UWCScholar :: Browsing by Author "Mlenzana, Nondwe"

Browsing by Author "Mlenzana, Nondwe"

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Activity limitations and participation restrictions four years after traumatic spinal cord injury in Cape Town, South Africa
(University of the Western Cape, 2018) van Wyk, Vania; Joseph, Conran; Mlenzana, Nondwe
The distressing event of Spinal Cord Injury (SCI) leads to complete or incomplete injury, and results in many complications such as such as neurogenic shock, cardiovascular disease, temperature regulatory problems, respiratory complications, dysphagia, thromboembolism, and pressure ulcers amongst others. These complications limit the individual’s functioning and participation. Participation is fruitful and meaningful when you are actively involved in a specific activity. To understand the lack of participation within a specific setting, it is important to know what the limitations in activities are, and what causes these limitations. The goal of rehabilitation should be to reintegrate patients back into the community so that they can fulfil their roles. Aim: The aim of the study was (1) To determine included participants’ socio-demographic and injury characteristics; (2) To describe healthcare services received by people living with long-term Traumatic Spinal Cord Injury (TCSI) over the past 12 months; (3) To determine the point prevalence of common activity limitations of survivors of TSCI four years after injury; (4) To determine the point prevalence of participation restrictions of survivors of TSCI four years after injury; and (5) To determine factors associated with activity limitations and selected participation restrictions four years after injury.
Barriers and facilitators regarding patient adherence towards physiotherapy rehabilitation programs in the management of osteoarthritis in Nairobi, Kenya.
(University of Western Cape, 2020) Wanunda, Wendy Ashley; Mlenzana, Nondwe; Tawa, Nassib
Reduced adherence levels have been demonstrated by some patients affected with Osteoarthritis. Therefore, this study aimed at exploring the barriers and facilitators regarding patient adherence towards physiotherapy rehabilitation programs in the management of osteoarthritis in Nairobi, Kenya. The objectives of the study were to determine the clinical profile of patients with osteoarthritis on physiotherapy rehabilitation programs, to explore the patient-reported barriers and facilitators towards physiotherapy rehabilitation programs and exploring physiotherapists’ perceptions of patient adherence towards physiotherapy rehabilitation programs. The study setting was at the Kenyatta National Hospital physiotherapy clinic in Nairobi, Kenya.
Barriers experienced by service providers and caregivers in clubfoot management in Kenya
(SAGE Publications, 2015) Kingau, Naomi Wanjiru; Rhoda, Anthea; Mlenzana, Nondwe
Disability in childhood remains a challenge globally. Linked to this disability is an apparent increase in the prevalence of infants born with congenital clubfoot. Clubfoot can, however, be effectively managed but this management faces various challenges. This study aims at exploring the barriers experienced in Kenya.In-depth interviews were conducted with 20 participants. Informed consent was sought. Field notes were taken and the interviews tape-recorded. The interviews took 45 minutes to 1 hour. They were transcribed verbatim and analysed by thematic content.
Changes in activity limitations and predictors of functional outcome of patients with spinal cord injury following in-patient rehabilitation
(AOSIS, 2013) Joseph, Conran; Mji, Gubela; Mlenzana, Nondwe; Rhoda, Anthea; Statham, S.; De Wet, C.
The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord Independence Measure III (SCIM III). A longitudinal study design was utilised to study the change in functional abilities of patients with spinal cord injury between admission and discharge. A convenient sampling strategy was employed, in which every consecutive patient admitted to the rehabilitation centre within a three month period was eligible for the study. Demographic-, medical, and process of rehabilitation data were collected and collated from the patients' medical records using a data gathering sheet that was validated and tested for reliability. Functional abilities were measured by the SCIM III. Seventy-six patients met the inclusion criteria, consisting of 58 paraplegics and 18 tetraplegics. The mean age of this cohort was 34.14 years. A significant difference (p<0.001) in functional ability was detected for the total sample, with only12.5% of patients independent in walking ability and 28.12% in stair management. Four (4) factors were found to be predictors of functional outcomes on bivariate analysis, but when considered together in a multiple regression model, only functional status on admission remained correlated to functional outcomes. Conclusion and implication for practice: Significant improvement in functional abilities of persons with spinal cord injury following in-patient rehabilitation was observed. However, mobility and stair-management limitations were the most prevalent at discharge. Lastly, a lower functional status should be better targeted to optimise functional ability in the future. Future research should be directed towards illuminating whether personal factors or rehabilitation inefficiencies are responsible for the limitations observed at discharge.
Contextualization of a physiotherapy clinical practice guideline for stroke rehabilitation in Kenya
(University of the Western Cape, 2018) Kingau, Naomi Wanjiru; Rhoda, Anthea; Elbadawi, Mohammed; Mlenzana, Nondwe
Stroke is the third leading cause of death and disability worldwide. Eighty five per cent of strokes occur in developing countries, and it is estimated that the prevalence will increase in future. Evidence based rehabilitation programs inherent in clinical practice guidelines has the potential to improves functional activities, and participation. However Kenya does not have this guideline. Most clinical guidelines are developed in the western world, and reflect developed world healthcare systems and resources that are not always appropriate to developing nations. Likewise, guidelines are costly to produce. Kenya lacks the resources and the expertise for de novo guideline development. It is therefore appropriate and cost effective to contextualise the available high quality recommendations.
The development of guidelines that incorporate interprofessional practice principles into rehabilitation services at a primary health care facility
(University of the Western Cape, 2022) Kock, Luzaan; Mlenzana, Nondwe
There has been a global shift to an interprofessional model of care as interprofessional practice (IPP) has been highlighted as an innovative way to fight the challenges faced in the health system. The implementation of IPP is targeted at all employees who participate in the provision of healthcare services. IPP can happen at all levels of health care. The primary health care (PHC) level is seen as the core of a sustainable health system, and this study focused on the PHC level. Creating equal access to high-quality, patient-centred healthcare to the entire population is the goal of the provincial health plan known as Healthcare Plan 2030.
Experiences of persons with physical disabilities regarding rehabilitation services: a systematic review
(University of the Western Cape, 2011) Kumurenzi, A.; Frantz, Jose M.; Rhoda, Anthea; Mlenzana, Nondwe
Rehabilitation has been found to improve the integration of persons with disabilities into the society. For rehabilitation to be effective, there is a need to seek patients' perceptions of the services rendered to them. Incorporating these perceptions in the rehabilitation process of patients is one of the ways that recognises patients' involvement in rehabilitation. The most common identified persons with physical disabilities' experiences that have been explored are: accessibility of rehabilitation services, interaction of service providers with patients, provision of information related to disability and rehabilitation. This review aims at highlighting the experiences of persons with physical disabilities regarding rehabilitation services as it relates to different studies.
Exploration and determination of the process of care of stroke in Zambia
(University of the Western Cape, 2016) Mapulanga, Miriam; Mlenzana, Nondwe
Zambia is undergoing epidemiological changes from communicable diseases to NCDs as a result of demographic transition and hence Stroke is an emerging NCD in the country. The process of care of stroke in Zambia as country is unknown. Exploring the process of care of stroke in Zambia, could help understand the gaps in service delivery thereby helping to create interventions to improve stroke service delivery. The purpose of this study was to determine and explore the process of care of stroke in Zambia. As there is no information regarding stroke care in Zambia, the study aimed to explore and determine the process of care and explore the conditions under which diagnosis and management of stroke is done in Zambia and are the factors influencing stroke diagnosis and management in Zambia. The study was conducted in Zambia’s five general hospitals which were selected conveniently. The study consisted of both quantitative and qualitative methods. The quantitative part consisted of stroke patients’ medical records reviews, who were admitted to general hospitals between 1st January to 3oth October 2014. A sample of 80 medical records was selected randomly from each general hospital, making the total of 400 medical records from all the hospitals. Data was collected using a checklist which was specifically design for the study after literature review and contained stroke care processes including diagnosis, medical management, rehabilitation, lifestyle management and community linkage. Analysis of quantitative data was done using Statistical Package for Social Science (SPSS) version 22. The qualitative part consisted of individual in-depth interviews with a purposefully selected sample of three health workers from each hospital making 15 health workers. The in-depth interviews were based on predetermined themes including staffing levels, multidisciplinary team action, treatment guidelines, clinical capacity, planning and budgeting and technical environment. All the interviews were audio-taped, transcribed verbatim and the predetermined themes were analysed using content analysis. Ethical clearance to conduct the study was obtained from the University of the Western Cape Faculty Board Research and Ethics Committees and Senate Research Committee and ERES Converge in Zambia. Permission to conduct the study in Zambia was obtained from the Ministry of Health, Zambia. Informed consent was obtained from the health workers who took part in the study. The study found that the stroke process of care in Zambia ranged from diagnosis through to physical rehabilitation and lifestyle management. The stroke process of care was challenged in the area of diagnosis using biochemistry, haematology, CT scan, MRI and Angiography etc. The process of care in rehabilitation was challenged by lack of gadgets and space to use in rehabilitation. Community linkage, speech therapy and social welfares services were not part of the stroke process of care in Zambia as the study as established. Staff shortages, busy schedules, no treatment guidelines, poor clinical capacity, lack of resources and poor technical environment impacted negatively on the stroke process of care according to this study. Diagnosis and management of stroke was made with no treatment guidelines, poor clinical capacity and poor technical environment. The same were the factors which were influencing diagnosis and management namely staff shortages, no multidisciplinary teams due to busy schedules of health workers, lack of treatment guidelines, poor clinical capacity by health workers, lack of resources for stroke and poor technical environment. Using the Chi-square association of variables, the study showed that CT scan was associated with definitive diagnosis with the p-value of 0.000. Equally, Chi-Square test showed that Diagnosis was not associated with medical management (p value=0.058).
Factors inhibiting equalization of opportunities towards persons with physical disabilities in Uasin-Gishu County, Kenya
(University of the Western Cape, 2016) Koech, Christopher Arap; Mlenzana, Nondwe; Wanyonyi, Nancy Eileen Nekoye
Background: Persons with physical disabilities experience unfavorable conditions in health care, education, employment infrastructure and recreational facilities. Persons with physical disabilities have encountered challenges in accessing health services, accessing the inbuilt environment. Likewise they have also faced economic exclusion, religious exclusion and social/moral exclusion. Laws have been enacted globally, in Africa and in Kenya and the latest universal law being the United Nations Convention on Rights of Person with Disabilities. Aim of the study: To determine factors inhibiting equalization of opportunities with regards to the services in health, education, employment and to explore the factors inhibiting equalization of opportunities with regards to infrastructure and recreational facilities, to persons with physical disability in Uasin Gishu County, Kenya. Study area: Research was conducted at Moi Teaching and Referral Hospital and APDK Mobile Outreach Centers for Persons with disability. Research Design: Mixed method approach (concurrent) was used where the researcher integrated information at the final interpretation of the results. The study was done in quantitative and qualitative phases. Research Instruments: A self-administered questionnaire was used to collect quantitative data. The questionnaire that was in four sections was administered to 375 participants and it sought to determine the factors inhibiting equalization of opportunities to persons with physical disabilities with regards to health, education and employment. The reliability and validity of the research instrument was tested before use. Six focus group discussions using the nomination rule was conducted and it comprised of 6-8 participants. Structured interviews with four key informants were also held to explore the factors inhibiting equalization of opportunities to persons with physical disabilities in recreational facilities and infrastructure in Uasin Gishu County Kenya. Data analysis: Version 22 of the Statistical Package for Social Sciences (SPSS) was used to pinpoint the quantitative data. Descriptive statistics was used and the findings were presented in the form of frequencies and percentages. To test the relationship between the different categories of variables inferential statistics (chi-square) was used, (p<0.05). For the qualitative data, the tape recorded interviews were transcribed verbatim, field notes typed, categorizing and ordering data was done and themes were produced. To obtain themes thematic content analysis was used. Ethics: The participants were made aware of the aim of the study, confidentiality and their freedom to withdraw from the study. Approval was obtained from the University of the Western Cape Senate Research Grants and Study Leave Committee before the study commenced. Ethical clearance was also obtained from the Institutional Research and Ethics Committee of MTRH and Moi University. Informed approval was also obtained before the survey and the FGD. Results: There were statistially significant relationship between nature of disability and workplace policies (p=0.001) to employment, distance from residence (p=0.001) to health facility and attitude of health workers on access to health. There was also a significant relationship between school policies (p=0.001) and help from family members (p=0.001) in access to education. The emerging themes in the FGD were the presence of sidewalks, zebra crossing, car parks, traffic control lights, benches and rest areas, transport adaptation, building adaptation, toilets and ramps/ lifts. The discussions in the emerging themes in the FGDs showed that persons with physical disabilities are yet to fully access infrastructure and recreational facilities. Conclusion: These results therefore showed that PWDs are yet to attain equalization of opportunities with regards to health, employment, education and recreation compared to their non-disabled counterparts and is therefore recommended that the legislations/policies in place be fully implemented in line with UN convention 2006 and persons with disabilities Act 2003 (Kenya).
The management of minor health ailments by doctors, clinical nurse practitioners and clients at the primary level of care in Cape Town
(University of the Western Cape, 2010) Mlenzana, Nondwe; Mji, Gubela
INTRODUCTION: Community Health Centres (CHCs) are overcrowded. The overcrowding poses a problem to health professionals as they are in charge of screening clients and the management of minor health ailments (MHA) in the primary health care setting. METHODOLOGY: The aim of this study was to describe and compare the perceptions and attitudes of clients presenting with MHA to those of doctors and clinical nurse practitioners (CNPs) (health professionals) at the CHCs regarding the management of MHA. The study was conducted at the four selected CHC in Khayelitsha and Phillipi, Cape Town. Information was collected from 100 clients and 15 health professionals. Data was analysed both qualitatively and quantitatively and the descriptive method was used. RESULTS: All three groups had similar perceptions of what MHAs are and how MHA should be managed. There were different perceptions regarding where these ailments should be managed. The doctors and CNPs were frustrated and felt overburdened by clients presenting with MHA. Doctors were of the opinion that educating clients about the management of these ailments would alleviate their load. CONCLUSION: Health education was identified as a tool that could assist in the situation of managing MHA and as the key underpinning principle for the delivery of comprehensive primary health care (PHC).
Mentoring and coaching in promoting publications in the Department of Physiotherapy at a local university in South Africa
(AOSIS, 2010) Frantz, Jose M.; Rhoda, Anthea; Rowe, Michael; Phillips, Julie; Karachi, Farhana; Mlenzana, Nondwe; Pharaoh, Hamilton; Steyl, Tania; Struthers, Patricia
A growing shift towards research and evidence based practice in academia is associated with requirements to disseminate research results in the form of publication in peer reviewed journals. Mentoring has been identified as an important component of developing young authors, as it increases confidence and competence, and facilitates professional development. This led to the formation of a support group to stimulate peer-review publication in the physiotherapy department at the University of the Western Cape. The Kirkpatrick Framework of Evaluation was used to evaluate the success of the mentoring process which made use of a participatory action research methodology. The writing group consisted of nine academic members of staff and took place over ten weeks. The programme included writing, giving feedback, discussion and peer review on a weekly basis. Focus group discussions were taped and transcribed in order to evaluate the mentoring process by identifying relationships within the data and categorising key concepts, which were shaped into a thematic framework. The findings indicated that participants experienced a variety of emotions throughout the programme, with an overall feeling of personal growth by the end. In addition, participants also reported improved writing, reviewing and communication skills. Six months following the programme, six participants had submitted at least one article to a peer reviewed journal. It is clear from this study that some academics still find the task of writing and reviewing articles daunting, and that guidance and support in the form of a writing programme can be useful.
Participation restrictions of stroke patients living in the community at selected community health centres in the Metropole Districts in the Western Cape, South Africa
(University of the Western Cape, 2014) Arowoiya, Ayorinde Ibukun; Mlenzana, Nondwe; Rhoda, Anthea
Stroke is the second leading cause of death globally and the consequences on human and economic health are of major concern. The aim of this study was to determine and explore the participation restrictions experienced by stroke patients. The study populations were stroke patients living within the community in Western Cape, South Africa. A mixed methods approach was used to collect data in this study which consisted of two phases. For the first phase, the descriptive, observational cross sectional design was used to determine the participation restrictions of stroke patients living within the community and the factors associated with community with respect to integration. In this phase, an interviewer- administered questionnaire was used to collect data; the instrument for this study is the standard World Health Disability Assessment Schedule 2.0 (WHODAS 2.0) for disability assessment which includes the International Classification of Functioning Health and Disability (ICF) concept in disability assessment which has been tested and found to be reliable and valid, to determine various participation restrictions among stroke patients living in the society. While in the second phase of this study, two focus group discussions were conducted at the selected community health centre; these participants were conveniently selected from those who participated in the first phase of the study. This was conducted to retrieve in-depth information on difficulties encountered in participating in daily life situations. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square and Anova t-test was used to determine the association between the demographics statistic and participation restrictions. Alpha level was set at 0.05. For qualitative findings, audiotaped interviews and note taken were transcribed and translated into English; the expressed ideas were coded and reduced into subthemes, themes and categories. Ethical clearance and permission to conduct study was sought, consents from participants were sought, clearly stating the right to participate and withdraw from the study was respected and anonymity and confidentiality has been ensured. The result of the study showed that participants encountered difficulty with cognition, (23.3% of participants reported severe difficulty in learning a new task; 20% reported severe difficulty analyzing and finding solution to day to day activities), mobility (34% acknowledged difficulty walking a long distance like one kilometer after stroke), self-care ( 44% indicated difficulty staying alone for few days after stroke, while the majority, 61% complaints of difficulty with getting dressed by self), getting along with people with the majority of the difficulties (36%) are sexual activities, household activities with major complaints (46.6% and 31.4%, for severity and exemption respectively) in getting needed household work done, severe difficulty (51.7%) reported in relaxation and pleasure after stroke, 50.8% been financially restrained after stroke, 40% with difficulty in joining in the community activities, 39.2% severely affected by people perception towards them and 25.8% of the participants indicated extreme time spent on health; all difficulties investigated within the society 30 days after the incidence of stroke. However, the result of the qualitative phase reported the participation restrictions experienced by the participants. Difficulty in cognition was reported, which promotes indiscipline among family members. Limitation in activity level such as in mobility (walking for a long distance, standing from a sitting position), in self-care (washing the whole body, eating, staying alone after stroke), in getting along (maintaining friendship, sexual activities), in household activities and work activities was reported. Participants experienced difficulty in joining in community activities, emotional fluctuations, poor perception of attitudes of others after stroke, excessive use of time on health conditions, increased financial impact of health condition and burden impact on family was reported. Environmental barriers such as transportation and toilet facilities were reported. The current study findings suggest appropriate and specific programmes should be aimed at improving participation among stroke survivors in the community.
People with disabilities and service providers’ experiences of community based rehabilitation in Rwanda
(2009) Dusaberurema, Dieudonne; Mlenzana, Nondwe
Background: Globally the number of people with disabilities (PWDs) is escalating especially in developing countries. Different approaches and strategies have been used to care for PWDs but could not meet their expectations. Community Based Rehabilitation(CBR) is recognised by the World Health Organisation (WHO) as the strategy to address their needs using both the medical and social model. CBR was established and implemented in two areas of Rwanda ten years ago with overall objectives that aim to facilitate accessibility to CBR service and full participation of PWDs in the community.However, the number of PWDs accessing rehabilitation services in Rwanda is still limited.Since the CBR programme started in Rwanda, there has been a lack of information on whether the CBR services provided by these two programmes are meeting the needs of PWDs and whether they facilitated the service providers to deliver the services more easily as intended. The aim of this study was to determine the experiences of PWDs and service providers of the Inkurunziza and Gahini CBR programmes in Rwanda.A qualitative method of data collection used in the study included focus group discussions with the selected PWDs. In-depth interviews were conducted with a purposively selected sample of service providers. This study was carried out at two day centers one from the Inkurunziza CBR programme and the other from Gahini CBR programme. The results revealed that the CBR programmes have increased the number of PWDs accessing CBR services. Services provided at these centres addressed some of the needs of PWDs, which included provision of assistive devices, and rehabilitation services, which were accessible. Most of the participants claimed that the programme is not doing anything to help them with activities that can assist to generate income and facilitate accessibility to schools or vocational training. The study findings indicated that services delivered in both CBR programmes only addressed some of the needs of the PWDs accessing the two CBR programmes. The service providers reported that they found it difficult to reach certain areas to provide CBR services to PWD due to geographical constraints. It is recommended that the CBR services provided by the two programmes need to focus more on education, training and employment of PWDs.
Perceptions and expectations of patients regarding a new rehabilitation model to encompass the vision of the new health plan 2030
(University of the Western Cape, 2017) Petersen, Rochelle Louisa; Mlenzana, Nondwe
People with disabilities face many challenges. Some are made to feel inferior by others because of their physical or mental disabilities. Primary healthcare described by the Alma Ata Declaration as "health for all", is a process of care which encompasses a comprehensive approach to meet the basic healthcare needs of all, including people with disabilities. The main focus of the primary healthcare approach is to put people at the centre of healthcare. Primary healthcare utilises rehabilitation as a service. Rehabilitation services worldwide are set to improve the standard that the United Nations Convention of the Rights of People with Disabilities and National Committee of Rights People with Disabilities aims to achieve. There are however, gaps in the delivery of healthcare services at a primary level, as identified by the Western Cape Department of Health in South Africa. The 2030 healthcare plan was developed to fill the gaps at this level of service. The plan builds on the comprehensive service plan of healthcare 2010 which aimed to strengthen community-based services, primary healthcare and district hospitals. The plan also looks at how the Department of Health will operate using this platform. The framework was established to focus on changes inclusive of threats in the environment such as technological advances and the availability of resources, building on lessons learned in the Comprehensive Service Plan 2010 as well as a reimagined future to improve healthcare services for all. Key stakeholders in the Western Cape aim to improve these health services by providing patientcentred care, moving towards a goal orientated outcome, improving services at a district health level, improvement of equity, affordable health services and establishing premeditated partnerships.
Perceptions and satisfaction of caregivers regarding rehabilitation services from selected rehabilitation centres in the Western Cape
(2018) Mlenzana, Nondwe; Eide, Ana; Frantz, Jose M.
Understanding caregivers’ views on rehabilitation services is important as it may assist in informing healthcare services and patient management. The aim of this study was to explore caregivers’ perceptions and satisfaction regarding rehabilitation services in the Western Cape, South Africa, and to inform clinical practice and policy in this emerging field.
Perceptions regarding medical management of clubfoot in Kenya
(University of the Western Cape, 2012) Kingau, Naomi Wanjiru; Mlenzana, Nondwe; Rhoda, Anthea
Clubfoot is one of the congenital and structural conditions that lead to physical impairment in children globally. Service providers have different perceptions on the various methods of management of clubfoot. This has led to adoption of various approaches of management of clubfoot. Although there is a wide range of experiences of parents/caregivers of children with clubfoot regarding medical management of this condition, there is no documented data on these experiences. The study therefore aimed at exploring the perceptions regarding the medical management of clubfoot in Kenya. The objectives of this study were to explore the service providers and parents/caregivers perceptions on the use of the different methods of medical management of clubfoot; explore the process followed before and after the commencement of management from the service providers and parents/caregivers when using surgical and conservative methods of management as well as exploring the barriers and enabling factors that the service providers experience during the management of clubfoot. Methodology: This study was conducted at talipes clinic of Mbagathi District Hospital, Kenyatta National Hospital and Kijabe Mission Hospital in Kenya. The study utilized a qualitative design and purposive convenient sampling was utilized to recruit participants. Twenty participants were recruited; the sample consisted of ten parents/caregivers of children with clubfoot and ten service providers. Semi-structured interview and probes were used for data collection, interviews were audiotaped and a research assistant took notes, data was collected until saturation. Data was transcribed verbatim and analyzed by thematic-content analysis. The results indicated that most of the service providers perceived Ponseti method as the most effective method of clubfoot management with early intervention. Surgery was found to be the second most utilized method which was indicated for complex and neglected clubfoot. The factors that affected service providers in clubfoot management included: Shortage of trained staff in Ponseti management, missed diagnosis at birth; poor referral system and poor compliance with treatment appointments. The factors that affected parents/caregivers compliance with the treatment regime included: (i) unaffordable transport expenses; (ii) long distance; (iii) little or no social/family support; culture/tradition and stigmatization while compliance was facilitated by (i) good communication between the parents/caregivers and the clinician; (ii) availability of free services (iii) social/ family support. Conclusion: The current study concluded that medical management of clubfoot was a success while majority of parents/caregivers agreed that they were faced with several challenges as fore mentioned which affected the outcome. Recommendation: the study therefore recommends the need to empower the community and service provider with knowledge on clubfoot and its management. There is also need for decentralisation of services and increase the number of health care givers in health facilities who are trained in clubfoot management. Finally physiotherapy academic institutions need to put emphasis on teaching clubfoot management in order to produce effective service providers.
Physiotherapists’ perceptions on stroke rehabilitation with focus on palliative care in Lusaka, Zambia
(University of the Western Cape, 2015) Mwanza, Christo; Mlenzana, Nondwe; Mpofu, Ratie
Palliative care is a vague and often confusing term used to describe a type of treatment model for chronic and life-threatening illnesses. WHO describes palliative care as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness by: early identification, impeccable assessment, and treatment of pain, physical, psychosocial and spiritual. The aim of this study is to explore the perceptions of physiotherapists on palliative care in order to contribute to the understanding of the role of physiotherapists to the care of stroke patient in Zambia. The objectives of this study are to explore physiotherapists’ knowledge on palliative care, their perceptions on management of palliative care as well as explore its application in the rehabilitation of stroke patients; and lastly to make recommendations on guidelines based on the outcomes of this study. Method: an exploratory study, using qualitative design was used. Data collection techniques were in-depth individual interviews and FGDs that consisted of purposively sampling of physiotherapists working; at four selected hospitals and a rehabilitation centre in Lusaka. Audio recording from the interviews was transcribed verbatim for each session by an independent person. The study employed thematic content analysis for data analysis. The data was classified systematically by means of coding to identify key factors or issues such as concepts, categories, themes and the relationship between them. Results indicated that all participants in the current study perceived palliative care as a medical care for the chronic and terminal ill patient in whom stroke patient and family will benefit if it is applied in the early stages of the disease trajectory; as well as it does improve the patient and family quality of life. Furthermore they emphasized on multidisciplinary team and holistic approaches in order to achieve all its tenets. Conclusion: the study had succeeded in exploring the physiotherapists’ perceptions on palliative care and contributed to the understanding of the role of physiotherapy to the care of stroke patients in general.
Reflection on an interprofessional community-based participatory research project
(Health and Medical Publishing Group, 2016) Frantz, Jose M.; Filies, Gerard C.; Jooste, Karien; Keim, Marion; Mlenzana, Nondwe; Laattoe, N.; Roman, Nicolette V.; Schenck, Catherina (Rinie); Waggie, Firdouza; Rhoda, Anthea
BACKGROUND. A collaborative interprofessional research project that involved community members was beneficial to community development. OBJECTIVE. To draw upon the experiences of academics relating to their involvement in an interprofessional community-based participatory research (CBPR) project. METHODS. A Delphi study was applied as a self-reflective evaluation process to reach consensus on the lessons learnt from participation in a CBPR project. Round one of the Delphi employed closed-ended questions and the responses were analysed descriptively using Microsoft Excel (USA). The second round consisted mainly of open-ended questions and responses, and was analysed qualitatively. Ethical clearance was obtained from the University of the Western Cape research committee. RESULTS. Based on round one of the Delphi study, it became evident that recognition of the community as a unit of identity, addressing health from physical, emotional and social perspectives and formation of long-term commitments were the CBPR principles most applied. Disseminating information to all partners and facilitation of the collaborative equitable involvement of all partners in all phases of the research were the principles least applied. Themes that emerged from the second round of the Delphi included the identification of clear objectives based on the needs of the community, a shift from identification of the needs of the community to the implementation of strategies, and the creation of capacity-building opportunities for all stakeholders. CONCLUSION. In a reflection on the research process, the interprofessional team of academics found that the basics of CBPR should be attended to first. A focus on clear objectives, implementation strategies and capacity building is important in CBPR.
Rehabilitation model to promote interprofessional practice at primary health care level in the Western Cape of South Africa
(AFAHPER-SD, 2017) Mlenzana, Nondwe; Frantz, Jose M.
Rehabilitation services at primary health care level in South Africa are considered as essential services for the disabled community. Currently there are challenges with implementation of rehabilitation services at community level in South Africa. Hence it is important to explore and identify gaps in rehabilitation services at primary level of care. This was a descriptive, explorative design using both quantitative and qualitative methods of data collection. Patients and service providers were purposively selected from selected community health centres. Quantitative data were analysed descriptively. Qualitative data were analysed and presented as themes. The majority of patients (n=365) interacted with only one rehabilitation professional and missed out on interdisciplinary team members. Twelve percent (12%) of the service providers did not ask permission to consult their patients. Patients were dissatisfied with rehabilitation service delivery. Patients were not happy with rehabilitation services and rehabilitation service providers did not focus on a patient-centred approach. The resultant recommended development of a rehabilitation model was based on the health care plan 2030 document that advocates for inclusion of strategies for clear access to rehabilitation services and rehabilitation interventions. Rehabilitation services will change from a therapist to a patient-centred approach and services will be viewed differently.
Rehabilitation professionals' views on the experiences of patients with physical disabilities accessing community health centres
(University of the Western Cape, 2018) Abdulqadir, Ayiman Husayn Khalleefah; Mlenzana, Nondwe
Rehabilitation services have been described as being necessary to maximize patient independence in order to enable them to participate fully in their communities. The Aim of the study was based on the problem statement and the research question, this study aims at exploring rehabilitation professionals' views on the experiences of patients with physical disabilities accessing CHCs in the Western. The objectives of the study were to explore the views of rehabilitation professionals regarding experiences by patients accessing rehabilitation services at the Community Health Centres (CHCs) in the Western Cape and to reach health experts consensus on how rehabilitation services should be provided at the CHCs based on the outcomes of objective 1. Methodology: This study used an exploratory design that used qualitative methods for data collection (workshops and focus group discussions (FGDs) and a Delphi study. The study was conducted at purposively selected CHCs in the Western Cape. The population in this study included all rehabilitation professionals who provide rehabilitation services in the CHCs, who were invited to participate in the study. Data collection: In the qualitative and the Delphi study, data was collected through workshops, focus group discussions and emails respectively. Data analysis: The workshops and the FGDs were audio recorded and then transcribed verbatim for content analysis.

Browsing by Author "Mlenzana, Nondwe"

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