Family Medicine

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Browsing Family Medicine by Author "Van Rooyen, F. C."

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    Characteristics of patients with recurrent involuntary admissions for seventy-two hour assessment at Kimberley Hospital Complex, Northern Cape Province, Republic of South Africa
    (University of the Free State, 2019-04) Marufu, Godwin; Steinberg, W. J.; Van Rooyen, F. C.
    Introduction: Mental illness is common throughout the world, yet the true prevalence is underestimated. Forty-three percent (43%) of all psychiatric admissions in South Africa are involuntary, with a cyclical rise in re-admission rates, referred to as the revolving door syndrome. There was a need to unravel this syndrome, and help identify early, those patients at high risk of it, so that appropriate interventions are implemented to optimise psychiatric care and stem this system failure. Aim: The study aimed to quantify the frequency of re-admissions and recurrent re-admissions and describe the demographic characteristics, social support systems, and clinical characteristics of patients admitted for involuntary seventy-two-hour observation at the Kimberley Hospital Complex, Department of Family Medicine in the Northern Cape Province of South Africa. Method: This was a retrospective, hospital records- based cohort study, of all qualifying 1142 consecutive, involuntary admission episodes, from 614 patients at Kimberley Hospital from 01 January 2016 to 31 December 2017. There was a purposeful, non-random participant selection. Results: Fifty-four percent of the participants were admitted only once during the study period (n=614; 54%). The recurrent re-admission rate was two percent (n=28; 2%), with an average 6 admissions per each participant in the recurrent readmissions group, and the admissions ranging from five to sixteen (range 5 - 16). In between, the re-admissions decreased from a low risk rate of 32% (n=365) to high risk rate of 12% (n=135). Conclusion: This study showed that recurrent re-admissions, also known as the revolving door syndrome, is as much a problem in the Northern Cape Province of South Africa as it is across the rest of the world. The participant at a high risk of re-admission was more likely to be male, Black, young, unemployed, single, abusing substances, coming from a low-income area, with a previous history of involuntary admission, with a diagnosis of Schizophrenia and/or substance-use psychiatric disorder, be on antipsychotic medication, and with a long in hospital stay. Being of Coloured ethnicity, was a particular risk factor for recurrent re-admissions.
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    A study of the knowledge, attitudes and practice of lifestyle modifications among patients with type 2 Diabetes mellitus attending the Outpatient Department of the National District Hospital, Bloemfontein, Free State
    (University of the Free State, 2020-09) Peter, Paul Ifeanyi; Steinberg, W. J.; Van Rooyen, F. C.
    Introduction: Type 2 Diabetes Mellitus (DM), no doubt, constitutes a major public health burden globally with uncontrolled diabetes mellitus often resulting in several short and longterm complications. It may also sometimes result in loss of lives. Therefore, it is of utmost importance that individuals with diabetes mellitus are regularly made aware of the need for optimal glucose control. Apart from the pharmacological management of Type 2 DM, a healthy lifestyle plays a prominent role in the optimal control of the blood glucose level and prevention of complications but often little is known about the practice of lifestyle modifications among the Type 2 DM patients. Objectives of the study: To determine the knowledge, attitude and practice of lifestyle modifications among patients with Type 2 DM attending the outpatient department (OPD) at the National District Hospital, Bloemfontein, Free State. Methods: This project was a descriptive study with a cross-sectional component. The study was conducted among patients with Type 2 Diabetes Mellitus attending the outpatient department (OPD), National District Hospital, Bloemfontein, Free State. A self-administered structured questionnaire was used for the data collection. Information regarding the socio-demographic characteristics of the participants and their anthropometric measurements was obtained. The participants' knowledge, attitude and practice regarding physical exercise and healthy diet with regards to lifestyle modification practices among Type 2 diabetes were assessed. Results: A total of 149 correctly filled questionnaires were included in the data analysis. Majority of the participants, 104(69.8%) were females, while the mean age of the participants was 47.7 years. Majority of the participants (82.0%) had a varied level of formal education. Only 23.3% of the respondents were employed. Almost half (49.3%) of the respondents have been living with diabetes for more than ten years since diagnosis. Of the respondents, 64.4% were obese, and 23.8% were overweight. There was decent knowledge of lifestyle modification practices with regards to physical exercise and healthy dietary habits among the respondents. Respondents displayed a good attitude to physical exercise, but more than half had a poor attitude regarding the adjustment of their diet. Even though the majority of the respondents (94.0%) had a positive attitude to the need for weight control, about two-thirds of the respondents admitted they do not monitor their weight regularly. Only 63.3% of the respondents engage in physical exercise on a regular basis. The practice of controlled and planned diet was found to be poor among the respondents. The identified barriers to lifestyle modifications were respondents feeling too heavy to engage in physical exercise, bad weather and financial constraints. There was no statistically significant association between the gender of the respondents and their attitude to regular physical exercise or dietary modifications. There was also no significant association between the gender of the respondents and their practice of lifestyle modifications. There was no statistically significant association between the number of years the respondents have been living with diabetes mellitus and their attitude to lifestyle modification practices. There was also no association with their practice of regular exercise or dietary modifications. There was no significant association between the BMI of the respondents and their practice of regular physical or dietary modifications. Conclusion: In conclusion, the study revealed that despite the good knowledge of physical exercise and healthy dietary habits with regards to lifestyle modification among the Type 2 DM patient at the Outpatient Department of the National District Hospital, Bloemfontein, the uptake of these practices is still low. There is a need to address the poor attitude and poor practice of dietary modification and the sub-optimal engagement in physical exercise among the patients. It is also vital to regularly emphasise to the patient the importance of not only engaging in the lifestyle modification practices but also the need to do it correctly. Proper practices are essential for it to be efficient and bring about the desired purpose, which is the optimal control of blood glucose, by so doing, preventing potential complications associated with uncontrolled diabetes mellitus.