Medical and physiotherapy students in tuberculosis (TB)-endemic settings are at high risk of developing occupational TB. Didactic lectures are the traditional method for delivering education on the topic of TB infection control (TB-IC) to undergraduate health science students. The aim of this study was to evaluate the impact of a novel educational package for teaching TB-IC to undergraduate health science students in a TBendemic setting.Undergraduate medical and physiotherapy students at Stellenbosch University, South Africa (n = 326) participated in a cross-sectional survey documenting TB-IC knowledge, attitudes and practices at the training institution. A self-administered questionnaire was completed before and after a novel educational intervention which utilized the health belief model (and included personal testimonials from healthcare workers and an IC expert who had survived occupational TB).Students perceived themselves to be at high risk of occupational TB, but underestimated drug-resistant TB mortality. Pre-intervention knowledge of TB-IC measures was poor, but improved post-intervention (58% vs . Senior students had better pre-intervention knowledge of N95 respirator use. Negative attitudes and TB-IC practices of senior staff at the training institution reportedly influenced those of students. TB-IC measures (natural and mechanical ventilation; airborne precaution signage; patient isolation) were reportedly poorly implemented. Access to personal protective equipment was problematic with 49% (87/177) of senior students stating that N95 respirators were never available.IntIn conclusion, students lack knowledge of TB-IC measures and report poor implementation of TB-IC measures at their training institution. A novel structured educational intervention increased students' knowledge of TB-IC measures and heightened awareness of occupational TB risk.
Background: Aphasia affects 0.37% of South Africans. Expressive aphasic patients’ ability to react appropriately to the environment contributes to their hospital experience, and ultimately their mental health and recovery. The challenge of communication for these patients makes it important to anticipate their experiences. Objectives: The purpose of the present study was to explore the patterns of patient experiences in relation to expressive aphasia following brain injuries in order to identify helpful recommendations for alternative communication and for promoting mental health and well-being.Methods: A qualitative case series study was completed with the participation of seven adults who had recovered from expressive aphasia. Participants had received their acute care at Worcester Provincial Hospital, South Africa and at the time of the study were able to communicate effectively concerning their experiences and perspectives. Interviews were transcribed and transcripts analysed by two independent researchers. A thematic analysis method, within a constructionist framework, and at a latent level, was applied.Results: Participants were generally satisfied with the services of health professionals. All participants described their families as being supportive. However, even though most participants had attempted to initiate alternative forms of communication, their families had not reciprocated this. Participants experienced sadness, frustration and anger following the onset of expressive aphasia. They reported gaining insight into the way their lives might change in the near future, such as their roles within the community, as well as into their experiences of introspection and self-reflection. Conclusions: Persons with new onset expressive aphasia during acute care at a large South African hospital experience negative emotions (such as feelings of frustration, entrapment and sadness) as well as inadequate responses to their desire to use alternative forms of communication. Anticipation of such negative experiences may substantially help communication. Formal training in this regard is recommended for health care professionals. Also, visitors to patients with expressive aphasia require basic instruction on the use of alternative communication.
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