Browsing by Author "Nhunzvi, Clement"

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    An occupatiobnal perspectice on the journey of recovery from substance abuse among young Zimbabwean men
    (2014) Nhunzvi, Clement; Galvaan, Roshan; Peters, Liesl
    Substance abuse is a rising global health and social problem that is associated with serious medical, psychiatric, family, occupational, legal, financial and spiritual problems. While recovery from substance abuse is possible, it is a subjective and contested process. To date, the recovery process has not been explored from an occupational perspective in Zimbabwe, where as many as 60% of all readmissions at Zimbabwe’s psychiatric referral centre during the period from January 2010 to December 2011 were secondary to substance-induced disorders, and less than three percent of these patients moved into long-term recovery or sustained sobriety with rehabilitation follow-up. This qualitative narrative inquiry explores the journey of recovery from substance abuse among young adult Zimbabwean men. The aim of the study was to investigate how occupations played a role in the recovery journeys of each of these men. Three young adult men identified as former substance abusers were purposively selected for the study. Data generation occurred through in-depth narrative interviews with each participant. Principles of trustworthiness and validation emphasising the persuasiveness, coherence and pragmatic use of the narratives were applied throughout the research process, and ethical issues in narrative research were upheld. Ethical clearance was applied for and granted by the University of Cape Town’s Human Ethics Research Committee and permission to do the research was sought and given by the Medical Research Council of Zimbabwe. The findings of the study — explanatory stories — were produced through narrative analysis. These stories revealed substance abuse to be an occupation associated with both positive and negative consequences. Recovery from such abuse emerged as an ongoing occupational transition negotiated through participation in other occupations, and influenced by both personal and environmental factors. The way in which occupations were abandoned, modified and newly adopted during the process of this occupational transition is discussed. The construction and reconstruction of a positive occupational identity was seen as central to the process of occupational transition. The study concluded that engagement and participation in ‘engaging occupations’ was an intricate contributor to the recovery journey for young adult Zimbabwean men, and that narrative interviews should be used in generating data to explore the occupational nature of life and its events.
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    The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study
    (BioMed Central, 2017-08-22) Tadyanemhandu, Cathrine; Mukombachoto, Rufaro; Nhunzvi, Clement; Kaseke, Farayi; Chikwasha, Vasco; Chengetanai, Samson; Manie, Shamila
    Background: The burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge. The objective of the study was to determine the pulmonary complications developing after abdominal and thoracic surgery and the associated risks factors. Methods: A retrospective records review of all abdominal and thoracic surgery patients admitted at a central hospital from January 2014 to October 2014 was done. Data collected included demographic data, surgical history, comorbidities and the PPCs present. Results: Out of the 92 patients whose records were reviewed, 55 (59.8%) were males and 84 (91.3%) had abdominal surgery. The mean age of the patients was 42.6 years (SD = 18.4). The common comorbidities were HIV infection noted in 14(15.2%) of the patients and hypertension in 10 (13.0%). Thirty nine (42.4%) developed PPCs and the most common complications were nosocomial pneumonia in 21 (22.8%) patients, ventilator associated pneumonia in 11 (12.0%), and atelectasis in 6 (6.5%) patients. Logistic regression showed that a history of alcohol consumption, prolonged surgery, prolonged stay in hospital or critical care unit, incision type, and comorbidities were significant risk factors for PPCs (p < 0.05). The mortality rate was 10.9%. Conclusion: PPCs like nosocomial and ventilator associated pneumonia were common and were associated with increased morbidity and adversely affected clinical outcomes of patients. HIV and hypertension presented significant comorbidities which the health team needed to recognize and address. Strategies to reduce the occurrence of PPCs have to be implemented through coordinated efforts by the health practitioners as a team during the entire perioperative period.