Development of a training programme for primary care providers to counsel patients with risky lifestyle behaviours in South Africa

Malan, Zelra; Mash, Robert; Everett-Murphy, Katherine

doi:10.4102/phcfm.v7i1.819

Cited by 24 publications

(22 citation statements)

References 22 publications

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“…Even brief interventions based on the 5 As (ask, alert, assess, assist and arrange), which could be incorporated into routine practice, have been shown to be effective in helping patients to stop smoking. 21 In addition, it is important that doctors use appropriate guidelines and treat patients with diabetes, hypertension and hypercholesterolaemia. The review re-emphasises that PHC doctors should identify patients at risk for developing IHD, ensure optimal control of any comorbid conditions and assess regularly.…”

Section: Discussionmentioning

confidence: 99%

Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Chetty

Ross

2016

Afr. j. prim. health care fam. med.

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BackgroundIncidence and prevalence of non-communicable diseases, including ischaemic heart disease (IHD) and associated acute myocardial infarction (AMI), are increasing in South Africa. Local studies are needed as contextual factors, such as healthcare systems, gender and ethnicity, may affect presentation and management. In AMI, reviews on time between onset of chest pain and initiation of urgent treatment are useful, as delays in initiation of thrombolytic treatment significantly increase morbidity and mortality.AimThe aim of the study was to determine the profile and management of patients admitted with ischaemic chest pain.SettingThe study was carried out in a busy urban-based district hospital in KwaZulu-Natal, South Africa. The population served is poor, and patients are mainly Indian with associated high risk of IHD.MethodsA chart review of all patients seen at the hospital with acute ischaemic chest pain between 01 March and 31 August 2014 was undertaken.ResultsMore male than female patients were admitted, with a wide variation in age. Most eligible patients received required thrombolytic intervention within an acceptable time period after arrival at hospital.ConclusionChest pain and AMI were a relatively common presentation at the study site, and urgent diagnosis and initiation of fibrinolytic therapy are essential. The encouraging door-to-needle time may have been influenced by the availability of specialist family physicians, trained as ‘expert generalists’ to provide appropriate care in a variety of settings and consultant support to junior staff. The role of the family physician and primary healthcare doctor in primary prevention are re-emphasised through the study findings.

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Section: Discussionmentioning

confidence: 99%

Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Chetty

Ross

2016

Afr. j. prim. health care fam. med.

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“…This could be a result of compassion fatigue associated with elevated patient caseloads (Khamisa, Oldenburg, Peltzer, & Ilic, 2015). These findings suggest that current initiatives to train clinic staff in person-centred care strategies (Malan, Mash, & Evertt-Murphy, 2015) should be accompanied by efforts to reduce human resource shortages.…”

Section: Discussionmentioning

confidence: 98%

Assessing capability for implementing mental health counselling within primary care facilities in a middle‐income country: A feasibility study

Myers

Breuer

Lund

et al. 2019

Psychiatric Ment Health Nurs

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Accessible summary What is already known about this topic? Integrating mental health counselling into primary care services is a recommended strategy for reducing the mental health treatment gap in low‐ and middle‐income countries. To support this strategy, potential barriers to counselling integration must be identified and addressed. Organizational preparedness for implementation may influence the extent to which the introduction of counselling is successful. Features of primary care facilities associated with preparedness for the implementation of mental health counselling have not been explored. What the paper adds to existing knowledge? This study uses a novel approach to explore variations in preparedness of primary care services to implement counselling and factors potentially associated with these variations. Findings suggest there is considerable variation in the preparedness of facilities to implement counselling. Organizational factors such as resource availability, management style and facility environment are potentially associated with capability for implementing mental health counselling. What are the implications for practice? Health planners could use this method to identify poorly functioning services that may benefit from additional interventions to build preparedness for counselling implementation. Future research should examine whether differences in facility preparedness impact on the implementation and outcomes of this service. AbstractIntroductionDifferences in primary care facilities' preparedness for implementing mental health counselling may affect the implementation process but have rarely been studied.AimTo assess the feasibility of using a novel methodological approach to explore variations in capability for implementing mental health counselling and factors potentially associated with this variation among primary care services in the Western Cape, South Africa.MethodsStaff from 26 facilities participated in discussions about their facility's mental health implementation capability. Three researchers conducted observations of the facility's environment, staff–patient interactions and resources. We used qualitative comparative analysis to identify factors potentially associated with implementation capability.ResultsFacilities appeared to vary in their capability for implementing counselling services. The availability of person‐centred health services, a therapeutic environment and sufficient human resources may be requirements for implementation preparedness. Other factors that seem to support preparedness include the availability of confidential space for counselling and an adequately managed facility.DiscussionThis study identified several features of well‐functioning primary care facilities. Facilities with these features may be better prepared to implement a new counselling service.Implications for practiceThis method may identify facilities that are poorly prepared for implementation that could benefit from preparedness‐building interventions. Whether differences in p...

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“…Within the southern African sub-region, a best practice brief behaviour change counselling (BBCC) training programme was recently developed and implemented among PCPs. 33 To the best of our knowledge, a similar programme has not yet been implemented in the East and West African subregions. Our findings may thus be a reflection of the effect of quality of training and physician awareness of the need for personal lifestyle change on patient counselling rates.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle, cardiovascular risk knowledge and patient counselling among selected sub-Saharan African family physicians and trainees

Ameh

Yakubu

Miima³

et al. 2019

Afr. j. prim. health care fam. med.

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Background Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies. Aim The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA. Setting FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA. Methods A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following collation of responses, the relationship between the participants’ CVD prevention knowledge, lifestyle practices and CVD counselling rates was assessed. Results Of the 174 participants (53% response rate), 83% were married, 51% were females and the mean age was 39.2 (standard deviation [SD] 7.6) years. Most of the participants responded accurately to the CVD prevention knowledge items, but few had accurate responses on prioritising care by 10-year risk. Most participants had less than optimal lifestyle practices except for smoking, vegetable or fruit ingestion and sleep habits. Most participants (65%) usually counselled patients on nutrition, but less frequently on weight management, exercise, smoking and alcohol. The region of practice and physicians with poor lifestyle were predictive of patient counselling rates. Conclusion Training on patient counselling and self-awareness for CVD prevention may influence patient counselling practice. Promoting quality training on patient counselling among FPs as well as a healthy self-awareness for CVD prevention is thus needed. The complex relationship between physician lifestyle and patient counselling warrants further study. Keywords family physicians; cardiovascular diseases; lifestyle counselling; sub-Saharan Africa; online survey; family medicine trainee.

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Development of a training programme for primary care providers to counsel patients with risky lifestyle behaviours in South Africa

Cited by 24 publications

References 22 publications

Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Assessing capability for implementing mental health counselling within primary care facilities in a middle‐income country: A feasibility study

Lifestyle, cardiovascular risk knowledge and patient counselling among selected sub-Saharan African family physicians and trainees

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