Browsing by Author "Motsohi, Tsepo"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Open Access
    Management of hypertension in mental health patients in a primary care setting : an assessment of quality of care
    (2009) Motsohi, Tsepo
    In his experience working in the Metro District Health Services Clinics of the Department of Western Cape, the researcher has encountered numerous cases of sub-standard quality of medical care for mental health patients. These encounters, as well as a need to audit the general quality of care of patients with chronic diseases of lifestyle, have been the motivation behind the creation of this research project.The study is a retrospective cohort study using patient folders as a source of data. It compares the standards, processes and outcomes of the management of hypertension in two populations at Crossroads Community Health Clinic in Cape Town. The first cohort consists of hypertensive patients with psychiatric illnesses, and the second are hypertensive patients without psychiatric illnesses. The study attempts to examine the quality of care of established hypertension in patients with psychiatric illnesses.
  • Thumbnail Image
    Item
    Open Access
    Primary care practitioners' knowledge, attitudes and current practice in managing oral health conditions
    (2018) McCrindle, Lorna; Bresick, Graham F; Motsohi, Tsepo
    Background: Primary care practitioners are at the forefront of the health service and therefore have an opportunity to promote oral health, manage certain oral conditions, or refer appropriately to the closest dental service. In under-resourced areas, patients are more likely to present initially to a primary health care nurse or doctor, with oral or dental needs. Studies abroad have revealed that general practitioners do not always examine the oral cavity, enquire about oral health, or manage oral disease particularly well and have expressed an interest to learn more about oral health. A literature search for similar South African studies did not yield results. This study aims to describe current oral health care practice provided by primary care practitioners in Cape Town and to assess whether this level of service might benefit from interventions to improve the quality of care. Methods: The Nominal Group technique (NGT) was used to identify and achieve consensus among 8 community health centre primary care practitioners regarding the main challenges to providing oral health care and offer suggestions for strengthening oral health care. This assisted the development of a questionnaire, which was then distributed to practitioners at five Community Health Centres in the Cape Town Metropole. The questionnaire aimed to assess the knowledge, attitudes and current practices of practitioners in the area of oral health. Results: The NGT yielded valuable information to inform the questionnaire; two main topics were discussed which helped inform two sections of the 9-part questionnaire. A total of 53 doctors and clinical nurse practitioners completed the questionnaire. Only 17% of participants reported routinely examining the oral cavity, others examined it on request of the patient or suspicion of an abnormality. A minority (13.2%) stated that they routinely promote oral health in the consultation and reported limiting factors to include: insufficient time during consultations, forgetting to include oral health promotion, a limited knowledge of oral disease, and limited access to Oral Health Services. Suggestions for strengthening the oral health care included training clinicians in oral health, motivating clinicians to provide better oral health care, improving patient education on the importance of oral health care, and improving the integration of Primary Care services with Oral Health services. Limitations of this study include a small sample size, studying only urban community health centres in Cape Town, the absence of input from oral health experts, the absence of input from patients and missing data. Conclusion: It is apparent from this study that oral health is inadequately managed, for a number of reasons; including time constraints, limited knowledge of treating clinicians, and limited available oral health services. Possible interventions to improve this clinical area can be posed to relevant authorities and may include examining undergraduate curricula (medicine and nursing) to assess the content and quality of oral health education, provide in-house training to CHC staff by local dentists and oral hygienists, provide information sessions for staff at CHC about the local Oral Health Service available in their areas, and offering education to patients in the waiting room on the topic of good oral health.
  • Thumbnail Image
    Item
    Open Access
    A retrospective cohort study: The retention in care of HIV positive pregnant and breastfeeding patients universally initiated on lifelong ART ('OptionB+') in the Klipfontein/Mitchells Plain substructure in Cape Town
    (2016) Engelbrecht, Alida M; Motsohi, Tsepo
    The implementation of 'Option B+' has increased uptake and access to antiretroviral (ART) care. However, growing concerns exist regarding retention, especially once vertical transmission risk ceases. Considering the importance of adherence to achieve virological suppression and avoid resistance research on retention is crucial. This study compares the retention of women initiated on 'Option B+' to that of women initiating ART for their own health. Additionally possible predictors of loss to follow-up (LTFU) were explored. Women initiating ART between 1 April and 31 August 2013 were allocated to either the pregnant (n=228) or non-pregnant (n=177) cohort. Retrospective review of electronic recordkeeping systems and patient folders measured retention up to 15 months after ART initiation. Demographic data was captured to explore predictors of LTFU. To avoid outcome bias with participants transferred out, analysis included a 'worst case' scenario assuming LTFU of all these participants and a 'best case' scenario assuming continued retention in care.