Experiences of the health care delivery system in a rural South African setting

This exploratory study aimed to examine health care provider work-related experiences in a rural South African context. Participants were a convenient sample of 12 medical practitioners (private sector = 55%). The practitioners responded to an open-ended question on their health care delivery-related experiences. Thematic analysis of the data revealed that the medical officers experienced both care provider fatigue and satisfaction from their work roles. Experiences of care provider fatigue were characterised by stress, anxiety, hopelessness, depression, burnout, frustration, and anger. Care provider satisfaction was associated with happiness, ability to cope, security, conscience, and commitment. Job retention and satisfaction of the health care providers were dependent on material and manpower resourcing of health services.     

One-minute time interval estimation as a novel potent indicator of emotional concerns in cancer patients prior to starting chemotherapy

Our study explored the potential relationship between time estimation and issues that lead to distress in cancer patients prior to starting chemotherapy. Time estimation was assessed in 375 chemonaïve patients with solid tumors by evaluating each subject’s prospective estimation of how quickly one minute passed compared to the actual time. The median estimated value (40 s) was used to stratify the patients into the two categories of fast and slow time estimation. The National Comprehensive Cancer Network Distress Thermometer (DT) and Problem List (PL) were used at the beginning of treatment to evaluate levels of distress and patient concerns. A fast time estimation correlated significantly with gender and items reported in the emotional domain on the PL. Females exhibited significantly faster time estimation than males. Patients who reported fear, worry and loss of interest in usual activities estimated the one-minute interval significantly faster than patients who did not report such items. In the multivariate logistic regression model, patients who experienced fast time estimation had a higher risk of reporting items in the emotional domain. Time estimation is a novel potent indicator of emotional concerns on the PL. This test is an easily performed, time-saving, nonintrusive, ultrashort screening tool that is suitable even for patients who are not willing to reveal their emotional status via direct questionnaires.