Browsing by Author "Reddy, Preshani"

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    Evidence to inform the development of physiotherapy guidelines for HIV-infected and HIV non-infected women following obstetric and gynaecological surgery
    (University of the Western Cape, 2014) Reddy, Preshani; Frantz, José; Moodley, Manivasan
    Methods to improve women’s health have become an urgent global priority. Development of clinical guidelines is viewed as a way of improving the quality of health care in South Africa. At present there are no physiotherapy guidelines for women post-caesarean section delivery (CSD) and post-hysterectomy, which are the most common procedures performed by obstetricians and gynaecologists. South African women have the highest HIV-prevalence rates in the world, but there is a global dearth of literature on common postoperative complications for this cohort of women. The aim of this study was to provide evidence supporting the development of physiotherapy clinical guidelines relevant for HIV-infected and HIV non-infected women following caesarean section delivery and hysterectomy. The overall design of the study was prospective, descriptive and explanatory, with longitudinal, comparative and cross-sectional components incorporated at the different phases of the study. An amalgamated four-phase conceptual framework with specific objectives per phase was used to achieve the study aim. Phases 1 and 2 were conducted at four public hospitals in KwaZulu-Natal. Phase 1 identified the long-term complications and quality of life for HIV-infected and non-infected women post-CSD (N=310) and hysterectomy (N=101) over a six- month period; phase 2, which was cross-sectional in nature, identified treatment strategies and complications described by physiotherapists (N=31) for this cohort of women. Purposive probability sampling and purposive convenient sampling was used to select potential participants for phases 1 and 2. A self-administrated questionnaire with close and open-ended questions was used in the first two phases of the study. During phase 3, a systematic review and Delphi method (N=12) were used to investigate current management strategies of representative physiotherapists. Purposive sampling was used to select the participants who are considered as experts in the field of women’s health, for the Delphi study. The information from phases 1 to 3 was collated in phase 4 to provide the evidence to inform the development of the clinical guidelines. Phase 1 revealed that physical health complications commonly persisted for at least six months and negatively affected the quality of life of women post-CSD or post-hysterectomy. Phase 2 showed that very few patients post-CSD and hysterectomy were being referred for physiotherapy, and of those referred, the main problem being treated was respiratory complications. A systematic review of the literature yielded only one article relevant to the outcome of management of patients post- hysterectomy, thus illustrating the dearth of literature in this area. The experts who were consulted for the Delphi study suggested treatment techniques for the postoperative complications identified in phase 1, and consensus was reached on the techniques in the second Delphi round. The results were then collated in the final phase and presented in tables containing the identified problem, treatment and best available evidence to move towards the development of the guidelines. The common postoperative morbidities that were identified in this study can be prevented or treated with physiotherapy, but information is needed in this area to guide treatment practices. The prevention of postoperative complications can result in a decrease in demand for services, thereby reducing the current strain on the health system. The current study contributed to 18 of the 23 criteria in the appraisal of guidelines for research and an evaluation tool. The conceptual framework used to generate the evidence can also be employed in other facets of health care. In order to improve the quality of health care rendered to women, health care professionals require a complete picture of their patient. This research adds to the body of knowledge in an area where there is a dearth of literature and provides a platform to develop clinical guidelines. No national research exists that compares the postoperative complications of HIV-infected and non-infected women, which is essential to enable comprehensive care of HIV-infected women. The guidelines that will be developed can improve the quality of health care rendered to women, and establish the role of physiotherapists in this area.
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    HIV/AIDS knowledge, behaviour and beliefs among South African university students
    (2012) Reddy, Preshani; Frantz, Jose M.
    Globally, South Africa has the highest prevalence of HIV/AIDS. In the absence of cure, prevention is the only available method to reduce HIV prevalence rates. This can only be obtained through behavioural change, which is associated with a good knowledge about HIV. The study aims to determine the knowledge, beliefs, behaviours and sources of HIV and AIDS information among university students at two tertiary institutions in South Africa. The study was a quantitative, cross-sectional, descriptive and comparative survey. Students from the Western Cape Province and the KwaZulu-Natal Province participated in the study. The main findings of the study were that although students had an adequate general knowledge on HIV/AIDS, both groups scored the lowest in the transmission modes of HIV. The media was the main source of HIV/AIDS information for students and university health care facilities need to be more proactive in informing students about the transmission of HIV/AIDS.
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    Knowledge, attitudes, beliefs, behaviours and sources of hiv/aids information among university students at two tertairy institutions in South Africa
    (2009) Reddy, Preshani; Frantz, J.
    The incidence of HIV/AIDS appears to be stabilizing in South Africa. However, it is stabilizing at an extremely high number. The South African youth are the most vulnerable to the virus with the main route of transmission being heterosexual intercourse. In South Africa KwaZulu-Natal is the epicenter for the virus, while in the Western Cape has the lowest HIV/AIDS prevalence. The aim of the study was to determine the knowledge, attitudes, beliefs, behaviours and sources of HIV/AIDS information among university students at two tertiary institutions in South Africa. Method: The study was a quantitative, cross - sectional, descriptive and comparative survey. Students from the University of the Western Cape and the University of KwaZulu Natal (Westville Campus) participated in the study. The study instrument was a questionnaire which was complied from other questionnaires based on literature. The questionnaire consisted of questions to gather information pertaining to the students’ knowledge, attitudes, beliefs, behaviours and sources of HIV/AIDS information. The questionnaires were then tested for validity and reliability for South African students.The response rate for the questionnaires was 66% (N = 663). The main findings from the study showed that university students had a good general knowledge on HIV/AIDS.However students scored poorly in modes of HIV transmission. UKZN students scored higher than UWC students in the knowledge questionnaire. Males scored lower than females and there was also a significant association noted between age and knowledge.Students from both universities had a positive attitude towards people living with HIV/AIDS. There was a significant association between age and gender in terms of attitudes. Students from UWC deemed themselves as having less of a chance of contracting the disease compared to students from UKZN. UWC on the other hand students participated in more riskier behaviours than UKZN students. The media was the main source of HIV/AIDS information for students (79.9%). In terms of religiosity many students stated that the attend places of worship infrequently (35%).Recommendations: campus health care facilities need to be more proactive in informing the students about HIV/AIDS; alcohol and substance abuse needs to be addressed along with HIV/AIDS; campuses should draw up a full course on HIV/AIDS, courses to empower female students need to be offered and ongoing research needs to be done in this area to evaluate the effectiveness of the programmes being run.
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    Physiotherapy management strategies for women post-caesarean section delivery in public hospitals in KwaZulu-Natal, South Africa
    (SA Society of Physiotherapy, 2013) Reddy, Preshani; Frantz, Jose M.
    South Africa has seen a steady increase in the rate of caesarean section deliveries, and while physiotherapists are often requested to treat these patients, there are no guidelines on their physiotherapeutic management. Current treatment is therefore based on clinical presentations of the patient. This paper reports on the physiotherapy management strategies for women post-caesarean section delivery used at four public hospitals in KwaZulu-Natal during 2011-2012. The study used a quantitative, cross-sectional, descriptive design. The sample consisted of 31 physiotherapists who completed an anonymous self-administered questionnaire, of whom eight had not treated post-caesarean section delivery women at all in the one year period. The results showed mobilization (100%), breathing exercises (94%) and education (94%) were common choices, with 68% selecting pelvic floor exercises as part of their management strategy. The study concluded that the current physiotherapy management strategy for women post-caesarean section delivery is based mainly on the doctors’ referral. Due to their limited knowledge about physiotherapy treatment, doctors overlook other complication(s) and potential complication(s) that could benefit from treatment post-delivery. The study showed that there is a need to improve the role and influence of physiotherapists in the multidisciplinary team.
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    The quality of life of HIV-infected and non-infected women post-caesarean section delivery
    (AOSIS OpenJournals Publishing AOSIS (Pty) Ltd, 2017) Reddy, Preshani; Frantz, Jose M.
    There is a dearth of literature on the postnatal quality of life (QoL) of women. This study aimed to determine to QoL of HIV-infected and non-infected women post-caesarean section delivery. This prospective, longitudinal and comparative study was conducted at four public hospitals in KwaZulu-Natal. The participants were followed for six-months post-delivery and the QoL was measured using the SF-36 and the pelvic floor impact questionnaire (PFIQ-7). The results showed that the QoL of women were negatively affected post-operatively with the HIV-infected group scoring lower over the six-months. Understanding postpartum QoL problems is essential in efforts to provide effective comprehensive care.