Community Health

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Browsing Community Health by Author "Van Zyl, G. J."

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    An educational approach for the generation profile of undergraduate students in the Faculty of Health Sciences, University of the Free State
    (University of the Free State, 2011-11) Van der Merwe, Lynette Jean; Van Zyl, G. J.; Nel, M. M.
    English: In this research project, an in-depth study was done by the researcher with a view to formulating an educational approach for the distinct generation profile of undergraduate students in the Faculty of Health Sciences (FoHS), University of the Free State (UFS). This research was initiated in response to the identification of a gap in the knowledge regarding the so-called Generation Y (born 1981-2000), forming the current cohort of undergraduate students at the UFS. According to both scholarly and popular literature, Generation Y possesses unique characteristics that impact on the teaching and learning environment. Their distinctive values and behaviours, communication styles, skills and needs, learning styles and needs, as well as the prevailing environment and the shaping events of their position in history influence their attitudes and actions as students. In addition, the perceived differences between these students and the academic staff lecturing them, who generally belong to older generational cohorts, may lead to conflict and misunderstanding that impairs the successful attainment of outcomes in Health Sciences Education. Both education and health care face tremendous challenges in the 21st century. For example, the current Information-Communication Technology revolution has exerted compelling effects on social interaction as well as the current teaching and learning and health care environments. However, the demands on education and health care stretch further than just emerging technologies and their aftermath. Issues such as globalisation, socio-political and economic instability, inadequate and unequal access, as well as sustainability should also be addressed. The aim of this study was to formulate an educational approach for the generation profile of undergraduate students at the FoHS, UFS. This was attained by means of the following objectives, namely, obtaining data as to whether the characteristics of Generation Y as described in the literature are applicable and relevant to undergraduate students in the FoHS, UFS; identifying discrepancies in awareness and understanding of perceptions regarding the characteristics of Generation Y between undergraduate students and academic staff lecturing them; and finally, formulating an educational approach (including recommendations) for the generation profile of undergraduate students in the FoHS, UFS, incorporating the characteristics of undergraduate students as well as discrepancies in perceptions between undergraduate students and academic staff lecturing these students that could affect the teaching and learning environment. This study made use of a mixed-methods research design in two phases. In the first phase, concurrent triangulation, quantitative and qualitative data were gathered simultaneously by means of closed and open questions in a questionnaire survey for undergraduate students and academic staff members respectively. In the second phase, sequential explanatory design, the results from the first phase were used to inform the formulation of an agenda for a focus group interview held with academic staff members, yielding qualitative data. Quantitative data were analysed statistically, while thematic analysis of qualitative data were done. The final steps in the second phase included making use of the literature survey as well as the results of the questionnaire survey and focus group interview respectively to inform the formulation of the educational approach as indicated in the aim of the study. From the results of the questionnaire survey it emerged that although many of the characteristics typically ascribed to Generation Y in the literature are similar to those perceived by both undergraduate students and academic staff members regarding the cohort of undergraduate students in the FoHS, UFS, there were distinct differences between these perceptions and those described in the literature, indicating that Generation Y students in the FoHS possess a unique generational profile. In addition, academic staff members indicated significant differences in their perceptions from those of undergraduate students, with subsequent implications for the teaching and learning environment. Major themes identified from the focus group interview indicated that three important aspects were vital in the development of an educational approach, namely the nature of the teaching and learning environment, the personal qualities and attributes of the lecturer and the characteristics and role of the student.These findings were incorporated in the formulation of guidelines and recommendations for the educational approach proposed by the researcher. The conceptual framework guiding this approach alluded to the realisation that in order to stay relevant, educational approaches need to move away from traditional and somewhat archaic teacher-centred to innovative student-centred approaches intent on actively engaging students in transformative knowledge construction, as well as providing for mentoring by motivational role-models. Furthermore, emerging technology must be incorporated in a rational and balanced way without losing vital human interaction to ensure that an optimal teaching and learning environment is created. The training of skilled health professionals who are equipped to deal with the challenges of the future should ultimately lie at the heart of the educational approach in Health Sciences Education. This research project generated comprehensive knowledge of the profile of the so-called Generation Y undergraduate students in the Faculty of Health Sciences, University of the Free State, which informed the formulation of an educational approach that is both thoroughly grounded in theory as well as applicable in practice. This research study offers a novel contribution to the field of Health Sciences Education by providing evidence-based data incorporated into an educational approach that takes into consideration key elements for successful pedagogy in Health Sciences Education. These include the a) teaching and learning environment, b) approaches to teaching and learning as well as the role-players in this context, namely the c) participants (students) and d) practitioners (academic staff). The approach is built on the four key elements, and forms an integrated background to a central nexus alluding to concepts including structure and support, a student-centred viewpoint, technology, relationships, student characteristics, mentoring, engagement and supervision. Both the survey instrument developed for the purpose of data collection in this study, as well as the educational approach that was formulated, may be used to facilitate the creation of optimal teaching and learning environments in Health Sciences Education, both locally and further afield.
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    Employee assistance programme in health care: a framework for best practice and quality management
    (University of the Free State, 2011-05) Kruger, Willem Hendrik; Van Zyl, G. J.; Venter, A.
    Employee assistance was initiated early in the 19th century in the United States of America to assist employees with alcohol abuse in the workplace. During the 1970s, the concept of an employee assistance programme (EAP) was adapted to assist employees not only with alcohol-related problems, but also with personal and other work-related problems resulting in poor work performance. It is evident from the literature that no EAP is the same and that researchers have developed the seven EAP core technologies to promote uniformity within the field of employee assistance. The aim of this study was to establish a framework for a best-practice EAP for the health care sector and the quality management thereof. As background to the study, the researcher conducted an extensive literature review to investigate the current situation on the utilisation of EAPs in various industries worldwide. The literature review was used as a guide during the empirical phase of the study in order to gain more in-depth knowledge with regard to employee assistance in the health care sector. A case study design as a qualitative research approach was applied. Five focus group discussions were held with supervisors from various levels in several health care institutions as a data-gathering method. Several criteria for the bestpractice EAP were identified during the data gathering and a six-round Delphi survey was conducted to achieve consensus with regard to the criteria to be included in the best-practice EAP. Accordingly, a framework for a best-practice EAP and the quality management thereof was developed. The management of health care institutions should realise that their health care workers are their most valuable resource and that there is a need to assist them with personal and work-related problems. The framework was developed specifically for a health care institution with the option to adapt it in order to suit the unique requirements of each individual health care institution. This proposed framework could be used to develop an institution-unique EAP. The establishment of a workplaceunique EAP will show employees that they are regarded as the most valuable resource in the health care institution. The overall goal and objectives, as set out for the research study, were addressed and realised, and meaningful recommendations in the field of employee assistance have been made. The framework for a best-practice EAP is in line with the core technologies of EAPs, the needs of supervisors in health care institutions and the EAPs used internationally. The proposed framework includes the following main aspects, namely the need for an EAP in a health care institution, the strategic approach for the development of such a programme, the structure and processes of an EAP, and the evaluation of an EAP in terms of its effectiveness. The framework will contribute significantly to the management of human resources in the health care industry and provide a supportive work environment for health care workers to ensure healthy and productive employees.
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    A public health ethics framework for the geriatric community: a South African perspective
    (University of the Free State, 2021) Lategan, Laetus Oscar Kotze; Van Zyl, G. J.; Kruger, W. H.
    At the end of her tenure (2007–2017) as Director-General for the World Health Organization (WHO), Margaret Chan (2017) published a report on the developments in public health during this period. She emphasised the growing role that social determinants can play to improve public health. The new thinking is that social determinants, and not physical challenges only, contribute to health. The downside of her comment is that social factors can also negatively influence quality of health and well-being of communities. Such a negative impact will increase the vulnerability of a community. Ethical challenges are often associated with vulnerability. This is particularly evident in thegeriatric community. A growing ageing and consequently an elderly or geriatric community will place more demands on the already challenged social and health services. This, in turn, will put more strain on the geriatric community. Statistics from the WHO’s World Report on Ageing and Health (2015) suggests that the world population older than 60 years will nearly double by 2050. This is a global phenomenon. The 2020 South African Mid-year Population Estimates Report approximates the people older than 60 years to be 9.1% of the population. This Report states that the population 60 years and above increased by 1.9 million people from 2002 to 2020. This growth represents an increase of 1.1% for the period 2002 to 2003, and 3.0% for the period 2019 to 2020. A review of literature relevant to the geriatric community obtained from databases such as Science Direct, Proquest, Taylor and Francis, Sabinet African Journal Collection and relevant National Department of Health policies, strategies and plans, suggest the apparent absence of a public health ethics framework for the geriatric community. The perspectives originating from the literature led to the research question for this study: What are the important ethical aspects to consider for a public health ethics framework for the geriatric community in the South African context? This study was based on a literature review as part of a qualitative method and the Qmethodology, which is qualitative in its information collection and data sampling but quantitative in terms of the method of analysis. Six geriatric institutions, two each from the Free State, Northern Cape and Northwest Provinces, participated in the data collection for the study. A questionnaire (Q-sort table) was completed, comprising 50 statements (Q-set) which were ranked (Q-sorting) by the twenty-two participants (P-set) from the six participating institutions. The collection of data derived from the ranking of statements was representative of three indexes: (a) an Index of Social Determinants (Questions 1 – 20); (b) an Index of Public Health Ethics (Questions 21 – 35); and (c) an Index of a Public Health Ethics Framework (Questions 36 – 50). The data collected from the ranking of statements was analysed using the Statistical Package for Social Sciences software. Information was produced based on the interpretation of the data against the literature review presented in Chapter 1. The research results are discussed in Chapters 2 – 4. From Chapter 2 it is evident that the lack of sufficient healthcare provision and the quality of healthcare provision are social determinants impacting negatively on the geriatric community’s health. These social determinants contribute to the ethical challenges experienced by the geriatric community. Chapter 3 addresses the question of what public health ethics implies for the geriatric community. Working with the geriatric community, the ethical principles of (a) respecting their vulnerability and fragility, (b) protecting their lives from abuse and neglect, and upholding dignity, (c) securing a safe environment to live in, and (d) providing quality access to healthcare and provision, were identified as the ethical basis of public health for the geriatric community. The chapter concludes that public health ethics is the application ofethical principles through a professional ethic resulting in care and relationship building. In Chapter 4 eight building blocks are identified that were used in the development of a framework for public health ethics. These building blocks are: Promote the core value of public health; • Identify the principles for public health ethics; • Recognise ethical challenges for agent and recipient of service; • Advance ethics leadership; • Introduce ethics education; • Promote social justice; • Develop ethical expertise; and • Practise care ethics. In Chapter 5 an integrated public health ethics framework for the geriatric community is presented. The perspectives presented in the literature review (cf. Chapter 1), the perspectives developed on social determinants having an impact on the geriatric community (cf. Chapters 1 & 2), and the ranking of statements (cf. Chapters 2 – 4) contributed to the development of a public health ethics framework. Based on the ranking of statements, building blocks were identified that contributed to the public health ethics framework for the geriatric community (cf. Chapter 5). These building blocks contributed to a public health ethics framework, and were grounded in normative and applied ethics and linked to virtue ethics, deontology and consequentialism. Four questions associated with ethics were posed to explain the application of the framework. These questions also assisted with the alignment of the building blocks to the basic purpose of public health, namely the organised strategies, interventions, and services to improve the health and well-being of the community or population. The questions are: (a) Are we doing things right? (b) Are we doing the right thing? (c) How can the common good be promoted? (d) What benefit is there?