See completed projects

Experiences of drug-susceptible tuberculosis patients with symptoms of depression and anxiety: a cohort study of new patients in the Free State

CHSR&D researchers: Dr Gladys Kigozi, Prof Christo Heunis Dr Michelle Engelbrecht

The aim of this study is to explore depression and anxiety among new patients on susceptible tuberculosis (TB) treatment in Mangaung Metropolitan District in the Free State. More specifically, the study seeks: 1) to determine the prevalence of symptoms of depression and anxiety at treatment onset, after the intensive treatment phase (2 months) and at the end of treatment (6 months) among new susceptible TB patients; 2) to determine the influence of depression and anxiety on treatment outcomes of patients on susceptible TB treatment; 3) to explore experiences of TB patients with symptoms of depression and/or anxiety — narratives from the ground; and 4) to explore providers’ views of and experiences in managing TB patients with co-morbid depression and anxiety.

A prospective cohort study will be conducted among newly diagnosed susceptible TB patients registered between 1 July and 31 September 2019 in the Mangaung Metropolitan District. Data gathered through surveys and in-depth interviews with patients and key informant interviews with providers, as well as information from patient records will be analysed quantitatively and qualitatively. The study protocol will be submitted for review to the Health Sciences Research Ethics Committee, University of the Free State. Authorisation to conduct the study among patients will be sought from the Free State Department of Health.

Funding: National Research Foundation 

Towards a health-enabling working environment: developing and testing interventions to decrease HIV- and TB-stigma among healthcare workers in the Free State, South Africa

CHSR&D researchers: Dr Asta Rau, Dr Michelle Engelbrecht, Dr Gladys Kigozi, Andre Janse van Rensburg, Alfi Moolman

Partners: University of Antwerp; Free State Department of Health

The randomised control trial aims to 1) scientifically assess the extent and sources of HIV and TB stigma among the healthcare workforce in the Free State Province and 2) refine and test innovative stigma-reduction interventions. The baseline study measures HIV and TB stigma in eight randomly selected hospitals in the Free State among randomly selected respondents—using a self-administered questionnaire. HIV and TB stigma-reduction interventions applying a combination prevention approach by focusing on clinical, behavioural and structural factors that influence HIV and TB stigma in the workplace will be rolled out. In addition, stigma reduction activities are designed to target three social-ecology levels (individual, community, and structural). Post-intervention, all respondents from the baseline will be followed up using the same questionnaire.

Funding: VLIR-UOS (Vlaamse Interuniversitaire Raad; Flemish Interuniversity Council) 
Student funding: 2 x PhD bursaries for students registered at Antwerp University: 1 funded by FWO (Flanders Research Foundation) and 1 funded by BOF (Special research fund of Antwerp University).

Between a rock and a hard place: emotional well-being and work engagement of nurses who moonlight in Free State hospitals

CHSR&D researchers: Dr Michelle Engelbrecht, Dr Asta Rau, André Janse van Rensburg
Partners: Dr Petrus Nel (Industrial Psychology, Faculty of Economic and Management Sciences, UFS); Dr Marisa Wilke (School of Nursing, Faculty of Health Sciences, UFS)

‘Moonlighting’ nurses hold a permanent nursing job, plus one or more part-time nursing jobs. This practice has negative effects for them as individuals, for their institutions, and for patient care. Very little evidence exists on the emotional well-being of moonlighters and their work engagement. This research aims to fill this gap. It is also designed to identify coping skills of moonlighters who report higher levels of well-being—we envisage this informing subsequent intervention-focused phases.  A cross-sectional survey, as well as focus group discussions will gather data from all categories of nurses who moonlight at public or private hospitals in the Free State, including prison and army hospitals. Key foci are to: (1) investigate job demands faced by moonlighting nurses; (2) investigate resources of moonlighting nurses; (3) identify associations between burnout, compassion fatigue, compassion satisfaction, general health, psychological capital, coping skills and work engagement; (4) gain deeper insight into how job demands and resources of moonlighting nurses interface with their work engagement.

 UFS Interdisciplinary Grant

  • Situational analysis of the implementation of TB prevention and infection control strategies in Mangaung Metropolitan District (Completed 2016)
  • Tuberculosis prevention through systematic household contact investigation in the Free State, South Africa (Completed 2016)
  • Assessing the implementation of the Integrated School Health Programme (ISHP) in Maluti-a-Phofung (Completed 2016)
  • PROLIFE: Improving TB outcomes by modifying lifestyle behaviours through a brief motivational intervention (Completed 2018)


T: +27 51 401 2240 or

Marizanne Cloete: +27 51 401 2592

Katlego Mabulana: +27 51 401 2495
Juanita Hlongwane: +27 51 401 3269

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