Improving the annual review of diabetic patients in primary care: an appreciative inquiry in the Cape Town District Health Services

Mash, Robert; Levitt, Naomi; Vuuren, Unita Van; Martell, Rael

doi:10.1080/20786204.2008.10873764

Cited by 20 publications

(28 citation statements)

References 5 publications

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“…Although the predominant spoken language is isiXhosa, the recent population census revealed that other spoken languages include Setswana, isiZulu, English and Afrikaans (Lehohla, 2011). As is the case with other chronic conditions, epilepsy is managed in Community Health Centres (CHCs), which offer health care to most patients from low-socioeconomic groups (Mash, Levitt, Van Vuuren, & Martell, 2008). …”

Section: Methodsmentioning

confidence: 99%

‘A thing full of stories’: Traditional healers’ explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town

Keikelame

Swartz

2015

Transcult Psychiatry

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The experience of epilepsy is profoundly culturally mediated and the meanings attributed to the condition can have a great impact on its social course. This qualitative study used Kleinman’s Explanatory Model framework to explore traditional healers’ perspectives on epilepsy in an urban township in Cape Town, South Africa. The healers who participated in the study were Xhosa-speaking, had experience caring for patients with epilepsy, and had not received any training on epilepsy. Six individual in-depth interviews and one focus group with nine traditional healers were conducted using a semi-structured interview guide. Traditional healers identified several different names referring to epilepsy. They explained epilepsy as a thing inside the body which is recognized by the way it presents itself during an epileptic seizure. According to these healers, epilepsy is difficult to understand because it is not easily detectable. Their biomedical explanations of the cause of epilepsy included, among others, lack of immunizations, child asphyxia, heredity, traumatic birth injuries and dehydration. These healers believed that epilepsy could be caused by amafufunyana (evil spirits) and that biomedical doctors could not treat the supernatural causes of epilepsy. However, the healers believed that western medicines, as well as traditional medicines, could be effective in treating the epileptic seizures. Traditional healers were supportive of collaboration with western-trained practitioners and highlighted that the strategy must have formal agreements in view of protection of intellectual property, accountability and respect of their indigenous knowledge. The findings suggest a need for interventions that promote cultural literacy among mental health practitioners. Research is urgently needed to assess the impact of such collaborations between biomedical services and traditional healers on epilepsy treatment and care.

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Section: Methodsmentioning

confidence: 99%

‘A thing full of stories’: Traditional healers’ explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town

Keikelame

Swartz

2015

Transcult Psychiatry

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“…Findings from an annual review of diabetic patients in primary care in Cape Town reveal that there is a need for support groups in chronic illness care and management. The authors further state that support groups are an important strategy for increasing patients' self-efficacy [15]. A number of strategies that can be used for structured self-management interventions have been described internationally.…”

Section: The Role Of Epilepsy Support Groups and Self-managementmentioning

confidence: 97%

“…Health services provided include maternal and reproductive health, child health, TB, nutrition, school health, oral health, sexually transmitted infections (STI's), HIV, environmental health, mental health, rehabilitation services, and chronic illnesses (epilepsy, hypertension, asthma, and diabetes). Patients needing ambulatory care in CHCs are seen by clinical nurse practitioners and doctors [15]. Residents from these townships are of low socio-economic background and have high rates of illiteracy and unemployment [16].…”

Section: Participants and The Settingmentioning

confidence: 99%

Lost opportunities to improve health literacy: Observations in a chronic illness clinic providing care for patients with epilepsy in Cape Town South Africa

Keikelame

Swartz

2013

Epilepsy & Behavior

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“…Currently the education of diabetic patients and support of self-care has been left to the varied initiatives of individual health workers and there is no structured programme of education for people with diabetes in the Western Cape. Chronic care teams have identified that the health promoter should be the key person in delivering such a programme [7]. …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial

et al. 2012

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BackgroundDiabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life.MethodsTrial design: Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room.Objective: To evaluate the effectiveness of the group diabetes education programmeOutcomes: Primary outcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. Secondary outcomes: self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre’s allocationNumbers randomized: Seventeen health centres (34 in total) will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570.DiscussionThe study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely.Trial registerPan African Clinical Trial Registry PACTR201205000380384

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Improving the annual review of diabetic patients in primary care: an appreciative inquiry in the Cape Town District Health Services

Cited by 20 publications

References 5 publications

‘A thing full of stories’: Traditional healers’ explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town

‘A thing full of stories’: Traditional healers’ explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town

Lost opportunities to improve health literacy: Observations in a chronic illness clinic providing care for patients with epilepsy in Cape Town South Africa

Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial

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