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Transitional community adherence support for people leaving incarceration in South Africa a pragmatic openlabel randomised controlled trial
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A simplified and evidence-informed approach to removable partial dentures. Part 4. Seven simple steps design
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Quantifying how single dose Ad26COV2S vaccine efficacy depends on Spike sequence features
No full textDeveloping strategies for alleviating caregiver burden among informal caregivers of persons with severe mental disorders in Bushbuckridge, Mpumalanga province
No full textA thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Doctor of Philosophy Johannesburg, South Africa. May,2024Background: Globally, implementation of deinstitutionalisation led to a shift from institutional to community care of persons with severe mental disorders. This move calls for informal caregivers including families, relatives, friends, or neighbours to become key role players in the care and management of persons with severe mental disorders. The role of informal caregiving results in stress that consequently leads to caregiver burden. In South Africa, limited evidence exists on the
extent of the burden experienced by the informal caregivers of persons with severe mental disorders and strategies for supporting these informal caregivers in their role are lacking. This study aimed to explore the burden of care to inform the development of strategies for alleviating burden among informal caregivers of persons with severe mental disorders in Bushbuckridge, Mpumalanga province.
Methods: This study used a three-phased mixed methods approach with a multiphase design to facilitate a comprehensive investigation of caregiver burden among informal caregivers and to develop the multilevel strategies for alleviating the burden. Sequential and concurrent methods were combined to collect quantitative and qualitative data across five studies that were conducted to address the study objectives.
Results: The established extent of burden revealed that most informal caregivers (44.7%) reported moderate-to-severe levels of objective burden, and 35.9% reported moderate-to-moderate levels of subjective burdens. Objective burden levels were significantly associated with age, gender and residence (p = 0.025, p = 0.034, and p = 0.038, respectively), while subjective burden was significantly associated with daily caregiving (p = 0.012). The exploration of lived experiences
revealed that most informal caregivers experienced burden with subsequent impact on their emotional, mental, and physical health. The subsequent burdens were attributed to dealing with the chronic nature of severe mental disorders, role and financial strain, and stigmatisation from family and community. To deal with their caregiving demands informal caregivers expressed reliance on their internal resources, including resilience and resourcefulness. Expressed support needs included access to mental health services, and empowerment and social support from family, government, and religious and community organisations. The findings identified the need for conducting health screenings among the informal caregivers, as well as the need for strategies to support informal caregivers to complement their internal coping resources. The findings of the scoping review revealed that most studies were conducted in Asian countries. Psychoeducation
and support group interventions were identified as predominant strategies for alleviating caregiver burden. The service provider’s perspectives revealed that the current state of formal and informal community mental health services is inadequate to meet the needs of the informal caregivers.
Conclusion: The study’s findings informed the development of strategies for alleviating caregiver burden among informal caregivers in a low-resourced setting. The complexity of caregiver burden requires multilevel strategies, namely caregiver-driven, health worker-driven, community-based, intersectoral, policy, and legislature strategies across the individual, interpersonal, organisational, community, and policy levels. Caregiver empowerment, family and peer support, development of
caregiver-orientated institution and community-based services, task sharing, and task shifting were identified as overriding strategies relevant for alleviating informal caregiver burden in a low- resourced settingConsortium of Advanced Research Training in Africa (CARTA)MM202
A preliminary study on the accuracy of cast metal removable partial denture frameworks produced from wax printed and milled patterns
No full textBudget 2025 Preview: Pressures and tensions along the austerity road to fiscal sustainability
No full textThis policy brief, ahead of the tabling of the 2025 Budget Review, considers the policy context and the fiscal and economic environment in which the Budget will be tabled. It considers the merits, limitations, and likely consequences of the government’s approach to budget policy over the medium term, as contained in the 2024 Medium-Term Budget Policy Statement (MTBPS), which redoubled efforts to consolidate public finances while attempting to promote capital spending. Since the MTBPS, several material expenditure pressures have emerged, some of which were flagged in the Public Economy Project’s (PEP) 2024 MTBPS analysis, and the economic outlook has been revised. Based on this, the Public Economy Project’s revised outlook for public finance finds that the government’s ambitious plan to stabilise debt over the medium term is unlikely to be realised.TM202
