Johan Botes - Academia.edu (original) (raw)

Papers by Johan Botes

Research paper thumbnail of Patients’ preference for general or regional anaesthesia for caesarean deliveries at a district hospital, Free State, South Africa

South African journal of obstetrics and gynaecology, Nov 6, 2019

CASE REPORT Background. Informing patients about available anaesthesia options allows patients to... more CASE REPORT Background. Informing patients about available anaesthesia options allows patients to share in decision-making. Objectives. To determine the preference for general or regional anaesthesia among patients admitted for elective caesarean delivery at a district hospital in Bloemfontein, South Africa, and whether the patients were informed about their anaesthesia options by their doctor. Methods. Consecutive sampling was used. Patients ≥18 years old and who had had a caesarean delivery under general or regional anaesthesia participated in the study. Data were collected using a questionnaire, which was completed during formal interviews with patients. Results. Of the 50 patients interviewed, 30 (60.0%) preferred regional anaesthesia. With regard to the current surgery, 58.0% stated that they were informed of the available anaesthesia options. Conclusion. The majority of the patients in our study preferred regional anaesthesia. Although only 58.0% reported that they received information, many of those valued the doctor's opinion in their choice of anaesthesia.

Research paper thumbnail of Breastfeeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa

South African Journal of Child Health

Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving ... more Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing onbreastfeeding and factors that impact the decision on feeding method.Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the ageof 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infantfeeding intentions and behaviours.Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusivebreastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median durati...

Research paper thumbnail of Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

South African Family Practice

Bacterial meningitis is a potentially life-threatening disease associated with 10%-30% mortality ... more Bacterial meningitis is a potentially life-threatening disease associated with 10%-30% mortality despite adequate antibiotic treatment. 5,8 In association with HIV, cryptococcal meningitis accounts for 12%-44% of mortality. 9 Even though viral meningitis is more prevalent, bacterial meningitis is associated with high morbidity and mortality. It is also challenging to differentiate Background: Previous studies have found that indications for lumbar punctures (LPs) are managed differently, which raises the question of whether all LPs performed are clinically necessary. This study aimed to determine whether unnecessary (clinically not indicated) LPs were being performed at a district hospital in the Free State, South Africa. Method: This was a retrospective descriptive study. A list from the National Health Laboratory Service (NHLS) was used to identify all patients on whom an LP was performed in the adult emergency department of National District Hospital (NDH) in Bloemfontein, from 1 January 2018 to 30 June 2018. Data were captured on a data sheet and included demographic information, clinical signs and symptoms the patients presented with and the cerebrospinal fluid results. Results: A total of 364 patients fit the inclusion criteria. Of these patients, 97 files (26.6%) could not be found, patient gender and LP results could be retrieved from the NHLS barcodes. After reviewing the presenting symptoms and signs captured on the 267 files, the primary researcher considered 150 (56.4%) of the LPs performed to have been carried out unnecessarily. From the total population of 364 patients, 246 (67.6%) of the LP results were normal. Only 118 (32.4%) of the LPs performed showed some form of central nervous system pathology. Of the 150 LPs assessed to have been unnecessarily performed, 124 (84.0%) were normal. Conclusion: This retrospective review indicates that a high percentage of LPs that were clinically not indicated were performed at NDH during the study period.

Research paper thumbnail of Type 2 diabetes mellitus patients’ knowledge, attitude and practice of lifestyle modifications

Health SA Gesondheid

Background: Type 2 diabetes mellitus (T2DM) is a significant health burden globally, with uncontr... more Background: Type 2 diabetes mellitus (T2DM) is a significant health burden globally, with uncontrolled DM often resulting in short- and long-term complications. Unfortunately, healthcare providers have little control over patients’ necessary lifestyle modification practices outside the consultation room.Aim: To determine the level of knowledge, attitude and practice (KAP) of lifestyle modifications among patients with T2DM attending the National District Hospital Outpatient Department, Bloemfontein, and identify possible barriers to lifestyle modifications experienced by patients.Setting: Outpatient Department at a Free State hospital.Methods: Using a cross-sectional study, patients with previously diagnosed T2DM were invited to participate. Respondents completed a structured questionnaire to assess their KAP regarding lifestyle modifications.Results: Of the 149 respondents, 64.4% (n = 94) were obese and 24.0% (n = 35) overweight despite good knowledge of lifestyle modifications. Re...

Research paper thumbnail of Part 2: Medico-legal documentation Practical completion of pages 1 and 4 of the J88 form

South African Family Practice, 2014

This is Part 2 of a three-part series on medico-legal documentation. Part 1 addressed the knowled... more This is Part 2 of a three-part series on medico-legal documentation. Part 1 addressed the knowledge and skills necessary to complete a legal J88 document. The aim of Part 2 is to give practical guidance on completion of the J88 form in the case of assault. Part 3 will address the sexual assault section of the J88 form. As a legal document, the J88 form must be completed accurately with regard to demographic information, including the time and date of examination, to assist with interpretation of the findings. The full names of the person examined appear on the SAPS 308 form, and must be confirmed by the patient and an identification document, if available. The name of the healthcare provider must be identifiable and contact details must be stated to assist with tracing, if necessary. A complete history is important because a differential diagnosis needs be considered, and the clinical findings must be consistent with the description of the incident in terms of time, mechanism of the...

Research paper thumbnail of Exploring the differences in psychological traits between surgical specialties at an academic hospital in Bloemfontein

South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2019

BACKGROUND Studies have attempted to categorise undergraduate medical and postgraduate students a... more BACKGROUND Studies have attempted to categorise undergraduate medical and postgraduate students and specialists into personality types, to determine what influences personality has on specialty choice and job satisfaction. This study explored the personality characteristics of doctors in four surgical and three consulting specialties at an academic hospital in Bloemfontein, South Africa. METHOD This analytical cross-sectional study used the Zuckerman-Kuhlman Personality Questionnaire as a measuring tool which included five scales: impulsive sensation seeking (subscales impulsivity and sensation seeking), neuroticismanxiety, aggression-hostility, sociability (parties and friends and isolation intolerance), and activity ( work activity and general activity). Overall, 70 consultants and senior registrars from surgical specialties (anaesthesiology, obstetrics and gynaecology, orthopaedic surgery, surgery), (response rate 60.3%) and 58 consultants and senior registrars from three consult...

Research paper thumbnail of Journal response types and times: the outcomes of manuscripts finalised for submission by the University of the Free State School of Medicine medical editor, South Africa

Pan African Medical Journal, 2020

Introduction: health professionals are involved in research as researchers themselves and as supe... more Introduction: health professionals are involved in research as researchers themselves and as supervisors to undergraduate and postgraduate students. Authors may have unrealistic expectations regarding journal submission and review processes. The study aimed to describe journal response types and times for manuscripts finalised for submission by the University of the Free State School of Medicine medical editor. Methods: this descriptive cohort study with an analytical component included all manuscripts finalised for submission to accredited journals by the medical editor, 2014-2017. Excel spreadsheets capturing all stages of the manuscript process were used to confidentially note information regarding submission and subsequent journal responses. Results: ninety-five manuscripts were submitted to 72 peer-reviewed accredited journals. The total number of submissions was 163. Only 46 (48.4%) manuscripts were accepted by the first journals submitted to. Rejected submissions (n=82) had a median journal response time of 15.5 days (range 0-381 days), with a third being sent for review. Nine manuscripts were accepted with no revisions needed. Accepted submissions (n=72) had a median of one round of revision (range 0-4 rounds), and a median time of 119.5 days (range 0-674 days) from submission to final acceptance. Conclusion: within our setting, half of first submissions were unsuccessful, but rejection usually occurred rapidly. Acceptance for publication occurred at a median time of 4 months after one round of revision. If health professionals were made aware of expected outcomes and response times, it may prevent authors from falling victim to the publication practices of predatory journals.

Research paper thumbnail of Manuscripts submitted to South African Family Practice by the School of Medicine, University of the Free State: journal response types and times

South African Family Practice, 2018

Background: For authors, manuscript submission can seem fraught with obstacles. The present autho... more Background: For authors, manuscript submission can seem fraught with obstacles. The present authors describe their experience with South African Family Practice (SAFP) regarding response types and times, compared with other SA-based journals. Methods: This cohort study included information regarding communication with/from journals of manuscripts finalised for submission by the Free State University, School of Medicine medical editor, 2014-2017. Results: Twenty-six submissions were made to SAFP; 78 to other SA-based journals. The most frequent first response from SAFP was "revisions required" (62%) and "rejected" (49%) from other SA-based journals. Median final response of rejected submissions was approximately a month at SAFP and approximately two weeks at other SA-based journals. Median final response of accepted submissions was approximately three months at SAFP and approximately four months at other SA-based journals. Conclusion: This study provides data regarding expected outcomes and response times, which may prevent authors falling prey to email solicitations from predatory journals.

Research paper thumbnail of Profile of factors influencing academic motivation among grade 6 and 7 learners at a state school

South African Journal of Childhood Education, 2019

Background: Academic achievement is influenced by a system of internal and external stimuli. Inte... more Background: Academic achievement is influenced by a system of internal and external stimuli. Internal stimuli include interest, willingness and academic motivation. In South Africa, efforts to improve the quality of education have mostly focused on the provision of physical resources rather than emotional resources.Aim: The aim of this study was to determine the profile of four factors, namely, teacher style, role models, home environment and peer influence that can influence the academic motivation of grade 6 and 7 learners.Setting: A parallel-medium primary state school in an urban part of Bloemfontein, Free State.Methods: This was a cross-sectional observational study. Data were collected using an anonymous, self-administered questionnaire completed by the learners. The questions captured demographic data and measured the four categories of factors.Results: Overall, 115 out of 202 learners participated (response rate 56.9%). Almost all learners felt that their teachers encouraged...

Research paper thumbnail of The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

South African Family Practice, 2005

Background: It is compulsory for medical students of the University of the Free State to be immun... more Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students' clinical skills training programme. The aim of this study was to assess the students' perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process. Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire. Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations. Conclusion: Students were positive about practising immunisation techniques on their peers.

Research paper thumbnail of An evaluation of factors influencing perceptual experiences and future plans of final-year medical interns in the Free State, 2013–2014

South African Family Practice, 2016

Background: Medical internship refers to the 24-month period of supervised training in an accredi... more Background: Medical internship refers to the 24-month period of supervised training in an accredited facility, where newly qualified doctors rotate through all relevant medical domains before starting their community service as medical practitioners. The Free State province has one academic complex and three regional hospitals accredited for internship training. Objectives: To evaluate the experience and future plans of final-year interns enrolled in a two-year medical internship programme in the Free State, and whether they felt sufficiently prepared to be medical doctors. Methods: This study was a cross-sectional study. A questionnaire was distributed to all consenting interns from the Free State completing their second year of internship during 2013 and 2014. Results: A total of 80 second-year internship doctors from four healthcare facilities completed the questionnaire. The majority (87.2%) indicated that they believe internship prepared them well for community service and 65.0% were positive about the supervision they received. However, only 52.5% felt that they were properly orientated. Conclusion: Medical interns felt positive about their experiences at their allocated Free State healthcare facilities and acknowledged they were better prepared for their careers. In some domains, insufficient supervision and lack of orientation impacted on the internship experience. Workload, lack of resources, insufficient staff and work environment at institutions are the main push factors.

Research paper thumbnail of The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective

South African Family Practice, 2016

Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health... more Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest. Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners' needs and preferences for CPD training. Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed. Results: The responses from 60 participants revealed that general practitioners still prefer the lecture form of presentations in large or small groups. Topics that ranked highly were Infective Diseases, Cardiology and Respiratory Diseases. Respondents indicated that general practitioners prefer not to leave their practices unattended for an extended period of time. Conclusion: Free State general practitioners still prefer the traditional lecture-room style of learning. Their declared learning needs are in line with the regular ailments they encounter within their practices. Strategies to accommodate those who find it difficult to attend, due to time and distance concerns, should be considered.

Research paper thumbnail of Part 1: Medico-legal documentation South African Police Services forms, Department of Justice forms and patient information

South African Family Practice

Medical practitioners share the responsibility of action against crime by supporting the justice ... more Medical practitioners share the responsibility of action against crime by supporting the justice system. The best way for a medical practitioner to achieve this is by proper examination of victims and/or perpetrators, and completing the legal documents meticulously. This can be a frightening experience without proper formal training. Paper 1 addresses the role and responsibility of the medical practitioner and issues around consent, general information on the completion of the J88, as well as the perceived gold standard of medical information relayed to the courts. Medico-legal documentation is more than the compilation of a medico-legal report. The clinical notes are part and parcel of the documentation to protect practitioners against negligence and malpractice investigations. Valid medico-legal consent differs from medical consent. Knowledge of legislation pertaining to child pornography and the practical and ethical aspects of photography is also necessary. Inappropriate complet...

Research paper thumbnail of Part 3: Medico-legal documentation practical completion of pages 2 and 3 of the J88 form

South African Family Practice

This is Part 3 of a three-part series on medico-legal documentation. Part 1 addressed the knowled... more This is Part 3 of a three-part series on medico-legal documentation. Part 1 addressed the knowledge and skills necessary to complete a legal J88 document. Part 2 provided practical guidance on completion of the J88 form in the case of assault. This article will focus on pages 2 and 3 of the J88 document, which deals with the alleged sexual offences of both adults and children. The assumption may exist that the J88 is the only significant document with respect to medical findings in alleged rape and child sexual abuse cases, and that the court needs this information to make a decision on the medical aspects of a case. However, the court needs the information to be interpreted by a medical practitioner, who must indicate the significance of the findings, determine who should supply relevant additional information, and then place the entire picture in context. This article attempts to highlight the value of the relevant aspects, while raising awareness of an unscientific interpretation...

Research paper thumbnail of Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

South African Family Practice, 2016

Background: Medical internship in South Africa is a two-year period after completing the basic me... more Background: Medical internship in South Africa is a two-year period after completing the basic medical degree. Interns rotate through six different domains, where they are exposed to various clinical procedures. These skills are often not up to standard, and interns feel unprepared for future challenges. This study evaluated the self-perceived readiness of interns rotating through the Universitas Academic Health Complex in performing basic medical procedures, and the frequency of performing these procedures. Methods: This was a descriptive quantitative study. Consenting participants completed an anonymous questionnaire regarding four pre-selected medical procedures per department. Results: The majority of the 61 participants were second-year interns (52.5%), female (54.0%), with a median age of 25 years. Interns felt ready to perform the majority of procedures, but more than 50% reported not being ready to perform circumcisions, episiotomy and perineal repair, assisted delivery and appendectomies. Some procedures in Family Medicine, Internal Medicine, Obstetrics and Gynaecology, General Surgery and Psychiatry were rarely performed by at least half of the participants. Conclusions: Exposure of medical students during their clinical years to practical training is inadequate. The focus in the MBChB curriculum should be increased to a more specific practical approach during both the pre-clinical and clinical years.

Research paper thumbnail of Vd Bijl Breastfeeding SAJCH

South African Journal of Child Health, 2023

Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving ... more Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers
would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.
Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing on
breastfeeding and factors that impact the decision on feeding method.
Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the age
of 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infant
feeding intentions and behaviours.
Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusive
breastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median duration for both
children was 3 months shorter. The intention to express breastmilk at work was 67.7% for Child 1 and 57.7% for Child 2; however,
the actual outcome was less than half of the intention (32.0%). Most respondents (71.0%) indicated there was no dedicated area for
expressing breastmilk at their place of work.
Conclusion. The intention to exclusively breastfeed was high (6 months), but the actual duration was 3 months shorter. The percentage
of doctor mothers who eventually expressed breastmilk at work was less than half of those who intended to do so. Breastfeeding female
doctors need more support in the postpartum period, especially when returning to work after maternity leave.

Research paper thumbnail of The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

South African Family Practice, 2005

Background: It is compulsory for medical students of the University of the Free State to be immun... more Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students' clinical skills training programme. The aim of this study was to assess the students' perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process. Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire. Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations. Conclusion: Students were positive about practising immunisation techniques on their peers.

Research paper thumbnail of Patients’ preference for general or regional anaesthesia for caesarean deliveries at a district hospital, Free State, South Africa

South African journal of obstetrics and gynaecology, Nov 6, 2019

CASE REPORT Background. Informing patients about available anaesthesia options allows patients to... more CASE REPORT Background. Informing patients about available anaesthesia options allows patients to share in decision-making. Objectives. To determine the preference for general or regional anaesthesia among patients admitted for elective caesarean delivery at a district hospital in Bloemfontein, South Africa, and whether the patients were informed about their anaesthesia options by their doctor. Methods. Consecutive sampling was used. Patients ≥18 years old and who had had a caesarean delivery under general or regional anaesthesia participated in the study. Data were collected using a questionnaire, which was completed during formal interviews with patients. Results. Of the 50 patients interviewed, 30 (60.0%) preferred regional anaesthesia. With regard to the current surgery, 58.0% stated that they were informed of the available anaesthesia options. Conclusion. The majority of the patients in our study preferred regional anaesthesia. Although only 58.0% reported that they received information, many of those valued the doctor's opinion in their choice of anaesthesia.

Research paper thumbnail of Breastfeeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa

South African Journal of Child Health

Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving ... more Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing onbreastfeeding and factors that impact the decision on feeding method.Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the ageof 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infantfeeding intentions and behaviours.Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusivebreastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median durati...

Research paper thumbnail of Clinical review of the clinical necessity of lumbar punctures performed on adults at National District Hospital Emergency Department

South African Family Practice

Bacterial meningitis is a potentially life-threatening disease associated with 10%-30% mortality ... more Bacterial meningitis is a potentially life-threatening disease associated with 10%-30% mortality despite adequate antibiotic treatment. 5,8 In association with HIV, cryptococcal meningitis accounts for 12%-44% of mortality. 9 Even though viral meningitis is more prevalent, bacterial meningitis is associated with high morbidity and mortality. It is also challenging to differentiate Background: Previous studies have found that indications for lumbar punctures (LPs) are managed differently, which raises the question of whether all LPs performed are clinically necessary. This study aimed to determine whether unnecessary (clinically not indicated) LPs were being performed at a district hospital in the Free State, South Africa. Method: This was a retrospective descriptive study. A list from the National Health Laboratory Service (NHLS) was used to identify all patients on whom an LP was performed in the adult emergency department of National District Hospital (NDH) in Bloemfontein, from 1 January 2018 to 30 June 2018. Data were captured on a data sheet and included demographic information, clinical signs and symptoms the patients presented with and the cerebrospinal fluid results. Results: A total of 364 patients fit the inclusion criteria. Of these patients, 97 files (26.6%) could not be found, patient gender and LP results could be retrieved from the NHLS barcodes. After reviewing the presenting symptoms and signs captured on the 267 files, the primary researcher considered 150 (56.4%) of the LPs performed to have been carried out unnecessarily. From the total population of 364 patients, 246 (67.6%) of the LP results were normal. Only 118 (32.4%) of the LPs performed showed some form of central nervous system pathology. Of the 150 LPs assessed to have been unnecessarily performed, 124 (84.0%) were normal. Conclusion: This retrospective review indicates that a high percentage of LPs that were clinically not indicated were performed at NDH during the study period.

Research paper thumbnail of Type 2 diabetes mellitus patients’ knowledge, attitude and practice of lifestyle modifications

Health SA Gesondheid

Background: Type 2 diabetes mellitus (T2DM) is a significant health burden globally, with uncontr... more Background: Type 2 diabetes mellitus (T2DM) is a significant health burden globally, with uncontrolled DM often resulting in short- and long-term complications. Unfortunately, healthcare providers have little control over patients’ necessary lifestyle modification practices outside the consultation room.Aim: To determine the level of knowledge, attitude and practice (KAP) of lifestyle modifications among patients with T2DM attending the National District Hospital Outpatient Department, Bloemfontein, and identify possible barriers to lifestyle modifications experienced by patients.Setting: Outpatient Department at a Free State hospital.Methods: Using a cross-sectional study, patients with previously diagnosed T2DM were invited to participate. Respondents completed a structured questionnaire to assess their KAP regarding lifestyle modifications.Results: Of the 149 respondents, 64.4% (n = 94) were obese and 24.0% (n = 35) overweight despite good knowledge of lifestyle modifications. Re...

Research paper thumbnail of Part 2: Medico-legal documentation Practical completion of pages 1 and 4 of the J88 form

South African Family Practice, 2014

This is Part 2 of a three-part series on medico-legal documentation. Part 1 addressed the knowled... more This is Part 2 of a three-part series on medico-legal documentation. Part 1 addressed the knowledge and skills necessary to complete a legal J88 document. The aim of Part 2 is to give practical guidance on completion of the J88 form in the case of assault. Part 3 will address the sexual assault section of the J88 form. As a legal document, the J88 form must be completed accurately with regard to demographic information, including the time and date of examination, to assist with interpretation of the findings. The full names of the person examined appear on the SAPS 308 form, and must be confirmed by the patient and an identification document, if available. The name of the healthcare provider must be identifiable and contact details must be stated to assist with tracing, if necessary. A complete history is important because a differential diagnosis needs be considered, and the clinical findings must be consistent with the description of the incident in terms of time, mechanism of the...

Research paper thumbnail of Exploring the differences in psychological traits between surgical specialties at an academic hospital in Bloemfontein

South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2019

BACKGROUND Studies have attempted to categorise undergraduate medical and postgraduate students a... more BACKGROUND Studies have attempted to categorise undergraduate medical and postgraduate students and specialists into personality types, to determine what influences personality has on specialty choice and job satisfaction. This study explored the personality characteristics of doctors in four surgical and three consulting specialties at an academic hospital in Bloemfontein, South Africa. METHOD This analytical cross-sectional study used the Zuckerman-Kuhlman Personality Questionnaire as a measuring tool which included five scales: impulsive sensation seeking (subscales impulsivity and sensation seeking), neuroticismanxiety, aggression-hostility, sociability (parties and friends and isolation intolerance), and activity ( work activity and general activity). Overall, 70 consultants and senior registrars from surgical specialties (anaesthesiology, obstetrics and gynaecology, orthopaedic surgery, surgery), (response rate 60.3%) and 58 consultants and senior registrars from three consult...

Research paper thumbnail of Journal response types and times: the outcomes of manuscripts finalised for submission by the University of the Free State School of Medicine medical editor, South Africa

Pan African Medical Journal, 2020

Introduction: health professionals are involved in research as researchers themselves and as supe... more Introduction: health professionals are involved in research as researchers themselves and as supervisors to undergraduate and postgraduate students. Authors may have unrealistic expectations regarding journal submission and review processes. The study aimed to describe journal response types and times for manuscripts finalised for submission by the University of the Free State School of Medicine medical editor. Methods: this descriptive cohort study with an analytical component included all manuscripts finalised for submission to accredited journals by the medical editor, 2014-2017. Excel spreadsheets capturing all stages of the manuscript process were used to confidentially note information regarding submission and subsequent journal responses. Results: ninety-five manuscripts were submitted to 72 peer-reviewed accredited journals. The total number of submissions was 163. Only 46 (48.4%) manuscripts were accepted by the first journals submitted to. Rejected submissions (n=82) had a median journal response time of 15.5 days (range 0-381 days), with a third being sent for review. Nine manuscripts were accepted with no revisions needed. Accepted submissions (n=72) had a median of one round of revision (range 0-4 rounds), and a median time of 119.5 days (range 0-674 days) from submission to final acceptance. Conclusion: within our setting, half of first submissions were unsuccessful, but rejection usually occurred rapidly. Acceptance for publication occurred at a median time of 4 months after one round of revision. If health professionals were made aware of expected outcomes and response times, it may prevent authors from falling victim to the publication practices of predatory journals.

Research paper thumbnail of Manuscripts submitted to South African Family Practice by the School of Medicine, University of the Free State: journal response types and times

South African Family Practice, 2018

Background: For authors, manuscript submission can seem fraught with obstacles. The present autho... more Background: For authors, manuscript submission can seem fraught with obstacles. The present authors describe their experience with South African Family Practice (SAFP) regarding response types and times, compared with other SA-based journals. Methods: This cohort study included information regarding communication with/from journals of manuscripts finalised for submission by the Free State University, School of Medicine medical editor, 2014-2017. Results: Twenty-six submissions were made to SAFP; 78 to other SA-based journals. The most frequent first response from SAFP was "revisions required" (62%) and "rejected" (49%) from other SA-based journals. Median final response of rejected submissions was approximately a month at SAFP and approximately two weeks at other SA-based journals. Median final response of accepted submissions was approximately three months at SAFP and approximately four months at other SA-based journals. Conclusion: This study provides data regarding expected outcomes and response times, which may prevent authors falling prey to email solicitations from predatory journals.

Research paper thumbnail of Profile of factors influencing academic motivation among grade 6 and 7 learners at a state school

South African Journal of Childhood Education, 2019

Background: Academic achievement is influenced by a system of internal and external stimuli. Inte... more Background: Academic achievement is influenced by a system of internal and external stimuli. Internal stimuli include interest, willingness and academic motivation. In South Africa, efforts to improve the quality of education have mostly focused on the provision of physical resources rather than emotional resources.Aim: The aim of this study was to determine the profile of four factors, namely, teacher style, role models, home environment and peer influence that can influence the academic motivation of grade 6 and 7 learners.Setting: A parallel-medium primary state school in an urban part of Bloemfontein, Free State.Methods: This was a cross-sectional observational study. Data were collected using an anonymous, self-administered questionnaire completed by the learners. The questions captured demographic data and measured the four categories of factors.Results: Overall, 115 out of 202 learners participated (response rate 56.9%). Almost all learners felt that their teachers encouraged...

Research paper thumbnail of The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

South African Family Practice, 2005

Background: It is compulsory for medical students of the University of the Free State to be immun... more Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students' clinical skills training programme. The aim of this study was to assess the students' perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process. Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire. Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations. Conclusion: Students were positive about practising immunisation techniques on their peers.

Research paper thumbnail of An evaluation of factors influencing perceptual experiences and future plans of final-year medical interns in the Free State, 2013–2014

South African Family Practice, 2016

Background: Medical internship refers to the 24-month period of supervised training in an accredi... more Background: Medical internship refers to the 24-month period of supervised training in an accredited facility, where newly qualified doctors rotate through all relevant medical domains before starting their community service as medical practitioners. The Free State province has one academic complex and three regional hospitals accredited for internship training. Objectives: To evaluate the experience and future plans of final-year interns enrolled in a two-year medical internship programme in the Free State, and whether they felt sufficiently prepared to be medical doctors. Methods: This study was a cross-sectional study. A questionnaire was distributed to all consenting interns from the Free State completing their second year of internship during 2013 and 2014. Results: A total of 80 second-year internship doctors from four healthcare facilities completed the questionnaire. The majority (87.2%) indicated that they believe internship prepared them well for community service and 65.0% were positive about the supervision they received. However, only 52.5% felt that they were properly orientated. Conclusion: Medical interns felt positive about their experiences at their allocated Free State healthcare facilities and acknowledged they were better prepared for their careers. In some domains, insufficient supervision and lack of orientation impacted on the internship experience. Workload, lack of resources, insufficient staff and work environment at institutions are the main push factors.

Research paper thumbnail of The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective

South African Family Practice, 2016

Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health... more Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest. Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners' needs and preferences for CPD training. Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed. Results: The responses from 60 participants revealed that general practitioners still prefer the lecture form of presentations in large or small groups. Topics that ranked highly were Infective Diseases, Cardiology and Respiratory Diseases. Respondents indicated that general practitioners prefer not to leave their practices unattended for an extended period of time. Conclusion: Free State general practitioners still prefer the traditional lecture-room style of learning. Their declared learning needs are in line with the regular ailments they encounter within their practices. Strategies to accommodate those who find it difficult to attend, due to time and distance concerns, should be considered.

Research paper thumbnail of Part 1: Medico-legal documentation South African Police Services forms, Department of Justice forms and patient information

South African Family Practice

Medical practitioners share the responsibility of action against crime by supporting the justice ... more Medical practitioners share the responsibility of action against crime by supporting the justice system. The best way for a medical practitioner to achieve this is by proper examination of victims and/or perpetrators, and completing the legal documents meticulously. This can be a frightening experience without proper formal training. Paper 1 addresses the role and responsibility of the medical practitioner and issues around consent, general information on the completion of the J88, as well as the perceived gold standard of medical information relayed to the courts. Medico-legal documentation is more than the compilation of a medico-legal report. The clinical notes are part and parcel of the documentation to protect practitioners against negligence and malpractice investigations. Valid medico-legal consent differs from medical consent. Knowledge of legislation pertaining to child pornography and the practical and ethical aspects of photography is also necessary. Inappropriate complet...

Research paper thumbnail of Part 3: Medico-legal documentation practical completion of pages 2 and 3 of the J88 form

South African Family Practice

This is Part 3 of a three-part series on medico-legal documentation. Part 1 addressed the knowled... more This is Part 3 of a three-part series on medico-legal documentation. Part 1 addressed the knowledge and skills necessary to complete a legal J88 document. Part 2 provided practical guidance on completion of the J88 form in the case of assault. This article will focus on pages 2 and 3 of the J88 document, which deals with the alleged sexual offences of both adults and children. The assumption may exist that the J88 is the only significant document with respect to medical findings in alleged rape and child sexual abuse cases, and that the court needs this information to make a decision on the medical aspects of a case. However, the court needs the information to be interpreted by a medical practitioner, who must indicate the significance of the findings, determine who should supply relevant additional information, and then place the entire picture in context. This article attempts to highlight the value of the relevant aspects, while raising awareness of an unscientific interpretation...

Research paper thumbnail of Self-perceived readiness of medical interns in performing basic medical procedures at the Universitas Academic Health Complex in Bloemfontein

South African Family Practice, 2016

Background: Medical internship in South Africa is a two-year period after completing the basic me... more Background: Medical internship in South Africa is a two-year period after completing the basic medical degree. Interns rotate through six different domains, where they are exposed to various clinical procedures. These skills are often not up to standard, and interns feel unprepared for future challenges. This study evaluated the self-perceived readiness of interns rotating through the Universitas Academic Health Complex in performing basic medical procedures, and the frequency of performing these procedures. Methods: This was a descriptive quantitative study. Consenting participants completed an anonymous questionnaire regarding four pre-selected medical procedures per department. Results: The majority of the 61 participants were second-year interns (52.5%), female (54.0%), with a median age of 25 years. Interns felt ready to perform the majority of procedures, but more than 50% reported not being ready to perform circumcisions, episiotomy and perineal repair, assisted delivery and appendectomies. Some procedures in Family Medicine, Internal Medicine, Obstetrics and Gynaecology, General Surgery and Psychiatry were rarely performed by at least half of the participants. Conclusions: Exposure of medical students during their clinical years to practical training is inadequate. The focus in the MBChB curriculum should be increased to a more specific practical approach during both the pre-clinical and clinical years.

Research paper thumbnail of Vd Bijl Breastfeeding SAJCH

South African Journal of Child Health, 2023

Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving ... more Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers
would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.
Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing on
breastfeeding and factors that impact the decision on feeding method.
Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the age
of 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infant
feeding intentions and behaviours.
Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusive
breastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median duration for both
children was 3 months shorter. The intention to express breastmilk at work was 67.7% for Child 1 and 57.7% for Child 2; however,
the actual outcome was less than half of the intention (32.0%). Most respondents (71.0%) indicated there was no dedicated area for
expressing breastmilk at their place of work.
Conclusion. The intention to exclusively breastfeed was high (6 months), but the actual duration was 3 months shorter. The percentage
of doctor mothers who eventually expressed breastmilk at work was less than half of those who intended to do so. Breastfeeding female
doctors need more support in the postpartum period, especially when returning to work after maternity leave.

Research paper thumbnail of The value of medical student hepatitis B immunisation as part of clinical skills training in the Clinical Skills Unit of the University of the Free State

South African Family Practice, 2005

Background: It is compulsory for medical students of the University of the Free State to be immun... more Background: It is compulsory for medical students of the University of the Free State to be immunised against hepatitis B before they have contact with clinical patients. Previously, the students were vaccinated on campus at the student health services. With the implementation of Curriculum 2000 (the revised MBChB programme), hepatitis B immunisation, as an example of an invasive procedure, was incorporated into the medical students' clinical skills training programme. The aim of this study was to assess the students' perceptions regarding immunising their peers, being immunised by their peers and the educational value of this process. Methods: Medical students in Phase II of the MBChB programme were included in this observational descriptive study and participation was voluntary. Students immunised their peers with a hepatitis B vaccine in the upper arm under the supervision of medical and nursing personnel in the laboratory of the Skills Unit. After the final immunisation, the students completed an anonymous questionnaire. Results: Sixty-six students completed the questionnaire. Of these, 80% felt that that they had improved their understanding of the theory of immunisation. Some (8%) students preferred to have the immunisation performed at a clinic or by a doctor and 6% had a problem with being vaccinated by a peer. A few (3%) students found it unacceptable to be immunised in a mixed gender group, 5% thought they had suffered complications and 5% indicated that there had been inadequate supervision. Most of the students (98%) responded positively to immunising their peers and 95% felt that it was advantageous to receive the immunisation in the skills laboratory environment. Approximately half (56%) of the students wanted to receive additional important immunisations. Conclusion: Students were positive about practising immunisation techniques on their peers.