Browsing by Author "Atkins, Salla"

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    Open Access
    Conducting a meta-ethnography of qualitative literature: Lessons learnt
    (BioMed Central Ltd, 2008) Atkins, Salla; Lewin, Simon; Smith, Helen; Engel, Mark E; Fretheim, Atle; Volmink, Jimmy
    BACKGROUND:Qualitative synthesis has become more commonplace in recent years. Meta-ethnography is one of several methods for synthesising qualitative research and is being used increasingly within health care research. However, many aspects of the steps in the process remain ill-defined.DISCUSSION:We utilized the seven stages of the synthesis process to synthesise qualitative research on adherence to tuberculosis treatment. In this paper we discuss the methodological and practical challenges faced; of particular note are the methods used in our synthesis, the additional steps that we found useful in clarifying the process, and the key methodological challenges encountered in implementing the meta-ethnographic approach.The challenges included shaping an appropriate question for the synthesis; identifying relevant studies; assessing the quality of the studies; and synthesising findings across a very large number of primary studies from different contexts and research traditions. We offer suggestions that may assist in undertaking meta-ethnographies in the future.SUMMARY:Meta-ethnography is a useful method for synthesising qualitative research and for developing models that interpret findings across multiple studies. Despite its growing use in health research, further research is needed to address the wide range of methodological and epistemological questions raised by the approach.
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    Open Access
    Greener grass? : international students' experiences at universities in the Western Cape
    (2002) Atkins, Salla; De la Rey, Cheryl
    Literature has indicated that international students may experience difficulties when entering their country of sojourn. Previous studies have not addressed the experience of these students in South Africa. Given the unique social and historical context of the country, students may encounter issues dissimilar to other countries. The objective of this study was to explore the experiences of international students in South Africa, in terms of the social, academic and general experience. Additionally, students' motivations and expectations were explored. For this purpose, a survey was conducted via e-mail to students at three Western Cape universities. The final sample comprised 142 postgraduate international students from three universities. The participants were from a variety of faculties, and originated from a variety of countries, most of them coming from the African continent.( A questionnaire, comprising closed-and open-ended questions, was constructed from findings in international research. The collected data were analysed both quantitatively and qualitatively. The quantitative analysis included chi-squares, Fischer's exact tests and logistic regression. The qualitative data were analysed using thematic content analysis. The main finding of this study was that students, although in most respects faring well, experienced problems in social interaction with South Africans.) Specifically, students reported having experienced discrimination. Their worst experiences were crime and social problems, and the experiences they enjoyed the most were mainly sightseeing and social activities, as well as faring well socially. Most students had arrived in the country in search of education, and with realistic expectations. The academic lives of most students were satisfactory. However, most students did not wish to remain in South African after the completion of their studies. Thus, there was no brain gain in favour of South Africa.
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    National stakeholders’ perceptions of the processes that inform the development of national clinical practice guidelines for primary healthcare in South Africa
    (BioMed Central, 2018-07-31) Kredo, Tamara; Cooper, Sara; Abrams, Amber; Daniels, Karen; Volmink, Jimmy; Atkins, Salla
    Background There is increased international focus on improving the rigour of clinical practice guideline (CPG) development practices. However, few empirical studies on CPG development have been conducted in low- and middle-income countries. This paper explores national stakeholders’ perceptions of processes informing CPG development for primary healthcare in South Africa, focusing on both their aspirations and views of what is actually occurring. Methods A qualitative study design was employed including individual interviews with 37 South African primary care CPG development role-players. Participants represented various disciplines, sectors and provinces. The data were analysed through thematic analysis and an interpretivist conceptual framework. Results Strongly reflecting current international standards, participants identified six ‘aspirational’ processes that they thought should inform South African CPG development, as follows: (1) evidence; (2) stakeholder consultation; (3) transparency; (4) management of interests; (5) communication/co-ordination between CPG development groups; and (6) fit-for-context. While perceptions of a transition towards more robust processes was common, CPG development was seen to face ongoing challenges with regards to all six aspirational processes. Many challenges were attributed to inadequate financial and human resources, which were perceived to hinder capacity to undertake the necessary methodological work, respond to stakeholders’ feedback, and document and share decision-making processes. Challenges were also linked to a complex web of politics, power and interests. The CPG development arena was described as saturated with personal and financial interests, groups competing for authority over specific territories and unequal power dynamics which favour those with the time, resources and authority to make contributions. These were all perceived to affect efforts for transparency, collaboration and inclusivity in CPG development. Conclusion While there is strong commitment amongst national stakeholders to advance CPG development processes, a mix of values, politics, power and capacity constraints pose significant challenges. Contrasting perspectives regarding managing interests and how best to adapt to within-country contexts requires further exploration. Dedicated resources for CPG development, standardised systems for managing conflicting interests, and the development of a political environment that fosters collaboration and more equitable inclusion within and between CPG development groups are needed. These initiatives may enhance CPG quality and acceptability, with associated positive impact on patient care.