Marianne Reid | University of the Free State (original) (raw)

Papers by Marianne Reid

African journal of development studies, Mar 22, 2024

Journal Of Endocrinology, Metabolism And Diabetes Of South Africa, Jan 2, 2021

To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabete... more To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa. Methods: A cluster randomised controlled trial was conducted involving 288 adults with type 2 diabetes from six communities in the Free State province. Individuals (n = 141) in three communities were randomly allocated to the intervention group, and individuals (n = 147) in another three communities were randomly allocated to the control group. Trained community health workers led monthly group sessions and home visits. The control group received the usual care. The primary outcome of the study was glycated haemoglobin (HbA1c), measured at baseline and endpoint after four months. Secondary outcomes included blood pressure, body mass index and waist circumference, measured at baseline and endpoint. Descriptive statistics were calculated per group. Results: No significant changes from baseline were found between groups regarding HbA1c (p = 0.87), body mass index (p = 0.21), waist circumference (p = 0.24) and systolic blood pressure (p = 0.13). Compared with the control group, the intervention group had a significant improvement in diastolic blood pressure (p = 0.02). Conclusions: The face-to-face peer-support intervention delivered by trained community health workers in a semi-urban rural area resulted in a significant improvement in diastolic blood pressure of adults with type 2 diabetes.

The aim of this study was to develop a framework to expand public health care services to HIV exp... more The aim of this study was to develop a framework to expand public health care services to HIV exposed and HIV positive children in the Free State. The objectives set in order to meet the aim were to identify strategies to expand health care services to these children and to then develop a framework to expand health care services to them within the Free State public health sector. The study consisted of various component projects, depicted as phases. The researcher conducted two components, Phase 1b and Phase 2 which links to the fore mentioned objectives of the study. A colleague, conducting research as Master student, conducted Phase 1a of the study, describing health care services rendered to HIV exposed and HIV positive children in the Free State public health sector. The researcher was intimately involved in Phase 1a, as she was acting as co-study leader. Health policy research was used, which is a type of health systems research, in an effort to inform higher levels of health on policy choices. Health managers were therefore active stakeholders in the development of the framework. The identification of strategies to expand health care services to HIV exposed and HIV positive children were one such activity where stakeholders assisted in the development of the framework. The Nominal Group Technique was used to identify mentioned strategies. A draft framework was developed using the Theory-of-Change Logic model as theoretical underpinning of the framework, with the empirical foundation being based on triangulated data obtained from literature findings, Phase1a and Phase 1b of the study. During a workshop with stakeholders, the framework was finalized, providing stakeholders the opportunity to validate the identified problem, namely that of fragmented care being delivered to HIV exposed and HIV positive children, due to over-verticalisation of programs. The validation of the framework was completed by d confirming the desired results, possible influential factors that could impact on the results, as well as strategies that could be followed to expand health care services to fore mentioned children. Since health policy research only informs policy choices,

BMC Public Health, Nov 30, 2020

Background: Peer support has been recognised as a promising strategy to improve self-management i... more Background: Peer support has been recognised as a promising strategy to improve self-management in patients living with chronic conditions, such as Type 2 diabetes (T2D). The purpose of the review was to synthesise the best available evidence on face-to-face peer support models for adults with T2D in low and middle-income countries (LMICs).

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

Journal of Interprofessional Care, Feb 23, 2023

South African Dental Journal, 2019

Planning and implementation of oral health education is of more value when oral health-related kn... more Planning and implementation of oral health education is of more value when oral health-related knowledge, attitudes and practices (KAP) are known. To assess and describe oral health-related KAP of adult patients in the Mangaung Metropolitan Municipality using the theory of planned behaviour. A quantitative descriptive design was used and data were collected from a sample of 207 adult oral health patients using a questionnaire based on the Theory of Planned Behaviour (TPB). Positive responses by participants towards oral-related KAP were regarded as strengthening oral health-related practices. Oral health-related knowledge as reflected by participants' behavioural beliefs (93.7%), normative beliefs (81.1%), subjective norms (70%) and perceived behavioural control (71.9%) strengthened oral health behaviours positively. Participants' control beliefs did not strengthen oral health practices. Participants' attitudes (62.3%), intention (98.5%), actual behavioural control (99%) and behaviour (95.1%) strengthened oral health-related practices. Adult patients generally portrayed behavioural beliefs, normative beliefs, subjective norms and perceived behavioural control that strengthened oral health behaviours positively. Understanding oral health-related KAP of adult patients would assist role players in the health sector to plan evidence based oral health education. Healthcare workers should be sensitive to the KAP of adult patients receiving oral health-related care. Oral health, knowledge, attitudes, practices, theory of planned behaviour. The mouth is an indicator of the state of a person's oral and general health. 1 Oral health is illustrated by the ability to speak, smile, chew, swallow and use different facial expressions without pain and discomfort. This favourable status may therefore be realised when there is an absence of disorders that affect different structures of the mouth, such as those causing possible pain, mouth lesions, tooth decay and gum disorders. 2,3 Worldwide , oral health disorders are reported to affect almost all adults at some point in their lives and these disorders rank among the top 100 conditions known to affect the quality of life. 4 Poor oral hygiene, diet and smoking are some of the risk factors causing oral health disorders in all corners of the world. 5 In Africa, poverty is one of the determinants of oral health disorders, as it predisposes people to a lack of information and poor lifestyle choices. 6 Poor oral health-related information and lifestyle choices can be improved by integrated oral health promotion strategies with the involvement of government,

Communitas, Oct 10, 2019

Health dialogue encompasses strategies to influence decisions to improve health, but it is often ... more Health dialogue encompasses strategies to influence decisions to improve health, but it is often still poorly understood. An analysis assists in creating a definition with a sound theoretical base, promoting consistency in using the concept, and understanding the underlying defining characteristics. The Walker and Avant approach was used to guide this concept analysis. The characteristics of health dialogue include an equal, symbiotic health relationship between the patient and the healthcare provider, and reciprocal health communication towards reaching an identified health goal via a health message. Antecedents include both patient and healthcare provider presenting with a positive attitude towards health dialogue, displaying sensitivity towards cultural, contextual and societal factors, and receiving training on health matters and communication skills. The consequence is an improved health outcome. Empirical referents comprise sharing an understanding of responsibility/decision-making, establishing a health plan, applying context-sensitive health communication strategies, and declaring mutual benefits received from the health relationship. This concept analysis serves to clarify the concept within theory development and research. The defined characteristics further afford healthcare providers ways to measure the concept in their work environment and encourage health communication.

This review will conduct searches in the Scopus databases and EBSCO Host platform on self-managem... more This review will conduct searches in the Scopus databases and EBSCO Host platform on self-management practices amongst patients with type II diabetes mellitus in preventing possible complications.The purpose of this review is to identified practices and lessons learnt from the findings to help develop a culturally appropriate intervention for prevention of nephropathy among patients with type II diabetes mellitus living in a lower middle income country rural setting.The review will be guided by the Joanna Briggs Institute approach to conducting scoping reviews as outlined by Peters et al. (2020).

The South African journal of clinical nutrition, Jul 6, 2018

Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in p... more Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in patients who are mostly still economically active. The growing incidence and health implications for those affected make T2DM a major public health issue. Objectives: To compile a demographic, anthropometric and knowledge, attitude and practices (KAP) profile of adult patients with T2DM in the public health sector of the Free State province, South Africa. Design: A descriptive observational study was conducted. Setting: A total of 255 participants attending public health facilities in the Free State were interviewed. Outcome Measures: Questionnaires were completed in an interview to determine demographics and KAP. Anthropometric measurements were obtained by standard techniques. Results: The majority of the participants (n = 222; 87.1%) were black women from urban areas, who were overweight and obese. The median age at diagnosis was 48 years (range 15-80 years), and 25 participants (9.8%) lacked formal schooling. In 212 participants (83.1%), a waist circumference above cutoff points was observed. Only half of the participants knew the normal range for blood glucose. Approximately 80% felt that they would be a different person if they did not have diabetes. Although 96.1% of participants were knowledgeable about the benefits of physical exercise, only 31.0% reported exercising on a daily basis. A statistically significant association was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Conclusion: Poor knowledge, a negative attitude and poor practices related to diabetes were observed in a very high percentage of participants, which may contribute to morbidity and mortality. The fact that knowledge was associated with attitude indicates that interventions aimed at improving knowledge could benefit patients in more than one way. Interventions to equip patients to successfully manage their condition are urgently required.

44th Biennial Convention (28 October - 01 November 2017), Oct 23, 2017

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

African Journal of Primary Health Care & Family Medicine, Apr 24, 2019

Health literacy in developing countries, including South Africa, is under-researched and poorly u... more Health literacy in developing countries, including South Africa, is under-researched and poorly understood. Even though research shows that individuals with poor economic status and low educational levels, who constitute 84% of the South African population, are particularly affected by limited HL, 2,17,18 information on the status of HL among South Africans is scant, resulting largely from the absence of milieu-appropriate HL tests. 19 Existing HL tests predominantly originated in developed countries, designed for populations in different socioeconomic , cultural and health system milieus, and are typically not suitable for use in South Africa, even if translated into a local language. Translation itself does not guarantee the relevance of existing tests for the health system, health concepts, and health and cultural beliefs of the country and target population Background: Research shows that poor health literacy (HL) can be a threat to health and health care. Health literacy is under-researched and poorly understood in developing countries, including South Africa, because of the absence of language and context-specific HL tests. Aim: The researchers aimed to develop an appropriate HL test for use among South African public health service users with Sesotho as their first language. Setting: The test was developed in the Free State Province of South Africa, for use among Sesotho speakers. Methods: Mixed methods were employed to develop the Sesotho Health Literacy Test (SHLT). The process of developing the test was carried out in distinctive methodological steps. Results: The stepwise process set out by identifying abstracts (n = 206) referring to HL tests. Sourcing of HL tests followed a tapered process resulting in the use of 17 HL tests. Elements within a conceptual framework guided HL test item selection (n = 47). Two Delphi sessions assisted in reaching consensus regarding final HL test items (n = 40). The readability testing of the SHLT tested 4.19 on the Coleman-Liau Index score. A context-suitable and comprehensive SHLT ensued from this work. Conclusion: The SHLT assessment instrument development creates a platform for HL testing among Sesotho first language speakers in South Africa. The context-sensitive methodology is entrenched in a theoretical framework, distributing HL test items between identified competencies and related skill dimensions and domains. The methodology can be applied to the development of HL tests for other languages and population groups in developing countries.

Cogent Social Sciences, 2021

Most indigenous populations in developing counties are burdened by limited health literacy, and v... more Most indigenous populations in developing counties are burdened by limited health literacy, and validated, cultural and language-specific health literacy measures are not available for them. This article describes a phased approach that was followed to validate the Sesotho Health Literacy Test (SHLT). Data from 474 patients and high school learners were used to test understandability of SHLT items, item response, factor analysis, and convergent and predictive validity of test items. SHLT items showed good internal reliability (Cronbach's α = 0.77). Exploratory structural equation modelling showed acceptable fit as the standardized root-mean-square residual (SRMR = 0.04). The convergent validity of the SHLT was good, indicated by people with more years of formal schooling scoring higher on the SHLT. The predictive validity of the SHLT was good, as those participants who scored high on the SHLT never had reading assistance. The test can be used by practitioners before they implement health promotion.

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in p... more Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in patients who are mostly still economically active. The growing incidence and health implications for those affected make T2DM a major public health issue. Objectives: To compile a demographic, anthropometric and knowledge, attitude and practices (KAP) profile of adult patients with T2DM in the public health sector of the Free State province, South Africa. Design: A descriptive observational study was conducted. Setting: A total of 255 participants attending public health facilities in the Free State were interviewed. Outcome Measures: Questionnaires were completed in an interview to determine demographics and KAP. Anthropometric measurements were obtained by standard techniques. Results: The majority of the participants (n = 222; 87.1%) were black women from urban areas, who were overweight and obese. The median age at diagnosis was 48 years (range 15-80 years), and 25 participants (9.8%) lacked formal schooling. In 212 participants (83.1%), a waist circumference above cutoff points was observed. Only half of the participants knew the normal range for blood glucose. Approximately 80% felt that they would be a different person if they did not have diabetes. Although 96.1% of participants were knowledgeable about the benefits of physical exercise, only 31.0% reported exercising on a daily basis. A statistically significant association was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Conclusion: Poor knowledge, a negative attitude and poor practices related to diabetes were observed in a very high percentage of participants, which may contribute to morbidity and mortality. The fact that knowledge was associated with attitude indicates that interventions aimed at improving knowledge could benefit patients in more than one way. Interventions to equip patients to successfully manage their condition are urgently required.

Health Sa Gesondheid, Jan 27, 2021

The key components of peer support include emotional support, informational support, appraisal su... more The key components of peer support include emotional support, informational support, appraisal support and instrumental support (De Vries et al. 2014; Egbujie et al. 2018). Emotional support may be associated with the sharing of lived experiences (Heisler et al. 2010; Ju et al. 2018), needing a 'shoulder to cry on' and/or simply someone to talk to and may be associated with building a relationship of trust (Yeung et al. 2018). Informational support relates to sharing information and assimilating new knowledge and skills (Krishnamoorthy et al. 2018; Yeung et al. 2018), and appraisal support refers to affirming feelings and behaviour (Dennis 2003). Instrumental support may relate to linking individuals with resources in the community and with healthcare professionals (Urichuk et al. 2018). There is a large body of evidence that supports the positive Background: Self-management is the backbone of diabetes care. For the patient with type 2 diabetes, this implies making decisions about a healthy diet, regular exercise and taking treatment appropriately. Some patients may experience barriers to the self-management of diabetes, such as lack of support. In this respect, peer support has been identified as a promising strategy in the self-management of diabetes. Aim: The study aimed to explore the experiences of adults with type 2 diabetes who took part in a diabetes peer support intervention in the Free State, South Africa. Such information may lead to the development of practical methods for diabetes self-management and control. Methods: Twelve purposively sampled Sesotho-speaking women (aged 51-84 years) participated in the Mmogo-method®, a visual-based narrative enquiry. Textual data from audio recordings of discussions, visual data from photographs of constructions and field notes were triangulated and analysed thematically. Results: Participants described the peer support intervention as very valuable. They regarded community health workers as an important source of support. Three themes emerged from the intervention: positive lifestyle changes, continuous support, and improved confidence and sense of connectedness. This was a significant finding reported in patients with diabetes, as it will contribute to successfully sustaining effective self-management behaviour. Conclusions: Peer support for patients with type 2 diabetes appeared to be a valued intervention, as participants related well to community health workers, who are ideally positioned in the healthcare system to provide the service.

International journal of nursing studies advances, Dec 1, 2023

Journal of Interprofessional Care

International Journal of Africa Nursing Sciences

African Journal of Primary Health Care & Family Medicine

Background: Health literacy influences patients' health outcomes, as their ability to read, inter... more Background: Health literacy influences patients' health outcomes, as their ability to read, interpret and apply health information associated with health-related decision-making. These decision-making skills need to be made up by patients diagnosed with chronic conditions-also Sesotho-speaking patients receiving treatment in public primary health care environments. Aim: The study aimed to assess the health literacy of Sesotho-speaking patients diagnosed with chronic conditions and to establish the associations between the sociodemographic data of patients and items of a health literacy test. Setting: This study was conducted in public healthcare (PHC) facilities in the Free State province, South Africa. Methodology: A quantitative descriptive cross-sectional design involved conveniently sampled patients with chronic conditions (n = 264) who were being treated at PHC facilities (n = 12) in the Setsoto subdistrict and who completed the Sesotho Health Literacy test during a structured interview. Descriptive statistics were calculated per group and compared by means of chi-square or Fisher's exact test and Kruskal-Wallis test. Results: Test results indicate high literacy levels in 35.6% (n = 94), moderate health literacy levels in 43.6% (n = 115) and low health literacy levels in 20.8% (n = 55) of participants. No association (p = 0.14) was found between health literacy level and gender or chronic conditions or between health literacy level and the participants' inability to read due to poor eyesight (p = 0.21). Positive associations (p ≤ 0.01) were established between a health literacy level and age and between health literacy level and education: participants with a South African School Grade Level 9-12 (p ≤ 0.01) had higher health literacy levels. Conclusion: Healthcare providers caring for Sesotho-speaking patients need to be sensitive about their patients' health literacy levels, as it may play a role in their health outcomes. Contribution: The value of the findings reported lies in the possibility of rapidly appraising the health literacy levels of a large indigenous population in South Africa diagnosed with chronic conditions.

African journal of development studies, Mar 22, 2024

Journal Of Endocrinology, Metabolism And Diabetes Of South Africa, Jan 2, 2021

To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabete... more To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa. Methods: A cluster randomised controlled trial was conducted involving 288 adults with type 2 diabetes from six communities in the Free State province. Individuals (n = 141) in three communities were randomly allocated to the intervention group, and individuals (n = 147) in another three communities were randomly allocated to the control group. Trained community health workers led monthly group sessions and home visits. The control group received the usual care. The primary outcome of the study was glycated haemoglobin (HbA1c), measured at baseline and endpoint after four months. Secondary outcomes included blood pressure, body mass index and waist circumference, measured at baseline and endpoint. Descriptive statistics were calculated per group. Results: No significant changes from baseline were found between groups regarding HbA1c (p = 0.87), body mass index (p = 0.21), waist circumference (p = 0.24) and systolic blood pressure (p = 0.13). Compared with the control group, the intervention group had a significant improvement in diastolic blood pressure (p = 0.02). Conclusions: The face-to-face peer-support intervention delivered by trained community health workers in a semi-urban rural area resulted in a significant improvement in diastolic blood pressure of adults with type 2 diabetes.

The aim of this study was to develop a framework to expand public health care services to HIV exp... more The aim of this study was to develop a framework to expand public health care services to HIV exposed and HIV positive children in the Free State. The objectives set in order to meet the aim were to identify strategies to expand health care services to these children and to then develop a framework to expand health care services to them within the Free State public health sector. The study consisted of various component projects, depicted as phases. The researcher conducted two components, Phase 1b and Phase 2 which links to the fore mentioned objectives of the study. A colleague, conducting research as Master student, conducted Phase 1a of the study, describing health care services rendered to HIV exposed and HIV positive children in the Free State public health sector. The researcher was intimately involved in Phase 1a, as she was acting as co-study leader. Health policy research was used, which is a type of health systems research, in an effort to inform higher levels of health on policy choices. Health managers were therefore active stakeholders in the development of the framework. The identification of strategies to expand health care services to HIV exposed and HIV positive children were one such activity where stakeholders assisted in the development of the framework. The Nominal Group Technique was used to identify mentioned strategies. A draft framework was developed using the Theory-of-Change Logic model as theoretical underpinning of the framework, with the empirical foundation being based on triangulated data obtained from literature findings, Phase1a and Phase 1b of the study. During a workshop with stakeholders, the framework was finalized, providing stakeholders the opportunity to validate the identified problem, namely that of fragmented care being delivered to HIV exposed and HIV positive children, due to over-verticalisation of programs. The validation of the framework was completed by d confirming the desired results, possible influential factors that could impact on the results, as well as strategies that could be followed to expand health care services to fore mentioned children. Since health policy research only informs policy choices,

BMC Public Health, Nov 30, 2020

Background: Peer support has been recognised as a promising strategy to improve self-management i... more Background: Peer support has been recognised as a promising strategy to improve self-management in patients living with chronic conditions, such as Type 2 diabetes (T2D). The purpose of the review was to synthesise the best available evidence on face-to-face peer support models for adults with T2D in low and middle-income countries (LMICs).

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

Journal of Interprofessional Care, Feb 23, 2023

South African Dental Journal, 2019

Planning and implementation of oral health education is of more value when oral health-related kn... more Planning and implementation of oral health education is of more value when oral health-related knowledge, attitudes and practices (KAP) are known. To assess and describe oral health-related KAP of adult patients in the Mangaung Metropolitan Municipality using the theory of planned behaviour. A quantitative descriptive design was used and data were collected from a sample of 207 adult oral health patients using a questionnaire based on the Theory of Planned Behaviour (TPB). Positive responses by participants towards oral-related KAP were regarded as strengthening oral health-related practices. Oral health-related knowledge as reflected by participants' behavioural beliefs (93.7%), normative beliefs (81.1%), subjective norms (70%) and perceived behavioural control (71.9%) strengthened oral health behaviours positively. Participants' control beliefs did not strengthen oral health practices. Participants' attitudes (62.3%), intention (98.5%), actual behavioural control (99%) and behaviour (95.1%) strengthened oral health-related practices. Adult patients generally portrayed behavioural beliefs, normative beliefs, subjective norms and perceived behavioural control that strengthened oral health behaviours positively. Understanding oral health-related KAP of adult patients would assist role players in the health sector to plan evidence based oral health education. Healthcare workers should be sensitive to the KAP of adult patients receiving oral health-related care. Oral health, knowledge, attitudes, practices, theory of planned behaviour. The mouth is an indicator of the state of a person's oral and general health. 1 Oral health is illustrated by the ability to speak, smile, chew, swallow and use different facial expressions without pain and discomfort. This favourable status may therefore be realised when there is an absence of disorders that affect different structures of the mouth, such as those causing possible pain, mouth lesions, tooth decay and gum disorders. 2,3 Worldwide , oral health disorders are reported to affect almost all adults at some point in their lives and these disorders rank among the top 100 conditions known to affect the quality of life. 4 Poor oral hygiene, diet and smoking are some of the risk factors causing oral health disorders in all corners of the world. 5 In Africa, poverty is one of the determinants of oral health disorders, as it predisposes people to a lack of information and poor lifestyle choices. 6 Poor oral health-related information and lifestyle choices can be improved by integrated oral health promotion strategies with the involvement of government,

Communitas, Oct 10, 2019

Health dialogue encompasses strategies to influence decisions to improve health, but it is often ... more Health dialogue encompasses strategies to influence decisions to improve health, but it is often still poorly understood. An analysis assists in creating a definition with a sound theoretical base, promoting consistency in using the concept, and understanding the underlying defining characteristics. The Walker and Avant approach was used to guide this concept analysis. The characteristics of health dialogue include an equal, symbiotic health relationship between the patient and the healthcare provider, and reciprocal health communication towards reaching an identified health goal via a health message. Antecedents include both patient and healthcare provider presenting with a positive attitude towards health dialogue, displaying sensitivity towards cultural, contextual and societal factors, and receiving training on health matters and communication skills. The consequence is an improved health outcome. Empirical referents comprise sharing an understanding of responsibility/decision-making, establishing a health plan, applying context-sensitive health communication strategies, and declaring mutual benefits received from the health relationship. This concept analysis serves to clarify the concept within theory development and research. The defined characteristics further afford healthcare providers ways to measure the concept in their work environment and encourage health communication.

This review will conduct searches in the Scopus databases and EBSCO Host platform on self-managem... more This review will conduct searches in the Scopus databases and EBSCO Host platform on self-management practices amongst patients with type II diabetes mellitus in preventing possible complications.The purpose of this review is to identified practices and lessons learnt from the findings to help develop a culturally appropriate intervention for prevention of nephropathy among patients with type II diabetes mellitus living in a lower middle income country rural setting.The review will be guided by the Joanna Briggs Institute approach to conducting scoping reviews as outlined by Peters et al. (2020).

The South African journal of clinical nutrition, Jul 6, 2018

Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in p... more Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in patients who are mostly still economically active. The growing incidence and health implications for those affected make T2DM a major public health issue. Objectives: To compile a demographic, anthropometric and knowledge, attitude and practices (KAP) profile of adult patients with T2DM in the public health sector of the Free State province, South Africa. Design: A descriptive observational study was conducted. Setting: A total of 255 participants attending public health facilities in the Free State were interviewed. Outcome Measures: Questionnaires were completed in an interview to determine demographics and KAP. Anthropometric measurements were obtained by standard techniques. Results: The majority of the participants (n = 222; 87.1%) were black women from urban areas, who were overweight and obese. The median age at diagnosis was 48 years (range 15-80 years), and 25 participants (9.8%) lacked formal schooling. In 212 participants (83.1%), a waist circumference above cutoff points was observed. Only half of the participants knew the normal range for blood glucose. Approximately 80% felt that they would be a different person if they did not have diabetes. Although 96.1% of participants were knowledgeable about the benefits of physical exercise, only 31.0% reported exercising on a daily basis. A statistically significant association was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Conclusion: Poor knowledge, a negative attitude and poor practices related to diabetes were observed in a very high percentage of participants, which may contribute to morbidity and mortality. The fact that knowledge was associated with attitude indicates that interventions aimed at improving knowledge could benefit patients in more than one way. Interventions to equip patients to successfully manage their condition are urgently required.

44th Biennial Convention (28 October - 01 November 2017), Oct 23, 2017

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

African Journal of Primary Health Care & Family Medicine, Apr 24, 2019

Health literacy in developing countries, including South Africa, is under-researched and poorly u... more Health literacy in developing countries, including South Africa, is under-researched and poorly understood. Even though research shows that individuals with poor economic status and low educational levels, who constitute 84% of the South African population, are particularly affected by limited HL, 2,17,18 information on the status of HL among South Africans is scant, resulting largely from the absence of milieu-appropriate HL tests. 19 Existing HL tests predominantly originated in developed countries, designed for populations in different socioeconomic , cultural and health system milieus, and are typically not suitable for use in South Africa, even if translated into a local language. Translation itself does not guarantee the relevance of existing tests for the health system, health concepts, and health and cultural beliefs of the country and target population Background: Research shows that poor health literacy (HL) can be a threat to health and health care. Health literacy is under-researched and poorly understood in developing countries, including South Africa, because of the absence of language and context-specific HL tests. Aim: The researchers aimed to develop an appropriate HL test for use among South African public health service users with Sesotho as their first language. Setting: The test was developed in the Free State Province of South Africa, for use among Sesotho speakers. Methods: Mixed methods were employed to develop the Sesotho Health Literacy Test (SHLT). The process of developing the test was carried out in distinctive methodological steps. Results: The stepwise process set out by identifying abstracts (n = 206) referring to HL tests. Sourcing of HL tests followed a tapered process resulting in the use of 17 HL tests. Elements within a conceptual framework guided HL test item selection (n = 47). Two Delphi sessions assisted in reaching consensus regarding final HL test items (n = 40). The readability testing of the SHLT tested 4.19 on the Coleman-Liau Index score. A context-suitable and comprehensive SHLT ensued from this work. Conclusion: The SHLT assessment instrument development creates a platform for HL testing among Sesotho first language speakers in South Africa. The context-sensitive methodology is entrenched in a theoretical framework, distributing HL test items between identified competencies and related skill dimensions and domains. The methodology can be applied to the development of HL tests for other languages and population groups in developing countries.

Cogent Social Sciences, 2021

Most indigenous populations in developing counties are burdened by limited health literacy, and v... more Most indigenous populations in developing counties are burdened by limited health literacy, and validated, cultural and language-specific health literacy measures are not available for them. This article describes a phased approach that was followed to validate the Sesotho Health Literacy Test (SHLT). Data from 474 patients and high school learners were used to test understandability of SHLT items, item response, factor analysis, and convergent and predictive validity of test items. SHLT items showed good internal reliability (Cronbach's α = 0.77). Exploratory structural equation modelling showed acceptable fit as the standardized root-mean-square residual (SRMR = 0.04). The convergent validity of the SHLT was good, indicated by people with more years of formal schooling scoring higher on the SHLT. The predictive validity of the SHLT was good, as those participants who scored high on the SHLT never had reading assistance. The test can be used by practitioners before they implement health promotion.

Sigma Theta Tau International's 27th International Nursing Research Congress, Jul 13, 2016

Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in p... more Type 2 diabetes mellitus (T2DM) is a global health problem with high morbidity and mortality in patients who are mostly still economically active. The growing incidence and health implications for those affected make T2DM a major public health issue. Objectives: To compile a demographic, anthropometric and knowledge, attitude and practices (KAP) profile of adult patients with T2DM in the public health sector of the Free State province, South Africa. Design: A descriptive observational study was conducted. Setting: A total of 255 participants attending public health facilities in the Free State were interviewed. Outcome Measures: Questionnaires were completed in an interview to determine demographics and KAP. Anthropometric measurements were obtained by standard techniques. Results: The majority of the participants (n = 222; 87.1%) were black women from urban areas, who were overweight and obese. The median age at diagnosis was 48 years (range 15-80 years), and 25 participants (9.8%) lacked formal schooling. In 212 participants (83.1%), a waist circumference above cutoff points was observed. Only half of the participants knew the normal range for blood glucose. Approximately 80% felt that they would be a different person if they did not have diabetes. Although 96.1% of participants were knowledgeable about the benefits of physical exercise, only 31.0% reported exercising on a daily basis. A statistically significant association was found between knowledge and attitudes, indicating that better knowledge about diabetes could be associated with a more positive attitude towards diabetes. Conclusion: Poor knowledge, a negative attitude and poor practices related to diabetes were observed in a very high percentage of participants, which may contribute to morbidity and mortality. The fact that knowledge was associated with attitude indicates that interventions aimed at improving knowledge could benefit patients in more than one way. Interventions to equip patients to successfully manage their condition are urgently required.

Health Sa Gesondheid, Jan 27, 2021

The key components of peer support include emotional support, informational support, appraisal su... more The key components of peer support include emotional support, informational support, appraisal support and instrumental support (De Vries et al. 2014; Egbujie et al. 2018). Emotional support may be associated with the sharing of lived experiences (Heisler et al. 2010; Ju et al. 2018), needing a 'shoulder to cry on' and/or simply someone to talk to and may be associated with building a relationship of trust (Yeung et al. 2018). Informational support relates to sharing information and assimilating new knowledge and skills (Krishnamoorthy et al. 2018; Yeung et al. 2018), and appraisal support refers to affirming feelings and behaviour (Dennis 2003). Instrumental support may relate to linking individuals with resources in the community and with healthcare professionals (Urichuk et al. 2018). There is a large body of evidence that supports the positive Background: Self-management is the backbone of diabetes care. For the patient with type 2 diabetes, this implies making decisions about a healthy diet, regular exercise and taking treatment appropriately. Some patients may experience barriers to the self-management of diabetes, such as lack of support. In this respect, peer support has been identified as a promising strategy in the self-management of diabetes. Aim: The study aimed to explore the experiences of adults with type 2 diabetes who took part in a diabetes peer support intervention in the Free State, South Africa. Such information may lead to the development of practical methods for diabetes self-management and control. Methods: Twelve purposively sampled Sesotho-speaking women (aged 51-84 years) participated in the Mmogo-method®, a visual-based narrative enquiry. Textual data from audio recordings of discussions, visual data from photographs of constructions and field notes were triangulated and analysed thematically. Results: Participants described the peer support intervention as very valuable. They regarded community health workers as an important source of support. Three themes emerged from the intervention: positive lifestyle changes, continuous support, and improved confidence and sense of connectedness. This was a significant finding reported in patients with diabetes, as it will contribute to successfully sustaining effective self-management behaviour. Conclusions: Peer support for patients with type 2 diabetes appeared to be a valued intervention, as participants related well to community health workers, who are ideally positioned in the healthcare system to provide the service.

International journal of nursing studies advances, Dec 1, 2023

Journal of Interprofessional Care

International Journal of Africa Nursing Sciences

African Journal of Primary Health Care & Family Medicine

Background: Health literacy influences patients' health outcomes, as their ability to read, inter... more Background: Health literacy influences patients' health outcomes, as their ability to read, interpret and apply health information associated with health-related decision-making. These decision-making skills need to be made up by patients diagnosed with chronic conditions-also Sesotho-speaking patients receiving treatment in public primary health care environments. Aim: The study aimed to assess the health literacy of Sesotho-speaking patients diagnosed with chronic conditions and to establish the associations between the sociodemographic data of patients and items of a health literacy test. Setting: This study was conducted in public healthcare (PHC) facilities in the Free State province, South Africa. Methodology: A quantitative descriptive cross-sectional design involved conveniently sampled patients with chronic conditions (n = 264) who were being treated at PHC facilities (n = 12) in the Setsoto subdistrict and who completed the Sesotho Health Literacy test during a structured interview. Descriptive statistics were calculated per group and compared by means of chi-square or Fisher's exact test and Kruskal-Wallis test. Results: Test results indicate high literacy levels in 35.6% (n = 94), moderate health literacy levels in 43.6% (n = 115) and low health literacy levels in 20.8% (n = 55) of participants. No association (p = 0.14) was found between health literacy level and gender or chronic conditions or between health literacy level and the participants' inability to read due to poor eyesight (p = 0.21). Positive associations (p ≤ 0.01) were established between a health literacy level and age and between health literacy level and education: participants with a South African School Grade Level 9-12 (p ≤ 0.01) had higher health literacy levels. Conclusion: Healthcare providers caring for Sesotho-speaking patients need to be sensitive about their patients' health literacy levels, as it may play a role in their health outcomes. Contribution: The value of the findings reported lies in the possibility of rapidly appraising the health literacy levels of a large indigenous population in South Africa diagnosed with chronic conditions.