Browsing by Author "Davids, Eugene Lee"

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    Factors that influence adolescents condom use decision-making in the Western Cape, South Africa
    (2019) Davids, Eugene Lee; Swartz, Alison; Mathews, Catherine
    This study explores factors that influence condom use decision-making of adolescents from two schools in the Western Cape, South Africa. Thematic analysis was used to analyse the data generated from 16 individual semi-structured interviews. When exploring the factors that influence adolescent’s condom use decision-making, sexual debut and the role that emotion plays in the decision-making process were frequently discussed. The themes which emerged for sexual debut included relationships were about displaying true love which was equated with having sex and respecting parents’ expectations and rules informing decisions not to have sex at this age. When exploring the themes which emerged for condom use decision-making, the adolescents spoke about their concerns for the future and organising their lives. In addition, anticipated fear about falling pregnant, becoming parents and being infected with a disease emerged when exploring adolescent condom use decision-making. Understanding adolescent condom use can assist in aligning sexual and reproductive health (SRH) interventions and supporting healthy SRH decision-making and healthy relationships for adolescents.
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    Outcomes of preadolescent children after inpatient psychiatric admission: a scoping review and qualitative study
    (2022) Swart, Tania; de Vries, Petrus J; Davids, Eugene Lee
    Background: Approximately twenty percent (20%) of children and adolescents have mental health disorders and between 50–75% of all adult mental illness has its onset before the age of 18. Few under 18-year-olds with mental health disorders are, however, admitted for psychiatric inpatient care. The majority of those are adolescents who present with emerging serious mental health disorders. Very little is known about inpatient admission of preadolescent children (under 13 years) with mental health disorders. A review in 2000 showed mixed results about outcomes from admissions and highlighted a number of challenges with outcome studies. Objectives: The purpose of this study was to investigate the outcomes of preadolescents (hereafter referred to as ‘children') after inpatient admission, both locally and internationally. Methods: To meet the first aim, we performed a scoping review. Two reviewers independently searched EBSCOhost and Scopus (January 2000 – February 2017), using keywords ‘inpatient'; ‘psychiatry'; ‘psychiatric unit'; ‘mental health'; ‘children'; ‘treatment outcome/s'; ‘follow-up'; ‘secondary care'; to identify studies examining child (0–12 years) psychiatric inpatient outcomes. To meet the second aim, perspectives of convenience sampled parent-child dyads, who were previously patients at an inpatient psychiatric unit for under 13-year-olds in Cape Town, South Africa, were gathered using in-depth individual interviews. Data generated from the interviews were transcribed and analysed using thematic analysis. Results: Seventeen studies were identified by the PRISMA-guided search strategy in the scoping review. Measurements used differed widely. Significant improvements were reported at discharge and was maintained in short-term follow-up (1–4 months) studies. However, medium-term (5–11 months) and long-term (1 year or more) follow-up studies showed mixed results, with marked deterioration in very long-term studies. The qualitative study showed that most families found inpatient admission helpful, and indicated positive outcomes, but with ongoing difficulties over time. Two main themes related to outcomes emerged from the 10 parent-child dyads included in the study. The first theme (“A turn in the road”) highlighted inpatient admission as the catalyst of positive outcomes. Diagnostic certainty; newly acquired cognitive and behavioural skills; improved parent-child relationships; appropriate school placements; development of peer relationships; as well as follow-up psychiatric care and medication, were seen as contributing to positive outcomes. Conversely, the second theme (“Still a rough journey”) described ongoing difficulties including lingering problems despite improvement; minimal improvement when lacking a diagnosis; regression with transition to mainstream secondary school; and negative outcomes associated with lack of peer relationships and discontinuation of psychiatric care and medication. Conclusion: Taking together findings from our work, inpatient stay for child psychiatric patients was found to result in substantial short-term improvement. Medium-term outcomes were less clear, while long-term outcomes appeared mixed, with potential deterioration in the very long-term. However, the relatively few and diverse studies found in the scoping review made interpretation of the findings difficult. One striking finding from the research, was the absence of internationally agreed outcome measures to inform such research. In this study, qualitative data from families and children who had received inpatient treatment provided several functional outcomes that may be important, both for outcomes research and for post-discharge clinical practice.
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    The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation
    (BioMed Central, 2018-01-11) Hoosen, Nikhat; Davids, Eugene Lee; de Vries, Petrus J; Shung-King, Maylene
    Background: Child and adolescent mental health in Africa remains largely neglected. Quick and cost-efective ways for early detection may aid early intervention. The Strengths and Difculties Questionnaire (SDQ) is globally used to screen for mental health problems, but little is known about its use in Africa. We set out to perform a scoping review to examine existing studies that have used the SDQ in Africa. Methods: A comprehensive scoping review methodology was used to identify all peer-reviewed studies ever pub lished that have used the SDQ in Africa. Data were extracted and analysed to assess the countries, languages and SDQ versions used, the purpose of the SDQ studies, psychometric properties of the SDQ, and to consider knowledge gaps for future in-country and cross-country studies. Results: Fifty-four studies from 12 African countries were identifed, most from South Africa. Many diferent lan guages were used, but authorized SDQs in those languages were not always available on the SDQinfo website. Authors frequently commented on challenges in the translation and backtranslation of mental health terminology in African languages. The SDQ was typically used to investigate internalisation/externalization disorders in diferent clinical populations, and was most frequently used in the evaluation of children and adolescents afected by HIV/ AIDS. Sixteen studies (29.6%) administered the SDQ to participants outside the intended age range, only 4 (7.4%) used triangulation of all versions to generate assessments, and eight studies (14.8%) used only subscales of the SDQ. Only one study conducted thorough psychometric validation of the SDQ, including examination of internal consistency and factor analysis. Where ‘caseness’ was defned in studies, UK cut-of scores were used in all but one of the studies. Conclusions: The SDQ may be a very useful tool in an African setting, but the scoping review suggested that, where it was used in Africa researchers did not always follow instrument guidelines, and highlighted that very little is known about the psychometric properties of the SDQ in Africa. We recommend comprehensive evaluation of the psycho metric properties of the SDQ in various African languages, including internal consistency, factor structure, need for local cut-of values and ensuring cultural equivalence of the instrument.