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Biomedical subjects

L Swartz

Publications and source records attributed to L Swartz.

At least 19 recordsLinked to original sources
PubMed2006

Post-partum depression and infant growth in a South African peri-urban settlement.

AIM: To examine the association between maternal post-natal depression and infant growth. BACKGROUND: Infant growth has recently been shown, in two studies from South Asia, to be adversely affected by maternal depression in the early post-partum period. It is uncertain whether a similar association obtains in developing countries outside Asia. METHOD: A sample of 147 mother-infant dyads was recruited from a peri-urban settlement outside Cape Town and seen at 2 and 18 months post partum. RESULTS: No clear effect of post-partum depression on infant growth was found. Although maternal depression at 2 months was found to be associated with lower infant weight at 18 months, when birthweight was considered this effect disappeared. CONCLUSIONS: Possible explanations for the non-replication of the South Asian findings are considered.

Adult↗
PubMed2005

'What I've noticed what they need is the stats': lay HIV counsellors' reports of working in a task-orientated health care system.

Counselling has been recognized as an important component of HIV and AIDS care, and an essential part of HIV testing. In South Africa, a commonly used model is for lay counsellors to be trained by non-governmental organizations and then to work alongside professionals in public health clinics. In studies of counselling in health care settings in the context of HIV, there has been a relative lack of attention to the organizational and systemic issues faced by counsellors and counselling programmes. Counsellors are involved in a dynamic interrelationship not only with their clients but also with the organizations in which they work. In this paper we report on counsellors' accounts of the impact of their unclear position on their work. Twenty-nine counsellors were interviewed using individual interviews and focus group discussions. The findings reveal a clash between an holistic counselling approach and a task-oriented health system. The results provide some indication of the need to consider workplace issues in planning and researching VCT.

Attitude of Health Personnel↗
PubMed1999

Post-partum depression and the mother-infant relationship in a South African peri-urban settlement.

BACKGROUND: Post-partum depression in the developing world has received little research attention, and its association with disturbances in the mother-infant relationship is unknown. AIMS: To determine the prevalence of post-partum depression and associated disturbances in the mother-infant relationship in Khayelitsha, a South African peri-urban settlement. METHOD: The mental state of 147 women who had delivered two months previously was assessed, and the quality of their engagement with their infants was determined. RESULTS: The point prevalence of DSM-IV major depression was found to be 34.7%. Maternal depression was associated with poor emotional and practical support from the partner. It was also associated with insensitive engagement with the infants. CONCLUSIONS: The rate of post-partum depression in Khayelitsha was around three times that found in British post-partum samples, and these depressions were strongly associated with disturbances in the mother-infant relationship.

Adult↗
PubMed1996

Prevalence of psychiatric morbidity in the adult population of a rural South African village.

We report on the first South African two-stage community prevalence study of psychiatric morbidity, conducted in Mamre, a rural "coloured' village, 50 km from Cape Town. Randomly selected adults (N = 481) were assessed using the Self-Reporting Questionnaire (SRQ) as a first-stage screen and the Present State Examination (PSE-9) was administered to a proportion of the sample (N = 121) as the second-stage criterion. Demographic, health care utilization, and substance abuse data were also collected. Using the PSE-9 CATEGO Index of Definition of 5, the weighted prevalence of psychiatric morbidity was 27.1% (confidence interval of 19.5-34.7%), the majority of cases being given a tentative diagnosis of depressive or anxiety disorder. The CATEGO algorithm may not be fully appropriate in this cultural context as there was an apparent over-diagnosis of paranoid states. The SRQ's weighted sensitivity and specificity were 0.49 and 0.82 respectively. Overall, the SRQ correctly identified 67% of cases and non-cases. No demographic variables predicted psychiatric morbidity, but there was an indirect link between morbidity and primary care utilization. Further South African studies of the validity of both the SRQ and of criterion instruments are needed. These may contribute to knowledge regarding cultural factors affecting psychiatric diagnosis.

Adolescent↗
PubMed1995

Reports of the experience of epilepsy in a rural South African village.

It has become increasingly acknowledge that the social and psychological consequences of epilepsy may be more debilitating than the epileptic seizures themselves. This study, which formed part of an ongoing community health project which was carried out in the South African village of Mamre, was aimed at gaining an understanding of some of these psychosocial aspects. Sixteen respondents were as well as their families, had accepted the epilepsy and learnt to cope with it, although some respondents felt stigmatized by the epilepsy and made various attempts to conceal it from outsiders. Problems which were caused by epilepsy included the fear of going out unaccompanied, as well as forgetfulness and irritable mood. Few respondents had epilepsy which could be described as well-controlled, yet none admitted being dissatisfied with their treatment. Implications of the study included the need to assist the respondents and their families to better understand the management of epilepsy, so that every effort would be made to attain maximal seizure control.

Adolescent↗
PubMed1993

Professional constructions of a 'lay' illness: 'nerves' in a rural 'coloured' community in South Africa.

As part of a larger study, medical practitioners working in Mamre, a 'coloured' village close to Cape Town, South Africa, were interviewed concerning their use of the term 'nerves' in interaction with their patients. Contrary to the initial perception of researchers and some clinicians, the term is not simply a folk category. It does, however, represent a medium through which psychosocial issues are discussed in the clinical encounter. Differences in the usage of the term by different practitioners seemed to indicate different attitudes towards patient care. The data are presented and discussed in the context of debates concerning the development of more accessible and responsive health services in a future South Africa, and the information gleaned has implications for future training of clinicians.

Black or African American↗
PubMed1992

On the edge: ward-rounds in a South African psychiatric emergency department.

Psychiatry, like other institutions in South Africa, is affected by issues of race. An examination of ward-rounds in a South African psychiatric emergency department, however, revealed that as important to an understanding of this unit is the recognition of the place of psychiatry in biomedicine. A key feature affecting staff in the unit was the fact of psychiatry's marginality relative to general medicine. Race was seldom and obliquely discussed, but played an important contributory role. Work towards the transformation of psychiatric care in a democratic South Africa must consider the institutional level as well as the more obvious question of racial inequality.

Black or African American↗
PubMed1991

Hidden dimensions of power and resistance in the translation process: a south African study.

This article examines the social relationships involved in the production of a Xhosa version of the Beck Depression Inventory (BDI). The South African sociopolitical context and the imperatives of the biomedical context are discussed. These play an important role in how the problem of semantic equivalence between translations, and the issue of the imposition of a colonialist, Western psychiatric framework are addressed. After a brief but critical outline of recommended translation techniques, the particular combination of back-translation and committee method employed in this study is presented. An analysis of the social relationships revealed a complex set of interrelated factors affecting the process. The power differential between researcher and back-translators, compounded by their different perceptions of the task, impeded discussion about the instrument. Translators had ostensibly markedly opposed claims to competence to speak for the "true Xhosa language". At a deeper level however, these claims, and indeed the entire translation enterprise, could be seen to be reproducing apartheid structures, regardless of the intention of the participants. The dynamics we describe are particularly salient in the South African context but may also be operative in other contexts.

Black or African American↗