Browsing by Author "Albertyn, Rene"

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    Open Access
    Evaluation of Burnout, Coping Strategies and Resilience in Paediatric Oncology Health Care Workers in Cape Town
    (2018) Jimoh, Azeezat M.; Shea, Jawaya; Albertyn, Rene
    Background: Burnout is a work-related condition with a significant footprint in the medical profession. It is characterised by emotional exhaustion (EE), depersonalisation (DP), and a low sense of personal accomplishment (PA) at one’s job. Depending on situational and individual factors, the prevalence of burnout among healthcare workers (HCWs) has shown an upward trajectory with peaks in certain medical specialities. Paediatric oncology unit (POU) HCWs are at a high risk of developing burnout because of the immense physical and emotional involvement that can be associated with caring for children with cancer. The burnout process can, however, be influenced by adopted coping strategies and resilience. Research into the phenomenon of burnout and associated factors in POU HCWs is low in South Africa in spite of the global attention it has commanded. Because of the need to institute appropriate and acceptable intervention strategies and to avoid erroneous conclusions often associated with burnout, it is imperative to understand the local prevalence and the possible associated factors. This study, therefore, seeks to establish the prevalence of burnout in POU HCWs and to understand how the adopted coping strategies and level of resilience influence the burnout process in a defined setting. Acknowledging and understanding how these psychosocial factors affect HCWs is fundamental to designing interventions to reduce work-related stress conditions. Objectives: This study seeks to determine the following: prevalence of burnout among POU HCWs in Red Cross War Memorial Children’s Hospital, Cape Town; identify adopted coping strategies by the HCWs; evaluate the level of resilience in the HCWs; and make recommendations that may help reduce burnout in paediatric oncology care and, probably, other fields of health care in South Africa. Methodology: This research used a mixed method approach (quantitative and qualitative) to explore burnout, coping and resilience amongst POU HCWs. A questionnaire consisting of validated instruments (Maslach Burnout Inventory-Human Services Survey [MBI- HSS], Brief Resilience Scale [BRS], the Brief COPE and researcher-designed questions) was used to conduct a survey after obtaining ethical clearance (HREC REF: 051/2017). Depending on preference, electronic or paper-based questionnaires were distributed to POU staff. Data analysis was performed using Microsoft EXCEL (2010 version). Results: The response rate was 50% (n= 25). Five out of the total respondents were dropped due to gross omissions in responses to the survey questions. The majority of the respondents were females (95%), and by profession, nurses had the highest representation (80%). Eightyfive per cent (85%) of the respondents have worked in the POU for more than a year. The burnout prevalence was 15% – 45% across the three dimensions of burnout - high EE (20%), high DP (15%) and reduced PA (45%). The majority (70%) of the respondents were moderately resilient. The coping styles predominantly used by the respondents in this study were positive reframing, religion, acceptance, planning, self-distraction and active coping. The least used coping styles were substance use, denial and behavioural disengagement, which are all maladaptive coping strategies. There was no statistically significant association between burnout and demographic characteristics. However, with a high prevalence of 45%, reduced personal accomplishment (rPA) was also associated with most demographic characteristics. rPA was high in females; age groups 25-25 and 46-60; single and married; respondents with number of children >1; respondents with a graduate level of education; POU professionals that are nurses and administrators; respondents with work experience in medicine and work experience in oncology for less than 10 years. Respondents with low levels of resilience experienced average levels of burnout as evidenced by average EE and DP scores, while those with moderate levels of resilience experienced low burnout as evidenced by low EE and DP scores (P< 0.05) Furthermore, EE and DP correlated negatively with the BRS while PA correlated positively with the BRS. Concerning coping strategies, EE and DP correlated positively with denial, substance use, behavioural disengagement, venting and self-blame. PA correlated positively with emotional support, positive reframing and religion but negatively correlated with active coping. Generally, the respondents expressed the desire for better goal-focused teamwork in the POU as well as the implementation of effective intervention strategies. Conclusion: The prevalence of burnout in this study is between 15% - 45%. The particularly high prevalence of reduced personal accomplishment (45%) is of interest because it cuts across most demographic features. This is suggestive of a stronger influence of situation specific factors, common to all respondents, contributing to burnout. The predominant use of emotion and problem-focused coping methods, and the moderate level of resilience in the majority of the staff appear to be protective against burnout. There is, however, the need and desire for implementation of effective group and institutional intervention programmes for burnout in the POU staff in terms of availability, awareness and accessibility.
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    Evaluation of pain incidence and pain management in a South African paediatric trauma unit
    (2011) Thiadens, Tessa; Vervat, Elleke; Albertyn, Rene; van Dijk, Monique; Van As, A B
    OBJECTIVES: To evaluate pain incidence and pain management in a South African paediatric trauma unit, and to compare the usefulness of 5 different assessment tools. DESIGN: A prospective observational study, using the Numerical Rating Scale for pain (NRS pain), Numerical Rating Scale for anxiety (NRS anxiety), the Alder Hey Triage Pain Score (AHTPS), the COMFORT behaviour scale and the Touch Visual Pain Scale (TVPS). All patients were assessed at admission; those who were hospitalised were again assessed every 3 hours until discharge. RESULTS: A total of 165 patients, with a mean age of 5.3 years (range 0 - 13), were included. NRS scores were indicative of moderate to severe pain in 13.3% of the patients, and no pain in 24% at admission. Two-thirds of the patients received no analgesics; for them, NRS pain, AHTPS and TVP scores were lower than the scores for the other children. CONCLUSION: Pain and anxiety incidences in this paediatric trauma unit are relatively low. Implementation of a standard pain assessment tool in the emergency department triage system can improve pain management. The AHTPS is the most promising for use in non-Western settings.
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    The measurement of procedural burn pain and anxiety in paediatric burns : the new BOPAS method
    (2002) Albertyn, Rene; Rode, Heinz; Thomas, Jenny
    The assessment of pain and anxiety in South Africa is complicated by language barriers, cultural differences, socio-economic difficulties and delayed cognitive development. The high number of paediatric burn injuries (annually 2000) treated at the Red Cross War Memorial Children's Hospital, the need to accurately assess pain and drug efficacy and the current lack of specifically designed methods to do so, led to the development of the Burn Observational Pain and Anxiety Scale (BOPAS). This scale is believed to be the first of its kind and was designed to measure both pain and anxiety in burned children. The aim of this study was: - To develop an observational pain and anxiety scale that can overcome ianguage barriers by excluding patient involvement in the assessment process. - To develop a scale that can differentiate between pain and anxiety during wound care procedures. - To develop a method that facilitates the translation of nominai information into numerical data. - To develop a scale that can evaluate drug and dose efficacy. A total of 105 chiidren, (M = 65, F = 40) aged 2-12 (average age 6.8 years), admitted for minor to moderate burn injuries to the Burns Unit of the Red Cross War Memorial Children's Hospital, were included in the sample. Five different consecutive studies varying between explorative and quasi-experimental were conducted to determine different levels of validity and reliability.
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    The use of children's free drawings in assessing the presence of paediatric pain
    (1996) Albertyn, Rene; Angless, Teresa M
    This study aims to investigate the use of hospitalized children's free drawings to assess the presence of post-operative pain in patients where language barriers previously prevented the use of existing pain assessment methods. This research involved 50 children ages 6 - 13 years, mostly from impoverished families, treated at the Red Cross Children's Hospital. The design is exploratory-descriptive in nature. The methodology was to collect drawings (110) on admission, after surgery (described as minor to moderate), when the children were expected to be experiencing pain, and also on discharge from hospital. These drawings were compared for picture content and children's responses to a combination of two scales developed and tested elsewhere (Word Graphic Scale and the Pain Ladder Scale), in an attempt to devise an alternative route to gauge subjective pain through drawings. Parental (44) and respondent (6) interviews provided information on parental reaction to children when in pain, and patient pain behaviour. Evidence suggests that children's free drawings can be successfully used in assessing the presence of pain but not the intensity thereof, and are recommended for use in the treatment process.