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Factors influencing elderly patient perceptions and experiences of clinical service quality in a private and a public radiology facility in the eThekwini District
(2025-05-25) Seeparsad, Nikita Shah; Khoza, Thandokuhle Emmanuel
Background: Over the years, South Africa’s ageing population has grown, resulting in vulnerable elderly individuals who require frequent use of healthcare. It is therefore important to ensure that these citizens receive the correct level of health services as they generally need more attention, effort and compassion in ensuring a pleasant healthcare experience. In line with the above, radiology healthcare specifically can be a more intensive process to the elderly individual. Hence it is important to know the elderly patient's clinical service requirements in order to improve their experiences when visiting radiology facilities. With a lack of literature on elderly patient satisfaction with clinical service quality in private and public radiology facilities specific to the Ethekwini district, the current study used the SERVQUAL model's five dimensions (tangibles, reliability, responsiveness, assurance and empathy) as the theoretical framework to quantify the service delivery of private and public radiology facilities, thereby attaining elderly patients’ perceptions and experiences. Aim: This research study aimed to determine the factors influencing elderly patient perceptions and their experiences of clinical service quality in a private and a public radiology facility in the Ethekwini district in order to identify, improve and enhance clinical care for elderly individuals. Methodology: A quantitative research methodology with a descriptive research design and a positivist paradigm was used in this study. A convenience sampling technique of all the elderly patients was used to collect data that was analyzed using the latest version (26) of SPSS (the Statistical Package for the Social Sciences). The tests used were the t-test, one sample t-test, paired sample t-test, independent sample t-test, the Analysis of Variance Model (ANOVA), Cronbach’s alpha and the Mann Whitney U test. Results: An independent sample t-test was performed across demographics and payment types, revealing that the gap for all items under tangibles for expectations and experiences was far greater for outpatients than for inpatient respondents, and those paying cash perceive the gap between their experiences and expectations to be significantly larger than those who use medical aid in private. Paired t-tests and Cronbach's alpha were used to assess each individual question's expectations and experiences across all domains and to determine internal consistency. A paired t-test was then performed on the entire domain, revealing a significant difference in the elderly's expectations and experiences with private and public radiology facilities, as well as their degree of clinical service quality. A one-sample t-test was used to analyze composite variables to determine significant differences in each overall domain, which revealed that the "mean" values were higher for the gap in expectations of elderly people, implying that while the elderly population agrees to some extent with the help/services they receive, their expectations are still higher than their experiences. A Mann-Whitney U test was used to compare each item within each domain across facilities. The mean rank values for these items with significant p-values were greater in private facilities than in public facilities, indicating that private facilities have a better level of agreement. To compare expectations and experiences across domains, the Mann-Whitney test was used for each item, comparing mean rankings rather than mean scores. All but two dimensions vary considerably amongst facilities: EXPECT_TAN (.058) and EXPECT_ASS (.146). The private Radiology facility had a greater agreement than the public Radiology facility. For each domain, the Mann Whitney test was used to compare the mean ranks of private and public facilities. According to the p-value, four significant results were found: GAP_TAN (.044), GAP_REL (.010), GAP_ASS (.013) and GAP_EMP (.006) demonstrated a considerable discrepancy between the public and private facilities. In all categories, individuals who use public facilities perceive a substantially larger difference between what they get and what they anticipate obtaining than those who use private facilities. Conclusion: The conclusion based on the first objective was that while there may be various factors impacting elderly patients’ perceptions of clinical care quality, not all of them can be addressed as some are influenced by personal socio-economic conditions. The second objective result was that while the six domains of healthcare quantification may be applicable to current healthcare systems to some extent, there are still areas for development.
The status of cervical screening and breast cancer healthcare services among incarcerated women in Westville Correctional Facility KZN, South Africa
(2026-06) Dube, Lindokuhle Winnie; Pillay , P.; Mkhize, Brenda Thabisile
Background: Incarcerated women represent a vulnerable population with severe health problems, including a heightened risk of cervical and breast cancer. The provision of comprehensive healthcare, including cancer prevention services, within prisons is a critical yet often neglected issue. Aim: This study investigated the status of cervical screening and breast cancer healthcare services among incarcerated women at Westville Correctional Facility in KwaZulu-Natal, South Africa. Methods: A mixed-methods approach was utilised, including a cross-sectional survey of 145 incarcerated women, a retrospective review of 1,639 Pap smear results from Westville Correctional Facility laboratory records (2013–2022) and in-depth interviews with healthcare workers (HCWs). Data analysis included descriptive statistics, chi square tests, and thematic analysis. Results: Retrospective data had a high HIV prevalence (54%). Despite this risk, cervical screening was low, with only 21.4% of women receiving a Pap smear during incarceration and 43.4% with no screening history. Breast cancer screening was virtually non-existent (1.4%). Knowledge regarding both cancers was low, with most of the incarcerated women unaware of risk factors, symptoms, and screening methods. Retrospective data revealed an erratic, campaign-based screening pattern, with a screening rate of less than 5% per year. Critically, 23.3% of women with a clinically healthy cervix had a cytological abnormality. A significant association between a healthy cervix and antiretroviral (ARV) treatment (X² (8) =61.907, p<0.001) was found. Findings from HCWs contextualised these results, revealing severe structural barriers including skeletal staffing, outdated equipment, and a protracted referral process that forces a reactive, crisis-driven care model. Furthermore, HCWs reported internalised stigma among offenders, something which actively suppresses health-seeking behaviour. Conclusion: An implementation gap exists in cancer prevention services, driven by non-systematic screening, critical health literacy deficits, and a carceral environment that erodes patient agency. The rate of occult cytological abnormalities underscores the inadequacy of visual inspection.
Artificial intelligence in medical imaging : knowledge and perspectives of South African radiographers
(2026-03-12) Mutambara, Precious; Khoza, Thandokuhle Emmanuel
Background: This study focused on determining the perspectives of Radiographers in relation to the integration of AI into medical imaging. Artificial intelligence (AI) is the use of technology and computers to replicate intelligent behaviours and analytical thoughts that are similar to that of humans. Several studies indicate that medical imaging professionals, such as Radiologists and Radiographers, are seeing an increase in the use of AI applications in clinical settings. Diagnostic Radiographers are pivotal for the integration of AI systems into medical imaging as they serve as an interface between technology and patients. Although some studies have examined the perspectives of Radiographers on AI in some African countries, there is still no clear picture of the Radiographers’ perspectives towards AI in the most technologically advanced country in Africa. Aim of study: The study aimed to ascertain the knowledge and perspectives of South African Radiographers regarding the integration of AI in diagnostic imaging in order to provide unique recommendations to support the training of Radiographers. Methodology: A quantitative cross-sectional research design was used. Non-probability purposive sampling was employed as it is the most appropriate approach for a content analysis inquiry. A self-administered questionnaire containing closed-ended questions was used to collect statistical data from Radiographers that statistical data from Radiographers that met the requirements for participation. On completion of the questionnaires, the results were tabulated and graphically demonstrated. Data was analysed using the latest version 27 of SPSS (the Statistical Package for the Social Sciences). Findings: SPSS version 27 was used to analyse the data and various statistical tests such as Descriptive statistics, the Analysis of Variance Model, the Binomial test, Pearson's correlation coefficient, One-sample t-test, Cronbach alpha and Independent samples t-test were adopted to analyse the data yielded by the collection tool. The findings indicated that over 90 % of Radiographers in South Africa are aware of the concept of AI. The majority of Radiographers in South Africa have a positive attitude towards AI as there was significant agreement that AI is beneficial to the various aspects of diagnostic Radiography. While AI possesses many benefits, Radiographers also acknowledge the various barriers affecting the implementation of AI in the medical imaging profession. Conclusion: It can be concluded that Radiographers recognize general AI concepts and are aware of some of AI’s functional roles within the field but are unfamiliar with the more technical components of the technology. Therefore, the introduction of AI in the Radiography curriculum is pivotal to ensuring that Radiographers have a strong foundation for understanding AI. It was noted that Radiographers in South Africa believe that AI will have multiple benefits for their job performance. Inasmuch as AI is equipped with benefits for Radiographers, several barriers that hinder the implementation of AI in Radiography were also noted.
A cross-sectional study on the use of traditional, complementary, and alternate medicine amongst pregnant women in the eThekwini District
(2025-12-17) Steele, Chrissandra Lorell Megan; Naranjee, N.; Mhlongo, X. L.
Traditional, complementary, and alternative medicine (TCAM) is widely used during pregnancy, yet little is known about its scope and determinants within South African contexts. This study examined the frequency, influencing factors, and types of TCAM used by pregnant women in the eThekwini District. Reported usage ranged between 66% and 99%, with natural products such as vitamins, probiotics, and herbs, as well as mind-body practices including massage and meditation, being the most common. A cross-sectional design was employed, focusing on pregnant women accessing maternal healthcare services within the district. The study analysed predisposing, enabling, and need-related variables shaping TCAM use. Findings revealed that cultural beliefs, spiritual practices, family influence, health-related anxieties, and preferences for autonomy and holistic care were major drivers. Structural challenges within conventional healthcare, including medication shortages, financial barriers, and access difficulties, also contributed to reliance on TCAM. Importantly, TCAM use was observed across socio-demographic groups, including women with higher education, reflecting the persistence of cultural and health beliefs beyond formal training. The study concludes that while traditional African remedies remain culturally significant, there is an emerging trend towards integrative care models that blend TCAM with biomedical approaches, motivated by safety and holistic concerns. Recommendations include advancing nursing research, incorporating TCAM screening into maternal healthcare, fostering interprofessional collaboration, developing policy frameworks, and raising public awareness to promote safe and informed use.
Factors influencing radiography students’ experiences of e-learning : a study conducted at a University of Technology in KwaZulu-Natal
(2026-05-29) Patel, Aisha; Gam, Nkululeko
E-learning and the use of technology is rapidly increasing in the Health Sciences field. E-learning, also known as electronic learning, can be defined as a technology-mediated approach of great potential from an educational perspective. E-learning refers to online learning that provides students with a virtual learning environment that is different from traditional methods of learning. E-learning is flexible and accessible and is used globally because it offers opportunities to meet significant educational outcomes, including long-term learning and increased participation. Notably, e-learning allows educational content to be adjusted to fit individual learning styles. Varying results have been attained regarding the correlation between students and their ease with using technology. Whilst various authors have discovered that some students experience poor commitment and motivation in the e-learning experience, other students were found to value the interactive and visual elements of e-learning. Younger students have easily adapted to the use of technology for e-learning. The most common challenge that students experience in a developing country are accessibility issues, whereas the main issue in developed countries is high dropout rates. Several scholars have reported on the high levels of e-learning implementation at Universities of Technology in South Africa. The university of interest has also vastly increased their reliance on technology for e-learning since the onset of COVID-19. The theoretical framework adopted in this study was the Technology Acceptance Model (TAM) developed by Fred Davis in 1986. The TAM is an information technology framework for analysing users’ acceptance and use of new and updated technologies, particularly in a working environment, which in this case was the university of interest. This model has three main constructs: perceived usefulness, perceived ease of use and actual use of e-learning. Attitude to use is a fourth factor which is influenced by the other three factors. Aim of the study The aim of this quantitative, cross-sectional study was to identify the factors influencing Radiography students’ experiences of e-learning at a university of technology in KwaZulu-Natal to improve e-learning methods such that e-learning is both beneficial and straightforward for students. Methodology This study used a quantitative approach, which is the technique of using numerical values derived from observations to explain phenomena through observations, and conclude thereupon. The collected data is then analysed using mathematical methods. The positivism paradigm was selected to conduct this study because it was appropriate for a quantitative research approach. The positivism paradigm revolves around the researcher working with observable reality within the society, which in this research will be the factors influencing Radiography students’ acceptance of technology for e-learning. This study was a descriptive cross sectional study as the researcher was able to determine and outline the factors affecting Radiography students’ acceptance of the technology used for e-learning at a specific point in time. There was no repetition of measurements amongst the research participants. The setting for this study was the Radiography department at a University of Technology in KwaZulu-Natal. The researcher chose this particular setting because this is where research participants could be found, as information is required on the students’ use of e-learning at this institute. The target population for the study was Radiography students studying at this university. This included first-, second-, third- and fourth-year students. The Radiography students targeted were from the Diagnostic, Sonography, Radiotherapy and Nuclear Medicine disciplines. The sample size for the main study was 206 students. A non-probability convenience sampling technique was used. The ethical approval number IREC 119/24 (Appendix 1) was provided when full approval was granted for the research to be conducted. Approval was obtained from the Director of Research and Postgraduate Support (Appendix 2a) at the university of interest to conduct this research study on first-, second-, third- and fourth-year Radiography students. Data analysis was performed using the following tests: descriptive statistics, ANOVA, Pearson’s correlation coefficient, one sample t-test, independent samples t-test, factor analysis and linear regression. Findings A total of 206 participants were selected to provide their inputs regarding the research topic. There was no significant difference in the demographic constructs across gender, age, year of study or discipline. Results from ANOVA to determine whether there are any significant differences in these constructs across race shows that PEOU (perceived ease of use) differs significantly across race (F (3, 202) = 5.367, p=.001). Tukey’s post hoc analysis shows that Indians (mean = 3.42) perceive e-learning to be easier to use than Blacks (mean = 3.04), p<.001. The results depicted significant agreement that participants thought of e-learning as useful; that it was easy to use; and that they intended to use it more in the future. On the other hand, there was significant disagreement on whether participants had a good attitude towards e-learning. The independent variables PEOU, PU and ATT account for 48.9% of the variance in ITU (intention to use), F (3, 202) = 64.437, p<.001. PU (β = .578, p<.001) and ATT (β = .190, p<.001) are both significant predictors of ITU. Conclusion In conclusion, it can be stated that the purpose of the research, which was to identify the factors influencing Radiography students’ experiences of e-learning at a university of technology in KwaZulu-Natal, has been achieved. Radiography students from the university generally have a positive experience when using technology for e-learning. Participants perceived e-learning to be useful. However, poor connectivity was an issue for most students. Participants also found e learning platforms easy to use and their skills with technology sufficient. There were also contradicting attitudes towards e-learning. However, most participants eventually adjusted to e-learning. Future recommendations are that the results obtained in this study encourage further research into this topic and that another similar study may be conducted in more detail with a larger sample size, as research is essential for the progression of existing literature. More advanced technological programs can be developed to better suit Radiography students in order to achieve online educational goals with greater efficiency.