Browsing by Author "Mash, B."
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- ItemAdvance directives or living wills : reflections of general practitioners and frail care coordinators in a small town in KwaZulu-Natal(Medpharm Publications, 2012) Bull, A. P. A.; Mash, B.Background: Living wills have long been associated with end-of-life care. This study explored the promotion of living wills by general practitioners (GPs) and frail care nursing coordinators who were directly involved in the care of the elderly in Howick, KwaZulu-Natal. The study also explored their views regarding the pro forma living will disseminated by the Living Will Society. Subjects: Seven GPs and three frail care nursing coordinators; 10 in total. Design: The design was qualitative in-depth interviews and analysis, using the Framework method. Results: Both doctors and nursing staff understood the concept of living wills and acknowledged that they were beneficial to patients, their families and staff. They were concerned about the lack of legal status of the living will. They felt that the pro forma document from the Living Will Society was simple and clear. Despite identifying the low level of living will usage among patients, doctors and nursing staff felt that third-party organisations and individuals should promote living wills to patients, rather than promoting them to patients themselves. Conclusion: GPs and frail care nurse coordinators were knowledgeable about living wills in general, and the Living Will Society pro forma document in particular. They valued the contribution that living wills make to the care of the elderly, as they benefit patients, their families, healthcare workers and the health system. They also valued the pro forma living will document from the Living Will Society for its clarity and simplicity. However, the GPs and frail care nursing coordinators viewed the living will process as patient driven. They viewed their main role to be that of custodians, and not advocates, of the living wills.
- ItemCoping strategies and social support after receiving HIV-positive results at a South African District Hospital(Health and Medical Publishing Group (HMPG), 2008) Myint, T.; Mash, B.[No abstract available]
- ItemDiabetes in Africa: The new pandemic - Report on the 19th World Diabetes Congress, Cape Town, December 2006(2007) Mash, R. J.; De Vries, E.; Abdul, I.; Mash, B.[No abstract available]
- ItemThe effects of a language barrier in a South African district hospital(Health & Medical Publishing Group, 2006-10) Schlemmer, A.; Mash, B.Background. Communication between health workers and patients at Hottentots Holland Hospital (HHH) is hindered by staff and patients not speaking the same language. HHH is a district hospital in the Cape Town Metropolitan District of the Western Cape where staff mainly speak Afrikaans or English and a large number of patients mainly Xhosa. Objectives. The study aimed to explore the effects of this language barrier on health workers and patients at HHH. Design. Three focus group interviews were held with 21 members of staff and 5 in-depth patient interviews were conducted. Results. The language barrier was found to interfere with working efficiently, create uncertainty about the accuracy of interpretation, be enhanced by a lack of education or training, cause significant ethical dilemmas, negatively influence the attitudes of patients and staff towards each other, decrease the quality of and satisfaction with care, and cause cross-cultural misunderstandings. Conclusion. The effects of the language barrier were considerable and persistent despite an official language policy in the province. The training and employment of professional interpreters as well as teaching of basic Xhosa to staff are recommended.
- ItemInhaled steroid use in adult asthmatics - Experience at a primary health care centre(Health & Medical Publishing Group, 2005) Nizami, T.A.; Mash, B.[No abstract available]
- ItemA medical audit of the management of cryptococcal meningitis in HIV-positive patients in the Cape Winelands (East) district, Western Cape(Medica l& Pharmaceutical Publications (Pty )Ltd -- MedPharm Publications, 2012-08) Von Pressentin, K. B.; Conradie, H.; Mash, B.Background: Cryptococcal meningitis (CM) has become the most common type of community-acquired meningitis. CM has a poor outcome if the initial in-hospital treatment does not adhere to standard guidelines. The aim of this audit was to improve the quality of the care of human immunodeficiency virus (HIV) positive patients with CM in the Cape Winelands District. Method: Following an initial audit in 2008, the researchers and a new audit team introduced interventions, and planned a second audit cycle. The folders of 25 HIV-positive adults (admitted to three district hospitals, one regional hospital, and one tuberculosis hospital) were audited. Results: Spinal manometry was performed more consistently in the regional hospital, than in the district hospitals. Reasons for failing to reach the 14-day amphotericin B target were in-patient deaths, drug stock problems, and renal impairment. The renal monitoring of amphotericin B treatment was suboptimal. The quality of care at district hospitals appeared to be comparable to that found at the regional hospital. The in-patient referral for antiretroviral treatment (ART) counselling was better in the district hospital setting. However, both levels of care had difficulty in achieving the four-week target between the onset of amphotericin B and onset of ART. Conclusion: Deficiencies in the quality of care remained. Between the prior and current audit cycles, there was no consistent improvement in care at the regional hospital. An integrated care pathway document has been developed, and adopted as policy in the Cape Winelands district. Its impact on the quality of care will be evaluated by a dedicated audit team in the future.
- ItemOutcomes for family medicine postgraduate training in South Africa(Medpharm Publications, 2012) Couper, I.; Mash, B.; Smith, S.; Schweitzer, B.After 1994, the post-apartheid government decided that primary health care and the district health system would be the cornerstone of their new health policy. As a consequence of this, the academic departments of Family Medicine and primary care recognised the need for a nationally agreed set of training outcomes that were more aligned with these new priorities within the public sector.
- ItemParticipatory development of a minimum dataset for the Khayelitsha district(Health & Medical Publishing Group, 2000-03) Mash, B.; Mahomed, HassanBackground. Traditional 'data-led' information systems have created excessive amounts of poor-quality and poorly utilised data. The Health Information Systems Pilot Project (HISPP), a Western Cape project that started in 1996, initiated a process in one of its three pilot sites to model an alternative approach to developing a district health information system. Objective. To develop a minimum dataset for Khayelitsha as part of an action-led district health and management information system in a participatory 'bottom-up' process. Method. The HISPP, in conjunction with health workers in the proposed Khayelitsha district, developed a minimum dataset through a process of defining local goals, targets and indicators. This dataset was integrated with data requirements at regional and provincial levels. Results. A minimum dataset was produced that defined all the data needed according to the frequency of reporting and the level at which it was required. Conclusion. The HISPP has demonstrated an alternative model for defining health information needs at district level. This participatory process has enabled health workers to appraise their own information needs critically and has encouraged local use of information for planning and action.
- ItemQuality of care for intimate partner violence in South African primary care : a qualitative study(Springer Verlag, 2014) Joyner, Kate; Mash, B.ENGLISH SUMMARY : Intimate partner violence (IPV) makes a substantial contribution to the burden of disease in South Africa. This article explores the current quality of care for IPV in public sector primary care facilities within the Western Cape. Only 10% of women attending primary care, while suffering from IPV, were recognized. Case studies, based on in-depth interviews and medical records, were used to reflect on the quality of care received among the women who were recognized. Care tended to be superficial, fragmented, poorly coordinated, and lacking in continuity. The recognition, management, and appropriate documentation of IPV should be prioritized within the training of primary care providers. It may be necessary to appoint IPV champions within primary care to ensure comprehensive care for survivors of IPV.