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S Afr Med J. 1997 Mar;87(3):305-9.

Staff knowledge, attitudes and practices in public sector primary care of diabetes in Cape Town.

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  • 1Centre for Epidemiological Research in South Africa, South African Medical Research Council, Parowvallei, W. Cape.

Abstract

OBJECTIVE:

To audit staff knowledge, attitudes and practices in the interest of improved public sector primary care for diabetics.

DESIGN:

External audit using face-to-face, private, questionnaire-based interviews.

SETTING:

Twelve public sector ambulatory health centres in Cape Town.

SUBJECTS:

Non-specialist, principal staff members (N = 35)-12 doctors, 10 primary health care nurses (PHCNs), 7 registered nurses (RNs) and 6 staff nurses (SNs).

RESULTS:

Staff members were long-standing employees (mean-doctors 6 years, PHCNs 8 years, RNs 5 years, SNs 12 years). Few had post-basic training (doctors 25%, PHCNs 20%, RNs 26%, SNs 83%). Knowledge of chronic diabetic complications was adequate, e.g. diabetic eye disease was mentioned by 100% of staff. There were gaps in knowledge of pathophysiology and of signs and symptoms of diabetic emergencies, e.g. < 33% knew control of hypertension to be important in the prevention of diabetic nephropathy. Knowledge of appropriate care of patients with hypoglycaemia (94% mentioned glucose administration) was better than that of hyperglycaemia (69% mentioned intravenous fluids). Problems were reported in inter-staff communication within (approximately 50%) and between (approximately 75%) disciplines by doctors, PHCNs and RNs. Staff/patient communication problems were reported by approximately 75% of staff. Solutions suggested by staff included meetings between staff members and with management, in-service training programmes and appointment systems for patients. Despite logistic, organisational and communication-related problems, most staff enjoy and believe in the value of their work.

CONCLUSIONS:

This study reveals deficiencies in in-service training with consequent gaps in knowledge and practice. Recommendations that would lead to improved quality of care and increased staff and patient satisfaction have been given.

PMID:
9137343
[PubMed - indexed for MEDLINE]
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