Feasibility of interactive diabetes workshops for primary health care nurses in a Free-State sub-district

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Date
2020-01
Authors
Mukurunge, Eva
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Publisher
University of the Free State
Abstract
The health care system of South Africa is driven by the primary health care (PHC) system approach, of which nurses are the backbone of health care service provision. The aim of the PHC approach is to ensure universal accessibility of health care services in an environment characterised by an ever-increasing prevalence of non-communicable diseases, including diabetes. Research has revealed that, in a Free State sub-district, PHC nurses have decreased levels of motivation for and limited knowledge of the management of diabetes. This study forms part of a complex intervention research programme that followed a phased approach, which allowed researchers to assess the feasibility of a health dialogue model that had been designed in previous research. The aim of this study was to establish the feasibility of interactive diabetes workshops for PHC nurses in a Free State sub-district. In order to ensure achievement of the aim, four objectives were developed: a) development of an interactive workshop programme according to previously identified key diabetes-related messages; b) determination of diabetes-related knowledge by means of a pretest and posttest; c) facilitation of interactive diabetes workshops; and d) assessment of the feasibility of these workshops for PHC nurses post the interactive workshops. An exploratory experimental pretest-posttest control group design was used in this study. A random sampling method was used to select 10 PHC clinics in a sub-district of the Free State, with five PHC clinics for each of the experimental (Thaba Nchu) and control (Botshabelo) sites. Each of the five PHC clinics in both the experimental and control groups were in a 15 km radius of each of Thaba Nchu and Botshabelo towns. A convenience sampling method was used at the 10 PHC clinics to select nurses. The sample size of the experimental and control groups was 21 nurses each. Data used for the development of the interactive workshop programme was collected through a systematic search of literature using the first three steps of a systematic review process. Data of diabetes-related knowledge was collected using a pre/posttest questionnaire. A five-point Likert scale was used for collection of data on assessment of the interactive diabetes workshops. Descriptive statistics were used for data analysis. Results obtained from the systematic literature search revealed that, for workshops to be engaging, interactive activities should be used during facilitation. Interactive activities can include scenarios, small-group discussions, role playing, Kagan’s rally coach, rally robin and timed pair share strategies. Statistically significant results from pre/post-testing in the experimental group indicated improved knowledge related to peripheral sensation (0.03) and depression (<0.01). Across the experimental and control groups, results for questions related to insulin use (0.04) and depression (0.001) were found to be statistically significant. In order for interactive workshops to be feasible, the participants and the facilitator should have consensus about time for facilitation. Interactive workshops should be considered as a training platform for diabetes refresher training courses for nurses at PHC clinics. The content of the workshops should cover the key diabetes messages, and the facilitation should include interactive activities that are likely to enhance learning and participant engagement. In conclusion, the researcher considers interactive diabetes workshops to be a feasible training platform for PHC nurses in a Free State sub-district. The training events could empower nurses with knowledge and skills, leading to improved health care services for diabetes patients.
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Keywords
Dissertation (M.Soc.Sc. (Nursing))--University of the Free State, 2020, Primary Health Care system (PHC), Universal accessibility to health care services, Interactive diabetes workshops
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