Emergency Medicine

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Browsing Emergency Medicine by browse.metadata.advisor "Geduld, Heike"

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    Mapping research outputs to previously defined research priorities in an emergency care academic community of practice in South Africa
    (Stellenbosch : Stellenbosch University, 2022-12) Meyer, Kirby; Geduld, Heike; Saunders, Colleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine.
    Background: Developing emergency care systems in Africa requires high quality contextual evidence to guide local policies. We sought to map research outputs from the divisions of emergency medicine at the University of Cape Town (UCT) and Stellenbosch University (SU) between 2015-2020 to the list published by van Hoving et al (2015) following a modified Delphi study identifying research priorities in South African emergency medicine. Methodology: This study utilised an evidence mapping approach to map a database of research outputs from UCT and SU Divisions of Emergency Medicine between 2015 and 2020. The Google Scholar, Scopus and the Web of Science databases were searched for research outputs with authors affiliated to either Division. Research outputs were mapped against the proposed research priorities outlined by van Hoving et al (2015). Results: During the study period, 276 publications and 107 dissertations/theses were produced by the Divisions of Emergency Medicine at UCT and SU. In total, 42% of the dissertations/theses had been published in a journal at the time of this study. Only 7% of the research publications mapped to the research priorities identified in the 2015 study in both research statement and study design, while 4% of the publications mapped to the priority list in research statement alone. Only 8,4% of the dissertations/theses mapped to the previously identified research priorities in both research statement and study design and only one mapped to the list by research statement alone. Common themes identified in the research outputs were (i) Prehospital emergency care, (ii) clinical emergency care, (iii) general systems and safety management, (iv) education and training, (v) research and (vi) policies and frameworks. Conclusion: Few of the research outputs in our database mapped to the proposed research priorities list. This evidence map allows for identification of ongoing knowledge gaps and will inform future agenda setting.
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    A qualitative exploration of the language and expression of pain in a Cape Town emergency centre
    (Stellenbosch : Stellenbosch University, 2020-12) Kajee, Muhammad Shaheen; Geduld, Heike; Hendrikse, Clint; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Family and Emergency Medicine. Emergency Medicine.
    ENGLISH SUMMARY : Background: Oligoanalgesia is increasingly being identified as an issue affecting emergency centres universally, especially in low- and middle-income countries where a lack of culturally specific pain scales compound the issue. Despite successful translation of pain scales into different languages, differing cultures and dialects often lead to the pain experience being inappropriately categorised and communicated. This study aimed to explore the language and the expression of pain in adult patients who required tube thoracostomies for penetrating chest trauma, at a district level hospital. Methods: The study was conducted at a district level hospital in Cape Town. An explorative qualitative study design was used, using a single stage semi-structured English language interview. All adults who had a thoracostomy tube inserted for penetrating chest trauma were eligible for inclusion. Audio recordings were transcribed, and thematic content analysis of interview data was performed. 22 participants were interviewed (All male, ages 18-45). All participants could speak English at least as a second language. Results: Participants had difficulty expressing pain using language and often used non-verbal means; expressing a limitation of functioning and a need for additional analgesia were common mechanisms to express severity of pain; expression of intensity pain was often conveyed by categorising pain as tolerable or intolerable with the latter associated with hopelessness and defeat. The actual language used was simple, and commonly used colloquialisms unique to the setting. Barriers to communication between patient and doctor related to use and interpretation of pain scales and the poor relationship between doctor and patient. Conclusion: This study emphasises the inadequacy of currently accepted pain assessment methods in this setting in terms of use and interpretation. It highlights the need for culturally appropriate tools and training of doctors in communication related to pain.