCDs and their risk factors. The findings of this study highlight the need for a school-based intervention programme to raise awareness of non-communicable disease risk factors among adolescents.

Satisfaction with quality of healthcare at primary healthcare settings: Perspectives of patients with type 2 diabetes mellitus.

BACKGROUND: Measuring client satisfaction is part of the quality assurance process and has become an integral part of healthcare management strategies globally. It is essential for improvement of amenities in healthcare facilities. OBJECTIVES: The aim of this study was to assess patients with type 2 diabetes' satisfaction with healthcare services at primary healthcare settings in the Cape Metropolitan district, Western Cape, South Africa. METHODS: This cross-sectional study used proportionate stratified random sampling. The Patient Survey for Quality of Care scale was used to assess patients with type 2 diabetes' satisfaction with quality of care received. Descriptive and inferential statistics were employed in the analysis of the quantitative data. The open-ended question was analysed qualitatively. RESULTS: The majority of patients were satisfied with the overall quality of care. Dissatisfaction was reported for waiting time to get appointments at the clinic, to see a healthcare professional on the same day and clarity of instructions for managing their diabetes. CONCLUSION: Employing more staff in the multidisciplinary team and improving health information by developing staff through continuous education could foster more positive experiences and provide care that contributes to the well-being of patients. CLINICAL IMPLICATIONS: Addressing patients' views regarding quality of healthcare services could assist in overall improvement of healthcare provision through the rectification of the system weaknesses. Satisfaction with quality of care could positively affect adherence to treatment protocols that could lead to better quality of life of patients with type 2 diabetes.

Supporting a student with visual impairment in the intensive care unit.

BACKGROUND: The Department of Physiotherapy at the University of the Western Cape began accepting students with visual impairments (VIs) into the undergraduate physiotherapy programme in 1996. However, until recently, none had received a clinical rotation in any high care setting. OBJECTIVES: The aim of this study was to explore the experiences of all stakeholders involved in the process of placing a student with VI into the intensive care unit (ICU). METHOD: This case study used interviews with relevant stakeholders to explore their experiences of integrating the ICU placement into the student's clinical programme. Interviews were recorded and transcribed, and then analysed thematically. RESULTS: There was a certain amount of anxiety present, especially among clinical staff, before the placement began. Discussions among stakeholders at each stage of the process served to identify potential problems before they arose, and allowed staff to plan solutions in advance. Challenges were found in both the attitudes of staff, and in the clinical environment, some of which were relatively easy to address, while others will require significant investments of resources to resolve. CONCLUSION: Our findings suggest that it may be possible to successfully place students with VI into intensive care settings, and they can enjoy positive learning experiences, given an appropriate context and adequate support. However, care needs to be taken at every stage of the process to ensure that supporting structures are in place prior to, and during, the placement. CLINICAL IMPLICATIONS: All stakeholders, including the students and the relevant clinical and academic staff, need to be actively involved in the process of planning for the clinical placement.

Prevalence of risk factors of non-communicable diseases among adolescents in Uasin Gishu County, Kenya

Objective: This study aimed to establish the prevalence of risk factors (tobacco use, alcohol abuse, physical inactivity and unhealthy diet) of non-communicable diseases (NCDs) among secondary school students in a developing country. Design: A descriptive cross-sectional study using the self-administered WHO STEP-wise questionnaire for chronic disease risk factor surveillance on adolescents attending secondary schools in Kenya. The study was carried out in the period between May and July 2018. Setting: Ten secondary schools were randomly selected in Uasin Gishu County, using stratified proportional sampling. Subjects: A total of 1,281 students assented to participate in the study. The mean age of the participants was 16.6 (SD±1.509) with the majority being female (55%, n=704) Results: The prevalence of alcohol abuse was 30.8%(n=394) with males having statistically significant higher rates than females (p < 0.05) and 6.8% of the participants were smokers. Of those that reported smoking, 60.9% were between 15-17 years of age. Adequate intake of three (3) servings of vegetables per day was seen in 13.5% of the respondents and 54.4% (n=697) of the total sample were found to be physically inactive. Conclusion: The prevalence of NCD risk factors among secondary school students in Uasin Gishu County is significant. As a result, health education and targeted interventions should be implemented in order to promote a healthy lifestyle which is important in preventing NCDs in future.

The role of physiotherapy in the treatment of HIV-related sensory neuropathy: The perceptions and referral practices of physicians.

BACKGROUND: HIV-related peripheral neuropathies are among the most prevalent chronic neurological disorders affecting persons living with HIV and AIDS. In order to improve the physical function and quality of life of those affected by the disease, a holistic or multidisciplinary approach, including physiotherapy, has been suggested for the management of neuropathic pain. AIM: The aim of this study was to explore the physicians' perceptions regarding the role of physiotherapy in the management of patients with HIV-sensory neuropathy (HIV-SN) and their referral practices in Tanzania. METHODS: A qualitative study design incorporating purposive sampling was employed in the study. A total of 10 physicians from a hospital in Tanzania agreed to participate in in-depth interviews. RESULTS: Physicians had poor perceptions of the role of physiotherapy in the management of patients with HIV-SN. Their inadequate knowledge of the role of physiotherapy and the limited number of physiotherapists employed negatively influenced their referral of patients with HIV-SN for physiotherapy. CONCLUSION: In Tanzania, referral for physiotherapy is still dependent on medical doctors. Inter-professional learning is imperative for minimising the stereotypes that may exist across professions, hence the need to improve awareness of specific roles in patient management. This could improve knowledge of the role of other professionals in the management and rehabilitation of affected patients and consequently improve perceptions and facilitate referrals of patients with HIV-SN for more integrated care.

Management of type 2 diabetes mellitus: adherence challenges in environments of low socio-economic status.

BACKGROUND: The efficacy of treatment for clients with diabetes is highly dependent on the individual's ability to manage the disease. Several constraints, such as poverty, illiteracy and insufficient resources (finances and specialised healthcare professionals), especially communities of low socio-economic status, could influence clients' ability to manage their disease. AIM: The main aim of this study was to outline the obstacles encountered by individuals with type 2 diabetes mellitus from an urban community with regard to management of their disease. SETTING: The study was conducted at a primary health care facility in the Western Cape, South Africa. METHODS: Ethical clearance was obtained from all relevant authorities. Eight (8) conveniently selected clients with type 2 diabetes mellitus per participating community healthcare centre (six approved centres in total) were invited to take part in focus group discussions. Twenty six clients, 15 females and 11 males, with a mean age of 58.92 years (SD = 7.33), agreed to participate. Audiotaped data were transcribed verbatim followed by content analysis and identification of themes. RESULTS: Themes that emerged were challenges with: a healthy eating plan, physical activity, financial constraints, other people's understanding of the disease, and service received at the community healthcare centre. Verbatim quotes were used to exemplify the themes. CONCLUSION: Clients with type 2 diabetes mellitus experienced several challenges in the management of their disease. These challenges should be addressed to assist with better glycaemic control and to curb the emergence of diabetic complications and their attendant cost implications.