Best practice guideline for the transition of final year nursing students to professional nurses in the military health service in South Africa
- Authors: Caka, Ernestina Masebina
- Date: 2014
- Subjects: School-to-work transition -- South Africa , Nurses -- Training of -- South Africa , Nursing students -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10070 , http://hdl.handle.net/10948/d1021097
- Description: The transition period from student nurses to professional nurses has been acknowledged as being very stressful, particularly in the military health service due to the dual transition. The phase is marked as final year nursing students try to consolidate the experience and knowledge gained during their four year training period with clinical decision making and problem solving skills being applied in the work environment. The students require support and guidance to effect a successful transition from being a student to being a professional nurse. The transition of students in the military health setting might be experienced differently due to the context that is vastly different from the other health care settings (Moore, 2006:541). The aim of the research was to explore the experiences of role transition of final year nursing students, particularly their preparedness to take up the role of a professional nurse in the military health setting in order to assist managers and educators to support and facilitate this professional adjustment appropriately. A qualitative, descriptive, contextual design was employed for the study and followed a three-phase approach. Phase one comprised a qualitative approach, where semi-structured and focus group interviews were conducted to gather the data. Nurse managers, nurse educators, final year nursing students and novice professional nurses formed part of the population for the study. Creswell’s method of data analysis was employed in analysing the data. The second phase dealt with the integrative review of literature on the transition of final year nursing students into professional nurses. Data extracted from the guidelines formed themes that were triangulated to form phase three of the study. Lastly, a best practice guideline was developed to facilitate the transition period of final year nursing students to professional nurses. Principles of trustworthiness were adhered to, participants were treated in a fair manner and confidential information was not divulged without the consent of the participants. Participants were asked to take part voluntarily and without coercion. Ethical approval was requested to give consent for the study to be undertaken and ethical principles were adhered to throughout the study. Findings were then disseminated after the conclusion of the study.
- Full Text:
- Date Issued: 2014
- Authors: Caka, Ernestina Masebina
- Date: 2014
- Subjects: School-to-work transition -- South Africa , Nurses -- Training of -- South Africa , Nursing students -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10070 , http://hdl.handle.net/10948/d1021097
- Description: The transition period from student nurses to professional nurses has been acknowledged as being very stressful, particularly in the military health service due to the dual transition. The phase is marked as final year nursing students try to consolidate the experience and knowledge gained during their four year training period with clinical decision making and problem solving skills being applied in the work environment. The students require support and guidance to effect a successful transition from being a student to being a professional nurse. The transition of students in the military health setting might be experienced differently due to the context that is vastly different from the other health care settings (Moore, 2006:541). The aim of the research was to explore the experiences of role transition of final year nursing students, particularly their preparedness to take up the role of a professional nurse in the military health setting in order to assist managers and educators to support and facilitate this professional adjustment appropriately. A qualitative, descriptive, contextual design was employed for the study and followed a three-phase approach. Phase one comprised a qualitative approach, where semi-structured and focus group interviews were conducted to gather the data. Nurse managers, nurse educators, final year nursing students and novice professional nurses formed part of the population for the study. Creswell’s method of data analysis was employed in analysing the data. The second phase dealt with the integrative review of literature on the transition of final year nursing students into professional nurses. Data extracted from the guidelines formed themes that were triangulated to form phase three of the study. Lastly, a best practice guideline was developed to facilitate the transition period of final year nursing students to professional nurses. Principles of trustworthiness were adhered to, participants were treated in a fair manner and confidential information was not divulged without the consent of the participants. Participants were asked to take part voluntarily and without coercion. Ethical approval was requested to give consent for the study to be undertaken and ethical principles were adhered to throughout the study. Findings were then disseminated after the conclusion of the study.
- Full Text:
- Date Issued: 2014
Pope John Paul II: a psychobiographical study
- Authors: Navsaria, Koneshverrie
- Date: 2014
- Subjects: John Paul, II, Pope, 1920-2005 , Psychology -- Biographical methods , Faith development
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/3539 , vital:20440
- Description: This psychobiography is focussed on the life of Pope John Paul II, whose historical personage epitomises the redemptive theme of triumph over tragedy and eternal hope. A phenomenological approach to the study allowed the researcher to observe the subject’s lived experience through the theoretical lens of Erik Erikson’s psychosocial development theory as well has having his faith development illuminated by Fowler’s faith development theory. Together, these theories highlighted significant aspects of Pope John Paul II’s personality development, for the greater purpose of uncovering the significance of his historical personage by reconciling his spiritual, political and academic attributes. This psychobiographical undertaking was grounded in qualitative research in the form of a single case. Two methodological strategies were used in this study. Firstly, Alexander’s model was used to organise, extract, prioritise and analyse data. The indicators of salience ensured that all significant parts of biographical data were carefully considered for analysis. Guba’s criteria for trustworthiness guided the methodology to ensure reliable data extraction and interpretation. Posing specific questions to the data enabled the researcher to extract units of analysis relevant to the aim of the study. Secondly, the use of conceptual frameworks and matrices enabled the longitudinal exploration, categorisation and description of the stages of psychosocial and faith development. The findings of this psychobiographical study of Pope John Paul II strongly support the importance of Erikson’s (1950) theory in understanding the processes of personality development in an individual life. In this psychobiographical study, the complex process of adaption and growth was highlighted by Erikson’s (1950) theory and placed periods of Pope John Paul II’s development in context. This study also demonstrated that gaining meaning in life through faith (Fowler, 1981) provides the individual with greater internal support when adjusting to life changes. Furthermore, greater intentionality on the part of therapists to thread faith and spirituality into their practice, is evidence of the eugraphic impact of this study.
- Full Text:
- Date Issued: 2014
- Authors: Navsaria, Koneshverrie
- Date: 2014
- Subjects: John Paul, II, Pope, 1920-2005 , Psychology -- Biographical methods , Faith development
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/3539 , vital:20440
- Description: This psychobiography is focussed on the life of Pope John Paul II, whose historical personage epitomises the redemptive theme of triumph over tragedy and eternal hope. A phenomenological approach to the study allowed the researcher to observe the subject’s lived experience through the theoretical lens of Erik Erikson’s psychosocial development theory as well has having his faith development illuminated by Fowler’s faith development theory. Together, these theories highlighted significant aspects of Pope John Paul II’s personality development, for the greater purpose of uncovering the significance of his historical personage by reconciling his spiritual, political and academic attributes. This psychobiographical undertaking was grounded in qualitative research in the form of a single case. Two methodological strategies were used in this study. Firstly, Alexander’s model was used to organise, extract, prioritise and analyse data. The indicators of salience ensured that all significant parts of biographical data were carefully considered for analysis. Guba’s criteria for trustworthiness guided the methodology to ensure reliable data extraction and interpretation. Posing specific questions to the data enabled the researcher to extract units of analysis relevant to the aim of the study. Secondly, the use of conceptual frameworks and matrices enabled the longitudinal exploration, categorisation and description of the stages of psychosocial and faith development. The findings of this psychobiographical study of Pope John Paul II strongly support the importance of Erikson’s (1950) theory in understanding the processes of personality development in an individual life. In this psychobiographical study, the complex process of adaption and growth was highlighted by Erikson’s (1950) theory and placed periods of Pope John Paul II’s development in context. This study also demonstrated that gaining meaning in life through faith (Fowler, 1981) provides the individual with greater internal support when adjusting to life changes. Furthermore, greater intentionality on the part of therapists to thread faith and spirituality into their practice, is evidence of the eugraphic impact of this study.
- Full Text:
- Date Issued: 2014
Practice guidelines for culturally sensitive drug prevention interventions
- Authors: Goliath, Veonna
- Date: 2014
- Subjects: Youth -- Drug use -- South Africa -- Port Elizabeth , Drug abuse -- South Africa -- Port Elizabeth -- Prevention , Ethnicity -- South Africa -- Port Elizabeth , Drug abuse -- Treatment -- South Africa -- Port Elizabeth , Drug abuse -- Social aspects -- South Africa -- Port Elizabeth , Group identity -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10005 , http://hdl.handle.net/10948/d1017193
- Description: South Africa has experienced a notable increase in adolescent drug use during the country’s transition from apartheid to democracy (Central Drug Authority [CDA], 2006). These findings are verified by epidemiological studies and two national youth risk behaviour surveys, highlighting the need for effective drug prevention interventions. Whilst drug use spans across age, gender and social strata, the rapid increase in both legal and illicit drug use among adolescents in the Northern Areas communities of Port Elizabeth has been particularly pronounced. The South African Community Epidemiology Network on Drug Use (SACENDU) statistics, which reflects on racial demographics in accordance with the Population Registration Act of 1950 (South Africa, 1950), reports that, in the year 2011, the ‘Coloured’ population constituted 62 percent of those individuals seeking treatment for drug abuse, compared to 15 percent ‘African’ treatment seekers in Port Elizabeth (Dada, Plüddemann, Parry, Bhana, Vawda & Fourie, 2012:44). Furthermore, methamphetamine use by persons under the age of 20 years in Port Elizabeth increased fivefold in a three-year period, i.e. from 7 percent in 2008 to 39 percent in 2011 (Dada et al., 2012), with the ‘Coloured’ population group accounting for the majority of methamphetamine users. These statistics reinforce a long-standing racial stereotype that associates ‘Coloured’ racial identity with an enhanced susceptibility to drug use. The National Drug Master Plan (South Africa, 2012a), and the Prevention of and Treatment for Substance Abuse Act (Act no 70 of 2008) propose that drug prevention programmes should address the values, perceptions, expectations and beliefs that the community associates with drug abuse (South Africa, 2008b). This view emphasises the importance of drug preventions interventions that are culturally sensitive and contextually relevant. The current study was guided by two conceptual frameworks, i.e. the Social Constructionist Framework and the Ecological Risk/Protective Resilience Framework, and focused on the Northern Areas of Port Elizabeth, a historically marginalised community inhabited by a predominantly ‘Coloured’ indigenous/ethnic group. The goal of the study was to enhance understanding of the socio-cultural meaning attributed to cultural identity, drug use, non-use and drug prevention in the Northern Areas of Port Elizabeth, with the view to developing guidelines for drug prevention interventions that are culturally sensitive and contextually relevant. The following objectives were formulated in order to achieve the goal of the study: • To explore adolescent narratives regarding the constructs ‘Coloured’, drug use, non-use and drug prevention programmes of three distinct groups of adolescents (drug users, non-users, and TADA peer mentors) from the Northern Areas. • To explore and describe the social service practitioners’ (social workers and social auxiliary workers’) constructions of drug use, non-use and drug abuse prevention in relation to adolescents from the Northern Areas, and how such constructions inform the drug prevention services rendered to adolescents from these communities. • To review the data collected from the adolescent narratives and the social service practitioners’ reflections on their drug prevention programmes against existing theory and models for drug prevention. • To synthesise the above information with a view to developing guidelines for culturally sensitive drug prevention programmes relevant and responsive to the specific social constructions of adolescents from the Northern Areas. A qualitative research approach, located in a narrative tradition of inquiry research design, was employed to achieve the goal of the study (Riessman, 2008). The study was conducted in two phases. The first phase involved an empirical study with the four sample groups (i.e. adolescent drug users, adolescent non-drug users, Teenagers against Drug Abuse [TADA] peer mentors and social service professionals (i.e. social workers and social auxiliary workers)). Phase two involved the co-construction of the practice guidelines for culturally sensitive and contextually relevant drug prevention interventions. Phase one started with the informal exploration of community stakeholders’ views on the identified research problem and the process of gaining access to the research population. Several gatekeepers (i.e. teachers, social workers, the Families Against Drugs [FAD] Support Group representatives, a minister of religion and a community stakeholder) were engaged to assist in recruiting participants from the four sample groups. A non-probability purposive sampling method was employed to purposively recruit 29 adolescent non-drug users and ten adolescent peer mentors (via the TADA Programme at one school). The same sampling method, followed by a snowball sampling technique, was employed to recruit the two remaining sample groups of ten adolescent drug users (in the recovery process) and nine social workers and social auxiliary workers respectively. The sample sizes were determined by the principle of data saturation.The data generation method used in respect of the non-users took the form of semi-structured written narratives, administered in a group context during school time, followed by a second round of data generation. The life-grid (Wilson, Cunningham-Burley, Bancroft, Backett-Milburn & Masters, 2007:144), a qualitative visual tool for mapping important life events, was employed to guide the co-construction of the biographical narratives generated during the individual semi-structured interviews with the sample of adolescent drug users. Focus group interviews were used to enhance an understanding of the peer mentors and social service practitioners’ views on the construct ‘Coloured’ and their existing drug prevention programmes. Each of the individual and focus group interviews was audio-recorded, transcribed and complemented by the field notes. Informal data gathering occurred through participant observation of two drug prevention programmes, attendance of a FAD Support Group meeting, and interviews with community volunteers and the South African Police Services (SAPS) Youth Development Forum. Both the content and the context of the narratives were analysed to arrive at the research themes, sub-themes and categories. The content of the narratives was analysed by employing categorical content analysis, whilst the form of the narratives (i.e. how the stories were told) was analysed by using the socio-cultural approach to narrative analysis (Grbich, 2007:130). The journey metaphor emerged from the adolescent drug users’ narratives, depicting a prototypical storyline of a drug use journey, starting with experimentation and culminating in abuse and dependence for some and an early exit from the journey for others. The conclusions that can be drawn from these findings illuminate key protective factors and processes at a multisystemic level that can be strengthened to enhance the adolescents’ resistance to drug use and/or delay the onset of use. Embedded in the participants’ narration of the drug use journey were nuances relating to internalised stereotypes of ‘White’ supremacy and ‘Coloured’ inferiority as an explanatory framework for venturing onto and prolonging the journey.The two themes that emerged during the process of content and narrative analysis of the qualitative data (from both adolescent drug users and non-users) were as follows: Constructing drug use as a ‘Coloured’ phenomenon and reconstructing ‘Coloured’ identity; Risk and protective factors located at individual, family, peer, school, community and societal domains. The four themes that emerged during the data analysis of the peer mentors and social service practitioners’ narratives were as follows: Construction of ‘Coloured’ identity; socio-cultural meaning construction about the reasons for drug use amongst adolescents from the Northern Areas; description of drug prevention services rendered in the Northern Areas; and reflection on barriers to rendering drug prevention interventions.
- Full Text:
- Date Issued: 2014
- Authors: Goliath, Veonna
- Date: 2014
- Subjects: Youth -- Drug use -- South Africa -- Port Elizabeth , Drug abuse -- South Africa -- Port Elizabeth -- Prevention , Ethnicity -- South Africa -- Port Elizabeth , Drug abuse -- Treatment -- South Africa -- Port Elizabeth , Drug abuse -- Social aspects -- South Africa -- Port Elizabeth , Group identity -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10005 , http://hdl.handle.net/10948/d1017193
- Description: South Africa has experienced a notable increase in adolescent drug use during the country’s transition from apartheid to democracy (Central Drug Authority [CDA], 2006). These findings are verified by epidemiological studies and two national youth risk behaviour surveys, highlighting the need for effective drug prevention interventions. Whilst drug use spans across age, gender and social strata, the rapid increase in both legal and illicit drug use among adolescents in the Northern Areas communities of Port Elizabeth has been particularly pronounced. The South African Community Epidemiology Network on Drug Use (SACENDU) statistics, which reflects on racial demographics in accordance with the Population Registration Act of 1950 (South Africa, 1950), reports that, in the year 2011, the ‘Coloured’ population constituted 62 percent of those individuals seeking treatment for drug abuse, compared to 15 percent ‘African’ treatment seekers in Port Elizabeth (Dada, Plüddemann, Parry, Bhana, Vawda & Fourie, 2012:44). Furthermore, methamphetamine use by persons under the age of 20 years in Port Elizabeth increased fivefold in a three-year period, i.e. from 7 percent in 2008 to 39 percent in 2011 (Dada et al., 2012), with the ‘Coloured’ population group accounting for the majority of methamphetamine users. These statistics reinforce a long-standing racial stereotype that associates ‘Coloured’ racial identity with an enhanced susceptibility to drug use. The National Drug Master Plan (South Africa, 2012a), and the Prevention of and Treatment for Substance Abuse Act (Act no 70 of 2008) propose that drug prevention programmes should address the values, perceptions, expectations and beliefs that the community associates with drug abuse (South Africa, 2008b). This view emphasises the importance of drug preventions interventions that are culturally sensitive and contextually relevant. The current study was guided by two conceptual frameworks, i.e. the Social Constructionist Framework and the Ecological Risk/Protective Resilience Framework, and focused on the Northern Areas of Port Elizabeth, a historically marginalised community inhabited by a predominantly ‘Coloured’ indigenous/ethnic group. The goal of the study was to enhance understanding of the socio-cultural meaning attributed to cultural identity, drug use, non-use and drug prevention in the Northern Areas of Port Elizabeth, with the view to developing guidelines for drug prevention interventions that are culturally sensitive and contextually relevant. The following objectives were formulated in order to achieve the goal of the study: • To explore adolescent narratives regarding the constructs ‘Coloured’, drug use, non-use and drug prevention programmes of three distinct groups of adolescents (drug users, non-users, and TADA peer mentors) from the Northern Areas. • To explore and describe the social service practitioners’ (social workers and social auxiliary workers’) constructions of drug use, non-use and drug abuse prevention in relation to adolescents from the Northern Areas, and how such constructions inform the drug prevention services rendered to adolescents from these communities. • To review the data collected from the adolescent narratives and the social service practitioners’ reflections on their drug prevention programmes against existing theory and models for drug prevention. • To synthesise the above information with a view to developing guidelines for culturally sensitive drug prevention programmes relevant and responsive to the specific social constructions of adolescents from the Northern Areas. A qualitative research approach, located in a narrative tradition of inquiry research design, was employed to achieve the goal of the study (Riessman, 2008). The study was conducted in two phases. The first phase involved an empirical study with the four sample groups (i.e. adolescent drug users, adolescent non-drug users, Teenagers against Drug Abuse [TADA] peer mentors and social service professionals (i.e. social workers and social auxiliary workers)). Phase two involved the co-construction of the practice guidelines for culturally sensitive and contextually relevant drug prevention interventions. Phase one started with the informal exploration of community stakeholders’ views on the identified research problem and the process of gaining access to the research population. Several gatekeepers (i.e. teachers, social workers, the Families Against Drugs [FAD] Support Group representatives, a minister of religion and a community stakeholder) were engaged to assist in recruiting participants from the four sample groups. A non-probability purposive sampling method was employed to purposively recruit 29 adolescent non-drug users and ten adolescent peer mentors (via the TADA Programme at one school). The same sampling method, followed by a snowball sampling technique, was employed to recruit the two remaining sample groups of ten adolescent drug users (in the recovery process) and nine social workers and social auxiliary workers respectively. The sample sizes were determined by the principle of data saturation.The data generation method used in respect of the non-users took the form of semi-structured written narratives, administered in a group context during school time, followed by a second round of data generation. The life-grid (Wilson, Cunningham-Burley, Bancroft, Backett-Milburn & Masters, 2007:144), a qualitative visual tool for mapping important life events, was employed to guide the co-construction of the biographical narratives generated during the individual semi-structured interviews with the sample of adolescent drug users. Focus group interviews were used to enhance an understanding of the peer mentors and social service practitioners’ views on the construct ‘Coloured’ and their existing drug prevention programmes. Each of the individual and focus group interviews was audio-recorded, transcribed and complemented by the field notes. Informal data gathering occurred through participant observation of two drug prevention programmes, attendance of a FAD Support Group meeting, and interviews with community volunteers and the South African Police Services (SAPS) Youth Development Forum. Both the content and the context of the narratives were analysed to arrive at the research themes, sub-themes and categories. The content of the narratives was analysed by employing categorical content analysis, whilst the form of the narratives (i.e. how the stories were told) was analysed by using the socio-cultural approach to narrative analysis (Grbich, 2007:130). The journey metaphor emerged from the adolescent drug users’ narratives, depicting a prototypical storyline of a drug use journey, starting with experimentation and culminating in abuse and dependence for some and an early exit from the journey for others. The conclusions that can be drawn from these findings illuminate key protective factors and processes at a multisystemic level that can be strengthened to enhance the adolescents’ resistance to drug use and/or delay the onset of use. Embedded in the participants’ narration of the drug use journey were nuances relating to internalised stereotypes of ‘White’ supremacy and ‘Coloured’ inferiority as an explanatory framework for venturing onto and prolonging the journey.The two themes that emerged during the process of content and narrative analysis of the qualitative data (from both adolescent drug users and non-users) were as follows: Constructing drug use as a ‘Coloured’ phenomenon and reconstructing ‘Coloured’ identity; Risk and protective factors located at individual, family, peer, school, community and societal domains. The four themes that emerged during the data analysis of the peer mentors and social service practitioners’ narratives were as follows: Construction of ‘Coloured’ identity; socio-cultural meaning construction about the reasons for drug use amongst adolescents from the Northern Areas; description of drug prevention services rendered in the Northern Areas; and reflection on barriers to rendering drug prevention interventions.
- Full Text:
- Date Issued: 2014
A chronic care coordination model for HIV-positive children requiring antiretroviral therapy
- Authors: Williams, Margaret
- Date: 2013
- Subjects: HIV-positive children -- Care -- South Africa , HIV-positive persons -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10062 , http://hdl.handle.net/10948/d1020346
- Description: The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.
- Full Text:
- Date Issued: 2013
- Authors: Williams, Margaret
- Date: 2013
- Subjects: HIV-positive children -- Care -- South Africa , HIV-positive persons -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10062 , http://hdl.handle.net/10948/d1020346
- Description: The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.
- Full Text:
- Date Issued: 2013
A strategy to facilitate renewed resilience to re-establish meaning for persons with spinal cord injuries
- Authors: Willemse, Hermanus Barend
- Date: 2013
- Subjects: Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10021 , http://hdl.handle.net/10948/d1008119 , Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Description: Census estimates in 2010 indicated that 6,3 percent South Africans aged 5 years and older are currently classified as disabled in five of the nine provinces in the country. The national figure for 2005 was 5 percent, with the figure for females (6,5 percent) slightly higher than that for males (6,1percent). Spinal cord injured persons and their significant others experience a range of emotions which affect their relationships with themselves, others and their environment. To deal with the life-changing consequences of the injury and regain control, these persons not only require a variety of coping strategies but rediscovery of resilience is inevitable if the experience of personal purpose and meaningful existence is ever to be regained. In the Nelson Mandela Bay Municipal area, Port Elizabeth, South Africa – the geographical area in which this research study was undertaken - persons with spinal cord injuries have many challenges to face due to the shortcomings the existing resource for health care delivery in the post-discharge phase. The research objectives identified for the study were, firstly, to explore and describe the lived experiences of persons with spinal cord injuries; secondly, to explore and describe the lived experiences of the significant others of persons with spinal cord injuries; and thirdly, to develop a strategy to guide the professional nurse and the health care team in facilitating the health care of persons with spinal cord injuries. The study was a qualitative, exploratory, descriptive, and contextual method of inquiry. The data obtained was used to formulate the strategy with its three sub-strategies to guide professional nurses and the health care team to facilitate renewed resilience and the re-establishment of meaning for persons with spinal cord injuries. Although the experiences of the significant others were explored in order to thicken the description of the experiences of persons with spinal cord injuries, the strategy developed was limited to the persons with spinal cord injuries. Although it is well documented that there are significant physical needs, the themes that emerged from the current research mostly related to psychological and social aspects. In acknowledging the human being as unitary multi-dimensional being, the researcher in his discussions and quest to address the issue of renewed resilience in spinal cord injured persons towards finding purpose and re-establishing meaning in their lives, focused on their psychological, spiritual and social health. The outcome of the study is a strategy constructed to facilitate renewed resilience, and three sub-strategies ‘addressing experienced emotions’, ‘facilitating meaningful relationships’ and ‘facilitating effective coping’. The strategy has as purpose the empowering of spinal injured persons in their efforts to re-establish meaning by serving as a tool to guide professional nurses and members of the health care team in their facilitating of renewed resilience in persons with spinal cord injury. It is envisaged that the co-ordination of the strategy will take place from the health care delivery facility nearest to the spinal cord injured individual concerned. In order for persons with spinal cord injuries to become accountable members of society, all levels and aspects of care aimed at physical, psychological, spiritual and social well-being need to be holistically addressed. The front-line role of the professional nurse is vital as the professional nurse acts as the co-ordinator for the health care team in ensuring that persons with spinal cord injuries receive quality and holistic care in order to deal meaningfully with the life-altering consequences of a spinal cord injury. Through this study, valuable insight was gained with regard to experiences of both persons with spinal cord injuries and that of their significant others. Recommendations were made for nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2013
- Authors: Willemse, Hermanus Barend
- Date: 2013
- Subjects: Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10021 , http://hdl.handle.net/10948/d1008119 , Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Description: Census estimates in 2010 indicated that 6,3 percent South Africans aged 5 years and older are currently classified as disabled in five of the nine provinces in the country. The national figure for 2005 was 5 percent, with the figure for females (6,5 percent) slightly higher than that for males (6,1percent). Spinal cord injured persons and their significant others experience a range of emotions which affect their relationships with themselves, others and their environment. To deal with the life-changing consequences of the injury and regain control, these persons not only require a variety of coping strategies but rediscovery of resilience is inevitable if the experience of personal purpose and meaningful existence is ever to be regained. In the Nelson Mandela Bay Municipal area, Port Elizabeth, South Africa – the geographical area in which this research study was undertaken - persons with spinal cord injuries have many challenges to face due to the shortcomings the existing resource for health care delivery in the post-discharge phase. The research objectives identified for the study were, firstly, to explore and describe the lived experiences of persons with spinal cord injuries; secondly, to explore and describe the lived experiences of the significant others of persons with spinal cord injuries; and thirdly, to develop a strategy to guide the professional nurse and the health care team in facilitating the health care of persons with spinal cord injuries. The study was a qualitative, exploratory, descriptive, and contextual method of inquiry. The data obtained was used to formulate the strategy with its three sub-strategies to guide professional nurses and the health care team to facilitate renewed resilience and the re-establishment of meaning for persons with spinal cord injuries. Although the experiences of the significant others were explored in order to thicken the description of the experiences of persons with spinal cord injuries, the strategy developed was limited to the persons with spinal cord injuries. Although it is well documented that there are significant physical needs, the themes that emerged from the current research mostly related to psychological and social aspects. In acknowledging the human being as unitary multi-dimensional being, the researcher in his discussions and quest to address the issue of renewed resilience in spinal cord injured persons towards finding purpose and re-establishing meaning in their lives, focused on their psychological, spiritual and social health. The outcome of the study is a strategy constructed to facilitate renewed resilience, and three sub-strategies ‘addressing experienced emotions’, ‘facilitating meaningful relationships’ and ‘facilitating effective coping’. The strategy has as purpose the empowering of spinal injured persons in their efforts to re-establish meaning by serving as a tool to guide professional nurses and members of the health care team in their facilitating of renewed resilience in persons with spinal cord injury. It is envisaged that the co-ordination of the strategy will take place from the health care delivery facility nearest to the spinal cord injured individual concerned. In order for persons with spinal cord injuries to become accountable members of society, all levels and aspects of care aimed at physical, psychological, spiritual and social well-being need to be holistically addressed. The front-line role of the professional nurse is vital as the professional nurse acts as the co-ordinator for the health care team in ensuring that persons with spinal cord injuries receive quality and holistic care in order to deal meaningfully with the life-altering consequences of a spinal cord injury. Through this study, valuable insight was gained with regard to experiences of both persons with spinal cord injuries and that of their significant others. Recommendations were made for nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2013
An intervention study to develop a male circumcision health promotion programme at Libode Rural Communities in the Eastern Cape Province, South Africa
- Authors: Douglas, Mbuyiselo
- Date: 2013
- Subjects: Circumcision Health promotion Penis surgery South Africa -- Libode
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: vital:18476 , http://hdl.handle.net/11260/d1007187
- Description: The purpose of this study was to develop an intervention health promotion programme to prevent circumcision related health problem such as sepsis, botched circumcision, dehydration, penile amputation and reduce the number of deaths. The intervention programme was aimed at promoting a safe male circumcision practice affecting boys aged 12-18 years at Libode rural communities in Eastern Cape Province of South Africa. This was achieved through a mixed method design using both quantitative and qualitative approaches utilizing sequential transformative strategy to allow for the convergence of multiple perspectives of the traditional male circumcision in Libode. The study was conducted in 22 schools of the rural communities of Libode because most of the participants are still attending school. Frequencies and percentages were used to analyse the quantitative data, utilizing the Statistical Package for Social Sciences (SPSS). A total of 1036 participants, AmaXhosa circumcised young men (abafana) and uncircumcised boys (amakhwenkwe) participated in the cross-sectional survey, quantitative phase of the study. Qualitative phase of this study was composed of 7 focus group discussions with a total of 84 circumcised and uncircumcised male participants and 10 key informants’ interviews were conducted. In analysis qualitative data, the researcher found the most descriptive words for each topic and turned them into categories or sub-themes. Topics that related to each other were then grouped in order to reduce the number of categories and to create themes. The similar categories of data were grouped and analysed using Tesch’s method. Findings indicated that traditional circumcision is performed during winter and summer holidays in order to cater for the boys who are attending schools. The circumcision age at Libode ranges from 12 and 18 years of age which is against the Health Standards in Traditional Circumcision Act (Act No. 6 of 2001). Although the participants were aware of the complications of male circumcision in Libode, there was a high preference for traditional circumcision (92.3% of participants) to hospital circumcision. The participants were of the view that the benefits of traditional circumcision outweigh the complications or challenges related to traditional circumcision. They wanted to be socially accepted and wanted to learn about manhood values in the traditional circumcision which are values that cannot be achieved through the hospital based circumcision. As male circumcision initiation is seasonal and the intervention programme needed to be approved by different stakeholders, the testing of intervention programme could not happen before the programme was approved by all the stakeholders.
- Full Text:
- Date Issued: 2013
- Authors: Douglas, Mbuyiselo
- Date: 2013
- Subjects: Circumcision Health promotion Penis surgery South Africa -- Libode
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: vital:18476 , http://hdl.handle.net/11260/d1007187
- Description: The purpose of this study was to develop an intervention health promotion programme to prevent circumcision related health problem such as sepsis, botched circumcision, dehydration, penile amputation and reduce the number of deaths. The intervention programme was aimed at promoting a safe male circumcision practice affecting boys aged 12-18 years at Libode rural communities in Eastern Cape Province of South Africa. This was achieved through a mixed method design using both quantitative and qualitative approaches utilizing sequential transformative strategy to allow for the convergence of multiple perspectives of the traditional male circumcision in Libode. The study was conducted in 22 schools of the rural communities of Libode because most of the participants are still attending school. Frequencies and percentages were used to analyse the quantitative data, utilizing the Statistical Package for Social Sciences (SPSS). A total of 1036 participants, AmaXhosa circumcised young men (abafana) and uncircumcised boys (amakhwenkwe) participated in the cross-sectional survey, quantitative phase of the study. Qualitative phase of this study was composed of 7 focus group discussions with a total of 84 circumcised and uncircumcised male participants and 10 key informants’ interviews were conducted. In analysis qualitative data, the researcher found the most descriptive words for each topic and turned them into categories or sub-themes. Topics that related to each other were then grouped in order to reduce the number of categories and to create themes. The similar categories of data were grouped and analysed using Tesch’s method. Findings indicated that traditional circumcision is performed during winter and summer holidays in order to cater for the boys who are attending schools. The circumcision age at Libode ranges from 12 and 18 years of age which is against the Health Standards in Traditional Circumcision Act (Act No. 6 of 2001). Although the participants were aware of the complications of male circumcision in Libode, there was a high preference for traditional circumcision (92.3% of participants) to hospital circumcision. The participants were of the view that the benefits of traditional circumcision outweigh the complications or challenges related to traditional circumcision. They wanted to be socially accepted and wanted to learn about manhood values in the traditional circumcision which are values that cannot be achieved through the hospital based circumcision. As male circumcision initiation is seasonal and the intervention programme needed to be approved by different stakeholders, the testing of intervention programme could not happen before the programme was approved by all the stakeholders.
- Full Text:
- Date Issued: 2013
Functional changes of the vasculature in HIV/AIDS patients on Haart and Haart Naïve HIV participants
- Authors: Awotedu, Kofoworola Olajire
- Date: 2013
- Subjects: Cardiovascular system -- Diseases HIV infections -- Treatment
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: http://hdl.handle.net/11260/185 , vital:21366
- Description: The present study sought to explore the functional changes that occur in the vasculature of HIV positive participants of African origin in Mthatha district of South africa which might lead to increased risk in their cardiovascular system. Available literature shows that arterial stiffness plays an important role in cardiovascular events such as stroke, vasculitis and myocardial infarction. Measurement of (aortic pulse wave velocity; PWV) provides some of the strongest evidence concerning the prognostic significance of large artery stiffening. This study was aimed at investigating the relationship between anthropometry, age, E-Selectin level, cytokine levels, haemodynamic variables, blood counts and blood lipid profile with pulse wave velocity. Some traditional cardiovascular risk factors such as alcohol, and smoking were also taken into account. This was a cross-sectional study comprising of 169 participants (62 males and 107 females). 63 were HIV negative (group A), 54 HIV positive on treatment (group B), and 52 were HIV positive not on treatment (group C). Pulse wave velocity (PWV) was assessed using the Sphygmocor Vx. Statistically, ANOVA was used for variables with normal distribution and non parametric tests were used for variables with skewed distribution. Notable significant differences were seen in the means of the following variables across all the 3 groups. Conclusion: This study showed that HIV infected patients with or without antiretroviral therapy have increase arterial stiffness which is associated with an increased cardiovascular risk. The sphygmocor is an accurate, non invassive and useful tool in the evaluation of arterial stiffness and its use in clinical practice should be encouraged. PWV and the augmentation index (AIx) are the two major non- iv invasive methods of assessing arterial stiffness. Life style modification should be incorporated into the management of HIV patients so as the continuous monitoring of their haematological and lipid profile.
- Full Text:
- Date Issued: 2013
Functional changes of the vasculature in HIV/AIDS patients on Haart and Haart Naïve HIV participants
- Authors: Awotedu, Kofoworola Olajire
- Date: 2013
- Subjects: Cardiovascular system -- Diseases HIV infections -- Treatment
- Language: English
- Type: Thesis , Doctoral , Ph D
- Identifier: http://hdl.handle.net/11260/185 , vital:21366
- Description: The present study sought to explore the functional changes that occur in the vasculature of HIV positive participants of African origin in Mthatha district of South africa which might lead to increased risk in their cardiovascular system. Available literature shows that arterial stiffness plays an important role in cardiovascular events such as stroke, vasculitis and myocardial infarction. Measurement of (aortic pulse wave velocity; PWV) provides some of the strongest evidence concerning the prognostic significance of large artery stiffening. This study was aimed at investigating the relationship between anthropometry, age, E-Selectin level, cytokine levels, haemodynamic variables, blood counts and blood lipid profile with pulse wave velocity. Some traditional cardiovascular risk factors such as alcohol, and smoking were also taken into account. This was a cross-sectional study comprising of 169 participants (62 males and 107 females). 63 were HIV negative (group A), 54 HIV positive on treatment (group B), and 52 were HIV positive not on treatment (group C). Pulse wave velocity (PWV) was assessed using the Sphygmocor Vx. Statistically, ANOVA was used for variables with normal distribution and non parametric tests were used for variables with skewed distribution. Notable significant differences were seen in the means of the following variables across all the 3 groups. Conclusion: This study showed that HIV infected patients with or without antiretroviral therapy have increase arterial stiffness which is associated with an increased cardiovascular risk. The sphygmocor is an accurate, non invassive and useful tool in the evaluation of arterial stiffness and its use in clinical practice should be encouraged. PWV and the augmentation index (AIx) are the two major non- iv invasive methods of assessing arterial stiffness. Life style modification should be incorporated into the management of HIV patients so as the continuous monitoring of their haematological and lipid profile.
- Full Text:
- Date Issued: 2013
Practice guidelines for supporting youth-headed families to enhance their resilience
- Authors: Soji, Zoleka
- Date: 2013
- Subjects: Child support -- South Africa , Child caregivers -- South Africa , Orphans -- Care -- South Africa , Child welfare -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10004 , http://hdl.handle.net/10948/d1016381
- Description: The topic of the research is derived from the researcher‟s own interest as a social worker and observations of reality within youth-headed families. Over the past few years the number of published studies on child and youth-headed households has grown out of the realisation that this multi-faceted phenomenon is growing in numbers and complexity. Most of these studies and reports concentrate on the issue of scale and the severity of the crisis of child and youth-headed households (UNICEF, 2002; Maqoko & Dryer, 2007 & Kuhanen, Shemeikka, Notkola & Nghixulifwa, 2008). These studies reveal the complex nature of the phenomenon of child and youth-headed families and the challenges that face young people within these families which impact on their growth and development. In most of the studies, the phenomenon of child and youth-headed households has been reported to have an impact on societal framework as a result of its complexity (UNICEF, 2002, 2008; van Dijk, 2008; Kuhanen et al., 2008; Evans, 2010). Over the past years there has been a steady increase in studies that has focussed on coping and resilience of children and young people. Many of these studies have identified resilience-related factors through quantitative ecological approaches to research. To date, there seems to be very few qualitative studies that have been undertaken to delineate the construct of resilience in child and youth-headed families within the South African context from the perspectives of children and young people growing up in these families (Beeka, 2008; Nkomo, 2008; Leatham, 2005). McCubbin (1999, in Smith 2006:48) argues that qualitative research is well suited to understanding processes and strategies in the study of resilience. This study therefore corresponds to McCubbin‟ calling by employing a qualitative research to the study of resilience in youth-headed families. The first goal of this study was to gain a deeper understanding of the experiences and needs of youth-headed families in Port Elizabeth, South Africa, as well as to enhance understanding of the protective factors and processes within youth-headed families and their environment that enable them to cope with their circumstances. The secondary goal of this study was to formulate practice guidelines for supporting members of youth-headed families that could be used by social workers and other service providers rendering services to these families in order to enhance their coping and resilience. The following objectives were formulated to guide the research process: - To explore and describe the experiences and needs of youth-headed families; - To explore the perceptions of community members regarding the needs of youth-headed families, as well as their perceptions regarding how these needs are addressed at community level; - To identify and describe the protective factors and/or processes within individual members of youth-headed families, their families and community context that promote the coping and resilience of youth-headed families; - To explore the views of service providers rendering services to youth-headed families regarding the nature of interventions and programmes rendered to these families; - To review the literature on existing family support programmes in order to identify good practice examples to inform the formulation of practice guidelines for supporting members of youth-headed families.
- Full Text:
- Date Issued: 2013
- Authors: Soji, Zoleka
- Date: 2013
- Subjects: Child support -- South Africa , Child caregivers -- South Africa , Orphans -- Care -- South Africa , Child welfare -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10004 , http://hdl.handle.net/10948/d1016381
- Description: The topic of the research is derived from the researcher‟s own interest as a social worker and observations of reality within youth-headed families. Over the past few years the number of published studies on child and youth-headed households has grown out of the realisation that this multi-faceted phenomenon is growing in numbers and complexity. Most of these studies and reports concentrate on the issue of scale and the severity of the crisis of child and youth-headed households (UNICEF, 2002; Maqoko & Dryer, 2007 & Kuhanen, Shemeikka, Notkola & Nghixulifwa, 2008). These studies reveal the complex nature of the phenomenon of child and youth-headed families and the challenges that face young people within these families which impact on their growth and development. In most of the studies, the phenomenon of child and youth-headed households has been reported to have an impact on societal framework as a result of its complexity (UNICEF, 2002, 2008; van Dijk, 2008; Kuhanen et al., 2008; Evans, 2010). Over the past years there has been a steady increase in studies that has focussed on coping and resilience of children and young people. Many of these studies have identified resilience-related factors through quantitative ecological approaches to research. To date, there seems to be very few qualitative studies that have been undertaken to delineate the construct of resilience in child and youth-headed families within the South African context from the perspectives of children and young people growing up in these families (Beeka, 2008; Nkomo, 2008; Leatham, 2005). McCubbin (1999, in Smith 2006:48) argues that qualitative research is well suited to understanding processes and strategies in the study of resilience. This study therefore corresponds to McCubbin‟ calling by employing a qualitative research to the study of resilience in youth-headed families. The first goal of this study was to gain a deeper understanding of the experiences and needs of youth-headed families in Port Elizabeth, South Africa, as well as to enhance understanding of the protective factors and processes within youth-headed families and their environment that enable them to cope with their circumstances. The secondary goal of this study was to formulate practice guidelines for supporting members of youth-headed families that could be used by social workers and other service providers rendering services to these families in order to enhance their coping and resilience. The following objectives were formulated to guide the research process: - To explore and describe the experiences and needs of youth-headed families; - To explore the perceptions of community members regarding the needs of youth-headed families, as well as their perceptions regarding how these needs are addressed at community level; - To identify and describe the protective factors and/or processes within individual members of youth-headed families, their families and community context that promote the coping and resilience of youth-headed families; - To explore the views of service providers rendering services to youth-headed families regarding the nature of interventions and programmes rendered to these families; - To review the literature on existing family support programmes in order to identify good practice examples to inform the formulation of practice guidelines for supporting members of youth-headed families.
- Full Text:
- Date Issued: 2013
Self-esteem, coping and the psychology of infertility
- Authors: Jordaan, Hendrina Jacoba
- Date: 2013
- Subjects: Infertility -- Psychological aspects , Self-esteem -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9959 , http://hdl.handle.net/10948/d1020055
- Description: This exploratory-descriptive study, using multiple case studies, investigated the self-esteem, coping and psychology of infertility of a sample of individuals who have received infertility treatment at a privately managed health care unit. Infertility is a complex condition associated with the inability to conceive a child, frequently manifesting itself as a result of various biological factors. A literature review indicated that being on Artificial Reproductive Technology (ART) treatment significantly increases the stress in an individual. In an attempt to gain insight into the way patients undergoing infertility treatment find the strength to complete their treatment cycles, and to endure and overcome the pressures associated therewith, in order to continue their lives – in spite of a negative treatment/pregnancy result, the researcher found it necessary to investigate the self-esteem, coping and the psychology of patients undergoing infertility treatment. An exploratory descriptive research design was used and the participants were chosen by means of a non-probability purposive sampling procedure. The participants were given a package of questionnaires to complete under the supervision of the group facilitator and researcher, prior to, as well as after the intervention. The assessment consisted of a biographical questionnaire and two standardised paper and pencil measures. The participants’ self-esteem was explored using James Battle’s (1981) Culture-Free Self-Esteem Inventory; while the coping resources were explored using Hammer and Marting’s (1988) Coping Resource Inventory (CRI). Although these data were not analysable, due to the small sample size, it was utilised in a qualitative manner to support the findings from the qualitative data. The data were also gathered from the participants via a psychological intervention programme in the format of three focus group sessions. All the qualitative results were analysed, according to Tesch’s model of content analysis. The general finding was that the period of infertility treatment is experienced as both difficult and challenging by individuals, and that there is immense healing in the sharing of one’s narrative with other infertility patients. It also surfaced that selfesteem, especially one’s feelings of worth, is most affected by a diagnosis of infertility, as well as by going through the roller coaster of the emotions associated with the treatment and monthly cycle of infertility. It was evident from the narratives told by the participants that every domain of one’s self-esteem is affected by a diagnosis of infertility, and that the biggest challenge in maintaining a positive selfesteem seemed to be in finding a balance between one’s real self and one’s ideal self. Furthermore, this study found that the challenge related to coping for the participants in this study was to present a coherent life narrative to the ‘world’, despite intense feelings of being misunderstood by others, and being faced with the discourse of infertility, as part of one’s life script. The main coping responses utilized by participants included the re-channelling of one’s focus, using denial, seeking out familial and social support, bargaining with God, and nurturing hope and faith that this journey of infertility is merely just a journey and not a destination, with the destination that of being blessed with a biological child of one’s own.
- Full Text:
- Date Issued: 2013
- Authors: Jordaan, Hendrina Jacoba
- Date: 2013
- Subjects: Infertility -- Psychological aspects , Self-esteem -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9959 , http://hdl.handle.net/10948/d1020055
- Description: This exploratory-descriptive study, using multiple case studies, investigated the self-esteem, coping and psychology of infertility of a sample of individuals who have received infertility treatment at a privately managed health care unit. Infertility is a complex condition associated with the inability to conceive a child, frequently manifesting itself as a result of various biological factors. A literature review indicated that being on Artificial Reproductive Technology (ART) treatment significantly increases the stress in an individual. In an attempt to gain insight into the way patients undergoing infertility treatment find the strength to complete their treatment cycles, and to endure and overcome the pressures associated therewith, in order to continue their lives – in spite of a negative treatment/pregnancy result, the researcher found it necessary to investigate the self-esteem, coping and the psychology of patients undergoing infertility treatment. An exploratory descriptive research design was used and the participants were chosen by means of a non-probability purposive sampling procedure. The participants were given a package of questionnaires to complete under the supervision of the group facilitator and researcher, prior to, as well as after the intervention. The assessment consisted of a biographical questionnaire and two standardised paper and pencil measures. The participants’ self-esteem was explored using James Battle’s (1981) Culture-Free Self-Esteem Inventory; while the coping resources were explored using Hammer and Marting’s (1988) Coping Resource Inventory (CRI). Although these data were not analysable, due to the small sample size, it was utilised in a qualitative manner to support the findings from the qualitative data. The data were also gathered from the participants via a psychological intervention programme in the format of three focus group sessions. All the qualitative results were analysed, according to Tesch’s model of content analysis. The general finding was that the period of infertility treatment is experienced as both difficult and challenging by individuals, and that there is immense healing in the sharing of one’s narrative with other infertility patients. It also surfaced that selfesteem, especially one’s feelings of worth, is most affected by a diagnosis of infertility, as well as by going through the roller coaster of the emotions associated with the treatment and monthly cycle of infertility. It was evident from the narratives told by the participants that every domain of one’s self-esteem is affected by a diagnosis of infertility, and that the biggest challenge in maintaining a positive selfesteem seemed to be in finding a balance between one’s real self and one’s ideal self. Furthermore, this study found that the challenge related to coping for the participants in this study was to present a coherent life narrative to the ‘world’, despite intense feelings of being misunderstood by others, and being faced with the discourse of infertility, as part of one’s life script. The main coping responses utilized by participants included the re-channelling of one’s focus, using denial, seeking out familial and social support, bargaining with God, and nurturing hope and faith that this journey of infertility is merely just a journey and not a destination, with the destination that of being blessed with a biological child of one’s own.
- Full Text:
- Date Issued: 2013
Standards to facilitate optimal experiences of short-term study abroad nursing students at a higher education institution
- Authors: Du Rand, Sussara Maria
- Date: 2013
- Subjects: Nursing -- Study and teaching -- United States , Transcultural nursing , Nursing -- Cross-cultural studies , Foreign study , Nursing students
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10066 , http://hdl.handle.net/10948/d1020659
- Description: Advances in technology have made globalization and internationalization a reality in the world. National borders are becoming more permeable and migration of goods, services, and health care workers takes place more readily. Higher Education Institutions (HEIs) have become competitors and vendors in the global knowledge economy and are expected to develop job seekers that are responsible and engaged global citizens and employees. Offering study abroad programmes is one of the ways that HEIs achieve this goal. It is estimated that in 2010, 4.7 million people studied abroad (OECD, 2012:360), and it is anticipated that this number will grow to 15 million by the year 2025 (Altbach & Knight, 2006:9). South Africa is emerging as a regional hub for study and research in sub-Saharan Africa (UNESCO: 2012b). Many organizations that train nurses are internationalizing their curriculum which effectively means that Schools of Nursing are seeking placement for students to study, gain insight into other cultures and practices, and to gain clinical experience in other countries. Students, the customers of the Higher Education Institutions, often pay large sums of money to undertake these study abroad programmes and therefore expect good quality learning experiences in return. The aim of this qualitative, contextual, exploratory, and descriptive study was to explore and describe the expectations and experiences of international nursing students and faculty members at a Higher Educational Institution in South Africa in order to develop standards that will enable HEIs to optimize the experiences of short-term study abroad nursing students. An in-depth contextual investigation was conducted on globalization and internationalization, as well as the higher education and health systems of three countries to understand the context of the study abroad programmes. Qualitative data was gathered from students and faculty members using focus groups and individual interviews to establish their expectations and experiences of the programme. Thematic synthesis was carried out on the contextual data and the qualitative data. Thereafter, thematic synthesis analysis was conducted using both sets of results to develop standards that can be used to optimize the experience of short-term study abroad nursing students at a HEI. A total of 35 standards were developed around the following main themes: the objectives of study abroad programmes should be stated clearly before arrival and include the expectations of the global, national, and local communities, the higher education institution and the staff and students; study abroad programmes should be managed in an ethical manner and in an enabling environment, as part of their strategic goals and plans of a HEI; students should be exposed to a variety of experiences and differences between the sending and hosting countries during their study abroad programmes; Standards to Facilitate Optimal Experiences of Short-term Study Abroad Nursing Students at a HEI; study abroad programmes should be evaluated at different intervals and levels to ensure quality of the programmes and to ensure that the objectives/outcomes are met. A limitation of the study was the sampling of the clinical mentors which did not include representatives from the overseas universities. It is recommended that the standards that were developed in this study be introduced and tested in HEIs and that more research be conducted on different levels and groups with regard to study abroad programmes in future.
- Full Text:
- Date Issued: 2013
- Authors: Du Rand, Sussara Maria
- Date: 2013
- Subjects: Nursing -- Study and teaching -- United States , Transcultural nursing , Nursing -- Cross-cultural studies , Foreign study , Nursing students
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10066 , http://hdl.handle.net/10948/d1020659
- Description: Advances in technology have made globalization and internationalization a reality in the world. National borders are becoming more permeable and migration of goods, services, and health care workers takes place more readily. Higher Education Institutions (HEIs) have become competitors and vendors in the global knowledge economy and are expected to develop job seekers that are responsible and engaged global citizens and employees. Offering study abroad programmes is one of the ways that HEIs achieve this goal. It is estimated that in 2010, 4.7 million people studied abroad (OECD, 2012:360), and it is anticipated that this number will grow to 15 million by the year 2025 (Altbach & Knight, 2006:9). South Africa is emerging as a regional hub for study and research in sub-Saharan Africa (UNESCO: 2012b). Many organizations that train nurses are internationalizing their curriculum which effectively means that Schools of Nursing are seeking placement for students to study, gain insight into other cultures and practices, and to gain clinical experience in other countries. Students, the customers of the Higher Education Institutions, often pay large sums of money to undertake these study abroad programmes and therefore expect good quality learning experiences in return. The aim of this qualitative, contextual, exploratory, and descriptive study was to explore and describe the expectations and experiences of international nursing students and faculty members at a Higher Educational Institution in South Africa in order to develop standards that will enable HEIs to optimize the experiences of short-term study abroad nursing students. An in-depth contextual investigation was conducted on globalization and internationalization, as well as the higher education and health systems of three countries to understand the context of the study abroad programmes. Qualitative data was gathered from students and faculty members using focus groups and individual interviews to establish their expectations and experiences of the programme. Thematic synthesis was carried out on the contextual data and the qualitative data. Thereafter, thematic synthesis analysis was conducted using both sets of results to develop standards that can be used to optimize the experience of short-term study abroad nursing students at a HEI. A total of 35 standards were developed around the following main themes: the objectives of study abroad programmes should be stated clearly before arrival and include the expectations of the global, national, and local communities, the higher education institution and the staff and students; study abroad programmes should be managed in an ethical manner and in an enabling environment, as part of their strategic goals and plans of a HEI; students should be exposed to a variety of experiences and differences between the sending and hosting countries during their study abroad programmes; Standards to Facilitate Optimal Experiences of Short-term Study Abroad Nursing Students at a HEI; study abroad programmes should be evaluated at different intervals and levels to ensure quality of the programmes and to ensure that the objectives/outcomes are met. A limitation of the study was the sampling of the clinical mentors which did not include representatives from the overseas universities. It is recommended that the standards that were developed in this study be introduced and tested in HEIs and that more research be conducted on different levels and groups with regard to study abroad programmes in future.
- Full Text:
- Date Issued: 2013
Strategies to provide holistic care and support to children who are AIDS orphans living in township communities
- Authors: Frood, Sharron Louise
- Date: 2013
- Subjects: Children of AIDS patients -- Care -- South Africa , Orphans -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10064 , http://hdl.handle.net/10948/d1020655
- Description: The human immunodeficiency virus/acquired immune-deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. “AIDS, (Acquired Immune Deficiency Syndrome), has devastated the social and economic fabric of African societies, made orphans of a whole generation of children and become the epicentre of the HIV/AIDS pandemic” (Fassin, 2007: 76). Like the virus itself, the AIDS crisis mutates rapidly. Children who are AIDS orphans living in South Africa, as in other African countries, suffer from recurrent psychological trauma. It starts with the illness and death of their parents and is followed by cycles of poverty, malnutrition, stigma, exploitation, sickness and often sexual abuse. The figures concerning those affected, which are staggering, offer various predictions regarding the number of orphans left in the wake of the pandemic. Between 1990 and 2003, the number of orphaned children rose from fewer than 1 million to more than 12 million in sub-Saharan Africa (UNICEF, 2005: 68). South Africa is severely affected by the AIDS pandemic, with the largest number of HIV infections in the world, a total of 5.7 million (RSA, 2010: 10), affecting approximately 3.2 million women and 280 000 children aged from 0 to14 years. There is a significant variation in HIV prevalence per province, with the Eastern Cape (EC) reportedly having an average prevalence rate of 28 percent. Hence South Africa is likely to be the country with highest percentage of children orphaned by AIDS within its population. Orphanhood is a major consequence of the AIDS pandemic in South Africa with an estimated 2.2 million AIDS-orphaned children, 11,188 per 100,000 by 2015. Most children who are AIDS orphans living in township communities live predominantly uncared for and unsupported. Therefore the purpose of this research study was to develop strategies to provide care and support to children who are AIDS orphans living in township communities. To achieve the purpose of this research study, a qualitative, exploratory, descriptive and contextual design was used by the researcher to gain insight from health and social care practitioners who render care and support to children who are AIDS orphans living in these communities. The data from in-depth interviews with the health and social care practitoners was used by the researcher to develop strategies to provide care and support to children who are AIDS orphans living in township communities. The study comprised the following four phases: Phase One: During this phase, the researcher will present an overview of the current legislative framework policies at an international, national and provincial level, regarding the the rights of children living in South Africa. Phase Two: During this phase data from two research populations were collected and analysed. As the research process of this study dealt with two groups of participants, namely in group one health care practitioners and group two comprised social workers and psychologists, who work in the township communities to provide care and support to children who are AIDS orphans living in these communities. The researcher discussed each group separately in the discussion of phase two of the study. Phase Three: Comprised the themes identified in the data gathered from the transcribed in-depth interviews, the field notes as well as the reflective journals were cross-validated to ensure trustworthiness of the data which was then organised into a conceptual framework. The conceptual framework was used to clarify the relationships of the concepts and the themes identified during the research process and also used to link the gathered data to previously established models and theories (Schneider, 2004: 133). Phase Four: The last phase of the research design, focused on the development of the “Steps of progression strategies” to provide holistic care and support to children who are AIDS orphans living in township communities. This was done making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008: 237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, simple, applicable and significant to nursing practice have been developed for use by the Department of Health and Department of Social Development as well as primary health and social care practitioners to provide holistic care and support to children who are AIDS orphans living in township communities in South Africa.
- Full Text:
- Date Issued: 2013
- Authors: Frood, Sharron Louise
- Date: 2013
- Subjects: Children of AIDS patients -- Care -- South Africa , Orphans -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10064 , http://hdl.handle.net/10948/d1020655
- Description: The human immunodeficiency virus/acquired immune-deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. “AIDS, (Acquired Immune Deficiency Syndrome), has devastated the social and economic fabric of African societies, made orphans of a whole generation of children and become the epicentre of the HIV/AIDS pandemic” (Fassin, 2007: 76). Like the virus itself, the AIDS crisis mutates rapidly. Children who are AIDS orphans living in South Africa, as in other African countries, suffer from recurrent psychological trauma. It starts with the illness and death of their parents and is followed by cycles of poverty, malnutrition, stigma, exploitation, sickness and often sexual abuse. The figures concerning those affected, which are staggering, offer various predictions regarding the number of orphans left in the wake of the pandemic. Between 1990 and 2003, the number of orphaned children rose from fewer than 1 million to more than 12 million in sub-Saharan Africa (UNICEF, 2005: 68). South Africa is severely affected by the AIDS pandemic, with the largest number of HIV infections in the world, a total of 5.7 million (RSA, 2010: 10), affecting approximately 3.2 million women and 280 000 children aged from 0 to14 years. There is a significant variation in HIV prevalence per province, with the Eastern Cape (EC) reportedly having an average prevalence rate of 28 percent. Hence South Africa is likely to be the country with highest percentage of children orphaned by AIDS within its population. Orphanhood is a major consequence of the AIDS pandemic in South Africa with an estimated 2.2 million AIDS-orphaned children, 11,188 per 100,000 by 2015. Most children who are AIDS orphans living in township communities live predominantly uncared for and unsupported. Therefore the purpose of this research study was to develop strategies to provide care and support to children who are AIDS orphans living in township communities. To achieve the purpose of this research study, a qualitative, exploratory, descriptive and contextual design was used by the researcher to gain insight from health and social care practitioners who render care and support to children who are AIDS orphans living in these communities. The data from in-depth interviews with the health and social care practitoners was used by the researcher to develop strategies to provide care and support to children who are AIDS orphans living in township communities. The study comprised the following four phases: Phase One: During this phase, the researcher will present an overview of the current legislative framework policies at an international, national and provincial level, regarding the the rights of children living in South Africa. Phase Two: During this phase data from two research populations were collected and analysed. As the research process of this study dealt with two groups of participants, namely in group one health care practitioners and group two comprised social workers and psychologists, who work in the township communities to provide care and support to children who are AIDS orphans living in these communities. The researcher discussed each group separately in the discussion of phase two of the study. Phase Three: Comprised the themes identified in the data gathered from the transcribed in-depth interviews, the field notes as well as the reflective journals were cross-validated to ensure trustworthiness of the data which was then organised into a conceptual framework. The conceptual framework was used to clarify the relationships of the concepts and the themes identified during the research process and also used to link the gathered data to previously established models and theories (Schneider, 2004: 133). Phase Four: The last phase of the research design, focused on the development of the “Steps of progression strategies” to provide holistic care and support to children who are AIDS orphans living in township communities. This was done making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008: 237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, simple, applicable and significant to nursing practice have been developed for use by the Department of Health and Department of Social Development as well as primary health and social care practitioners to provide holistic care and support to children who are AIDS orphans living in township communities in South Africa.
- Full Text:
- Date Issued: 2013
The effect of using a computer-based exploration tool on children's career development learning
- Authors: Crause, Ewald
- Date: 2013
- Subjects: Vocational guidance -- Computer network resources , Career development -- Computer network resources
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9947 , http://hdl.handle.net/10948/d1015020
- Description: Historically the process of career development was thought of as occurring in adolescence and adulthood; however, the renewed emphasis on lifelong career development has led to a greater focus on the career developmental stage of childhood. The present research focused on the development and trialling of a research-based computerised career exploration tool, Growing-up: Children Building Careers™ (GCBC™) that can be used for early intervention in children‘s career development. The integration of developmental considerations within a career developmental context is of paramount importance, considering that child and career developmental theories share certain basic foundational principles such as the dual recognition of identifiable life stages and the resolution or accomplishment of associated tasks. The focus of the research is to provide access to a research-based tool that can assist learners with developing age appropriate career developmental skills. As the overview of education policy and existing programs will show, there are challenges in providing access to and improving the nature, level, and quality of career development services. Gaps in access to career development learning are particularly evident at the elementary education level. Furthermore it is clear that learners need to be at the centre of a radical rethink of careers services within a lifelong learning framework in order to ensure access to navigational tools throughout a lifetime of work and study transitions. Digital environments, such as the GCBC™, are tools that broaden and extend learning possibilities for children and appropriately designed digital environments can provide a vehicle that can take children further than they might travel unassisted. The research is divided into five phases and includes eight to ten year old children as participants. Phase one focused on the program design and pilot study (ensuring content validity and age-appropriate language use), while phases two to five focused on the fieldwork (i.e., pre –test, program exposure, post-test, and focus group discussions). The researcher made use of a mixed research design that combines both quantitative and qualitative research methods. The total sample consisted of 146 children between the ages of eight to ten years old. The control group had 72 children and the experimental group 74 children with a mean age of 8.74 years (SD = 0.63) for the total sample. The quantitative data collection entailed a pre-and post-test design with learners‘ career development measured with the Childhood Career Development Scale (CCDS) and their career awareness with the Revised Career Awareness Survey (RCAS). Qualitative data was collected in the form of two focus group discussions, which included a small sample of children from the experimental group, as well as insights gained from educators following the GCBC™ fieldwork. The quantitative statistical analysis included descriptive and inferential statistics which allowed the researcher to not only describe the research findings, but to confirm the effectiveness of the GCBC™ as an intentional career development learning program. Furthermore, the responses of the children and educators who participated in or witnessed the facilitation of the GCBC™ provided support for the GCBC™ as a meaningful career learning experience which can be successfully implemented in educational settings.
- Full Text:
- Date Issued: 2013
- Authors: Crause, Ewald
- Date: 2013
- Subjects: Vocational guidance -- Computer network resources , Career development -- Computer network resources
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9947 , http://hdl.handle.net/10948/d1015020
- Description: Historically the process of career development was thought of as occurring in adolescence and adulthood; however, the renewed emphasis on lifelong career development has led to a greater focus on the career developmental stage of childhood. The present research focused on the development and trialling of a research-based computerised career exploration tool, Growing-up: Children Building Careers™ (GCBC™) that can be used for early intervention in children‘s career development. The integration of developmental considerations within a career developmental context is of paramount importance, considering that child and career developmental theories share certain basic foundational principles such as the dual recognition of identifiable life stages and the resolution or accomplishment of associated tasks. The focus of the research is to provide access to a research-based tool that can assist learners with developing age appropriate career developmental skills. As the overview of education policy and existing programs will show, there are challenges in providing access to and improving the nature, level, and quality of career development services. Gaps in access to career development learning are particularly evident at the elementary education level. Furthermore it is clear that learners need to be at the centre of a radical rethink of careers services within a lifelong learning framework in order to ensure access to navigational tools throughout a lifetime of work and study transitions. Digital environments, such as the GCBC™, are tools that broaden and extend learning possibilities for children and appropriately designed digital environments can provide a vehicle that can take children further than they might travel unassisted. The research is divided into five phases and includes eight to ten year old children as participants. Phase one focused on the program design and pilot study (ensuring content validity and age-appropriate language use), while phases two to five focused on the fieldwork (i.e., pre –test, program exposure, post-test, and focus group discussions). The researcher made use of a mixed research design that combines both quantitative and qualitative research methods. The total sample consisted of 146 children between the ages of eight to ten years old. The control group had 72 children and the experimental group 74 children with a mean age of 8.74 years (SD = 0.63) for the total sample. The quantitative data collection entailed a pre-and post-test design with learners‘ career development measured with the Childhood Career Development Scale (CCDS) and their career awareness with the Revised Career Awareness Survey (RCAS). Qualitative data was collected in the form of two focus group discussions, which included a small sample of children from the experimental group, as well as insights gained from educators following the GCBC™ fieldwork. The quantitative statistical analysis included descriptive and inferential statistics which allowed the researcher to not only describe the research findings, but to confirm the effectiveness of the GCBC™ as an intentional career development learning program. Furthermore, the responses of the children and educators who participated in or witnessed the facilitation of the GCBC™ provided support for the GCBC™ as a meaningful career learning experience which can be successfully implemented in educational settings.
- Full Text:
- Date Issued: 2013
The redemptive life story of Glenda Watson-Kahlenberg: a psychobiography
- Authors: Connelly, Ruth Ellen
- Date: 2013
- Subjects: Watson-Kahlenberg, Glenda -- Psychology , Redemption , Meaning (Psychology) , Well-being , Forgiveness
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9956 , http://hdl.handle.net/10948/d1019690
- Description: This psychobiography is focused on the life of Glenda Watson-Kahlenberg, whose life history epitomises the redemptive theme of triumph over tragedy. A phenomenological approach to the study allowed the researcher to observe the participant‟s lived experience through the theoretical lens of Frankl‟s conceptualization of a meaningful and full existence. A holistic perspective of factors contributing to redemption was accommodated by the Biopsychosocial-spiritual Model. The aim of this longitudinal revelatory study was to illuminate the process of redemption in a life, which leads to restoration and wholeness. This study breaks with traditional psychobiography – in that a life in progress has been selected; and personality development is not the key focus. This psychobiographical undertaking was anchored in qualitative research in the form of a single case study. Four types of triangulation were utilized, namely: data, investigators, theory and methodological triangulation. In addition, Alexander‟s identifiers of saliency, Miles and Huberman‟s data-management guidelines, Schultz‟s prototypical scenes, and Guba‟s criteria for trustworthiness, guided the methodology to ensure reliable data extraction and interpretation. The present researcher was in search of a deeper understanding of the enabling factors facilitating a restorative process in a life that was challenged by setbacks. Given the increasing pressures facing individuals in this modern era, the redemptive theme holds particular relevance, and was graphically demonstrated in the life of the participant who experienced trauma, widowhood, divorce, single parenthood, and a spate of medical and psychological setbacks. The findings suggest that the mental health clinician‟s utilisation of Frankl‟s conceptualisation of meaning in the most challenging circumstances, proffers itself as an all-purpose life-tool which enables individuals to overcome their challenges. The study demonstrated that gaining meaning in life is inextricably tied to an implicit legacy-oriented worldview. Of significance, is the role of forgiveness which emerged as the central redemptive catalyst. In this study, the resolution of past hurts through forgiveness, and the search for meaning, merge, forming an arterial theme in the life story of the participant. The dual impact of these factors not only reversed contaminated life-scripts, it also birthed a new calling in life which set the participant on a generative life course. The findings related to a redemptive life not only confirms existing theory, but also adds perspectives not previously considered. In addition, the findings related to the role of forgiveness has positive implications for the individual‟s physical and psychological wellbeing. Greater intentionality on the part of therapists to thread forgiveness into their practice, remains invitational in the light of the eugraphic impact demonstrated in this study.
- Full Text:
- Date Issued: 2013
- Authors: Connelly, Ruth Ellen
- Date: 2013
- Subjects: Watson-Kahlenberg, Glenda -- Psychology , Redemption , Meaning (Psychology) , Well-being , Forgiveness
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9956 , http://hdl.handle.net/10948/d1019690
- Description: This psychobiography is focused on the life of Glenda Watson-Kahlenberg, whose life history epitomises the redemptive theme of triumph over tragedy. A phenomenological approach to the study allowed the researcher to observe the participant‟s lived experience through the theoretical lens of Frankl‟s conceptualization of a meaningful and full existence. A holistic perspective of factors contributing to redemption was accommodated by the Biopsychosocial-spiritual Model. The aim of this longitudinal revelatory study was to illuminate the process of redemption in a life, which leads to restoration and wholeness. This study breaks with traditional psychobiography – in that a life in progress has been selected; and personality development is not the key focus. This psychobiographical undertaking was anchored in qualitative research in the form of a single case study. Four types of triangulation were utilized, namely: data, investigators, theory and methodological triangulation. In addition, Alexander‟s identifiers of saliency, Miles and Huberman‟s data-management guidelines, Schultz‟s prototypical scenes, and Guba‟s criteria for trustworthiness, guided the methodology to ensure reliable data extraction and interpretation. The present researcher was in search of a deeper understanding of the enabling factors facilitating a restorative process in a life that was challenged by setbacks. Given the increasing pressures facing individuals in this modern era, the redemptive theme holds particular relevance, and was graphically demonstrated in the life of the participant who experienced trauma, widowhood, divorce, single parenthood, and a spate of medical and psychological setbacks. The findings suggest that the mental health clinician‟s utilisation of Frankl‟s conceptualisation of meaning in the most challenging circumstances, proffers itself as an all-purpose life-tool which enables individuals to overcome their challenges. The study demonstrated that gaining meaning in life is inextricably tied to an implicit legacy-oriented worldview. Of significance, is the role of forgiveness which emerged as the central redemptive catalyst. In this study, the resolution of past hurts through forgiveness, and the search for meaning, merge, forming an arterial theme in the life story of the participant. The dual impact of these factors not only reversed contaminated life-scripts, it also birthed a new calling in life which set the participant on a generative life course. The findings related to a redemptive life not only confirms existing theory, but also adds perspectives not previously considered. In addition, the findings related to the role of forgiveness has positive implications for the individual‟s physical and psychological wellbeing. Greater intentionality on the part of therapists to thread forgiveness into their practice, remains invitational in the light of the eugraphic impact demonstrated in this study.
- Full Text:
- Date Issued: 2013
A psycho-educational programme to facilitate the mental health of adolescent girls who are victims of verbal bullying
- Authors: Jacobs, Ruwayda
- Date: 2012
- Subjects: Teenage girls -- Mental health -- South Africa , Psychoanalysis , Bullying
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9946 , http://hdl.handle.net/10948/d1014579
- Description: Bullying appears to be a worldwide phenomenon. It occurs within schools, homes, and in the community too. Bullying is a form of aggressive behaviour. Female bullying is not so easily noticed, as girls hardly ever use physical forms of aggression. Bullying can have a detrimental effect on the mental health of the victim. The victims of bullying experience symptoms of mental discomfort, which include low self esteem, feelings of helplessness, feelings of worthlessness and inferiority, lack of confidence, isolation, self-conscientiousness; and lastly, this can lead to suicide. Some form of intervention is necessary to provide adolescents with skills to combat bullying and help them to become mentally healthy again. The overall goal of the study was to develop, implement and evaluate a psycho-educational programme for female adolescents in a secondary school setting, in order to assist them in coping with bullying. The objectives of the research study were to: Conduct asituational analysis to identify the mental health needs of adolescent girls, as victimsof bullying. Develop a psycho-educational programme to facilitate the promotion of mental health of those adolescent girls who are victims of bullying. Implement the psycho-educational programme to facilitate coping by adolescent girls who are victims of bullying. Assess whether the adolescent girls have benefitted from attending the psycho-educational programme. The researcher used a qualitative, explorative, descriptive and contextual design. The research methodology consisted of four phases. In phase one of the research, a situational analysis was done; and the characteristics of mental discomfort exhibited by the victim were identified. The needs of the adolescent girl who has been bullied have already been described. Phase two involved the development of a psycho-educational programme. The information from the situational analysis was used to develop the conceptual framework. The six concepts in the survey list of Dickoff et al. (1968:422) were described as follows: the recipient is the adolescent girl who has been bullied, the agent is an advanced psychiatric nurse, the context is the community and the secondary school where bullying takes place, the dynamics of the intervention constitute the mental discomfort experienced by the adolescent girl. This is what motivates her to participate in the programme. The procedure was identified as the psycho-educational programme, while the terminus or outcome of the intervention for the adolescent girl would be for her to experience mental health after being exposed to the psycho-educational programme. The relationship between the concepts was used to form the mind map of the conceptual framework. This guided the development of the psycho-educational programme. The content of the programme has already been described. In phase three the psycho-educational programme is implemented and in phase four the programme is evaluated. The psycho-educational programme taught the teenage girls skills and it provided them with knowledge to cope better with the bullying. Attending the programme made the teenagers aware that they needed to change to experience mental health and happiness. The empirical study took place in phase four. The data-gathering method in phase four included the conducting of semi-structured interviews with the adolescent girls who participated in the programme, as well as the teachers of these adolescent girls and their parents. Naïve sketches, reflective journals, observations made and field notes formed part of this database. The data was analyzed by means of Tesch‟s descriptive analysis (in Creswell, 2003:192). The participants had to comment on how they were coping after the implementation of the psycho-educational programme. In conclusion, an intervention in the form of the psycho-educational programme was shown to be beneficial to adolescent girls who were victims of bullying, to assist them in coping with the aftermath of being bullied. Recommendations were made to enhance nursing practice, as well as nursing education and nursing research. Keywords: Adolescent girls, bullying, secondary schools, advanced psychiatric nurse, psycho-educational programme, mental health.
- Full Text:
- Date Issued: 2012
- Authors: Jacobs, Ruwayda
- Date: 2012
- Subjects: Teenage girls -- Mental health -- South Africa , Psychoanalysis , Bullying
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9946 , http://hdl.handle.net/10948/d1014579
- Description: Bullying appears to be a worldwide phenomenon. It occurs within schools, homes, and in the community too. Bullying is a form of aggressive behaviour. Female bullying is not so easily noticed, as girls hardly ever use physical forms of aggression. Bullying can have a detrimental effect on the mental health of the victim. The victims of bullying experience symptoms of mental discomfort, which include low self esteem, feelings of helplessness, feelings of worthlessness and inferiority, lack of confidence, isolation, self-conscientiousness; and lastly, this can lead to suicide. Some form of intervention is necessary to provide adolescents with skills to combat bullying and help them to become mentally healthy again. The overall goal of the study was to develop, implement and evaluate a psycho-educational programme for female adolescents in a secondary school setting, in order to assist them in coping with bullying. The objectives of the research study were to: Conduct asituational analysis to identify the mental health needs of adolescent girls, as victimsof bullying. Develop a psycho-educational programme to facilitate the promotion of mental health of those adolescent girls who are victims of bullying. Implement the psycho-educational programme to facilitate coping by adolescent girls who are victims of bullying. Assess whether the adolescent girls have benefitted from attending the psycho-educational programme. The researcher used a qualitative, explorative, descriptive and contextual design. The research methodology consisted of four phases. In phase one of the research, a situational analysis was done; and the characteristics of mental discomfort exhibited by the victim were identified. The needs of the adolescent girl who has been bullied have already been described. Phase two involved the development of a psycho-educational programme. The information from the situational analysis was used to develop the conceptual framework. The six concepts in the survey list of Dickoff et al. (1968:422) were described as follows: the recipient is the adolescent girl who has been bullied, the agent is an advanced psychiatric nurse, the context is the community and the secondary school where bullying takes place, the dynamics of the intervention constitute the mental discomfort experienced by the adolescent girl. This is what motivates her to participate in the programme. The procedure was identified as the psycho-educational programme, while the terminus or outcome of the intervention for the adolescent girl would be for her to experience mental health after being exposed to the psycho-educational programme. The relationship between the concepts was used to form the mind map of the conceptual framework. This guided the development of the psycho-educational programme. The content of the programme has already been described. In phase three the psycho-educational programme is implemented and in phase four the programme is evaluated. The psycho-educational programme taught the teenage girls skills and it provided them with knowledge to cope better with the bullying. Attending the programme made the teenagers aware that they needed to change to experience mental health and happiness. The empirical study took place in phase four. The data-gathering method in phase four included the conducting of semi-structured interviews with the adolescent girls who participated in the programme, as well as the teachers of these adolescent girls and their parents. Naïve sketches, reflective journals, observations made and field notes formed part of this database. The data was analyzed by means of Tesch‟s descriptive analysis (in Creswell, 2003:192). The participants had to comment on how they were coping after the implementation of the psycho-educational programme. In conclusion, an intervention in the form of the psycho-educational programme was shown to be beneficial to adolescent girls who were victims of bullying, to assist them in coping with the aftermath of being bullied. Recommendations were made to enhance nursing practice, as well as nursing education and nursing research. Keywords: Adolescent girls, bullying, secondary schools, advanced psychiatric nurse, psycho-educational programme, mental health.
- Full Text:
- Date Issued: 2012
An assessment of the motivational value of rewards among health professionals in Malawi's Ministry of Health
- Chanza, Alfred Witness Dzanja
- Authors: Chanza, Alfred Witness Dzanja
- Date: 2012
- Subjects: Employee motivation -- Malawi , Medical personnel -- Salaries, etc. -- Malawi , Medical personnel -- Job satisfaction -- Malawi , Public health -- Malawi
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9963 , http://hdl.handle.net/10948/d1020330
- Description: The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.
- Full Text:
- Date Issued: 2012
- Authors: Chanza, Alfred Witness Dzanja
- Date: 2012
- Subjects: Employee motivation -- Malawi , Medical personnel -- Salaries, etc. -- Malawi , Medical personnel -- Job satisfaction -- Malawi , Public health -- Malawi
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9963 , http://hdl.handle.net/10948/d1020330
- Description: The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.
- Full Text:
- Date Issued: 2012
Development of a value based pricing index for new drugs in metastatic colorectal cancer
- Authors: Dranitsaris, George
- Date: 2012
- Subjects: Drug -- Prices , Prescription pricing , Pharmaceutical industry -- Prices
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10140 , http://hdl.handle.net/10948/d1009310 , Drug -- Prices , Prescription pricing , Pharmaceutical industry -- Prices
- Description: Background: Worldwide, prices for cancer drugs have been under downward pressure where several governments have mandated price cuts of branded and generic products. A better alternative to mandated price cuts would be the estimation of a launch price based on drug performance, cost effectiveness and a country’s ability to pay. In this study, the development of a global pricing index for new drugs that encompasses all of these attributes in patients with metastatic colorectal cancer (mCRC) is described. Methods: A pharmacoeconomic model was developed to simulate clinical outcomes in mCRC patients receiving chemotherapy with the addition of a “new drug” that improves survival by 1.4, 3 and 6 months. Cost and health state utility data were obtained from cancer centers and oncology nurses (total n=112) in Canada (n=24), Spain (n=24), India (n=24), South Africa (n=16) and Malaysia (n=24). A price per dose was estimated for each survival increment using a target value threshold of three times the per capita gross domestic product (GDP) for each country, as recommended by the World Health Organisation (WHO). Multivariable analysis was then used to develop the pricing index, which considers survival benefit, per capita GDP and income dispersion as measured by the Gini coefficient as predictor variables. Results: Higher survival benefits were associated with elevated drug prices, especially in wealthier countries such as Canada and Spain. For a nation like Argentina with a per capita GDP of $15,000 and a Gini coefficient of 51, it is estimated that for a drug which provides a 4 month survival benefit in mCRC, the value based price would be $US 630 per dose. In contrast, the same drug in a wealthier country like Norway could command a price of $US 2,775 and still be considered cost effective according to the WHO criteria. Conclusions: A global pricing index was presented that can be used to estimate a value based price in different countries for new drugs in mCRC. The application of this index to estimate a price based on cost effectiveness would be a good starting point for opening dialogue between the key stakeholders and a better alternative to governments’ mandated price cuts.
- Full Text:
- Date Issued: 2012
- Authors: Dranitsaris, George
- Date: 2012
- Subjects: Drug -- Prices , Prescription pricing , Pharmaceutical industry -- Prices
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10140 , http://hdl.handle.net/10948/d1009310 , Drug -- Prices , Prescription pricing , Pharmaceutical industry -- Prices
- Description: Background: Worldwide, prices for cancer drugs have been under downward pressure where several governments have mandated price cuts of branded and generic products. A better alternative to mandated price cuts would be the estimation of a launch price based on drug performance, cost effectiveness and a country’s ability to pay. In this study, the development of a global pricing index for new drugs that encompasses all of these attributes in patients with metastatic colorectal cancer (mCRC) is described. Methods: A pharmacoeconomic model was developed to simulate clinical outcomes in mCRC patients receiving chemotherapy with the addition of a “new drug” that improves survival by 1.4, 3 and 6 months. Cost and health state utility data were obtained from cancer centers and oncology nurses (total n=112) in Canada (n=24), Spain (n=24), India (n=24), South Africa (n=16) and Malaysia (n=24). A price per dose was estimated for each survival increment using a target value threshold of three times the per capita gross domestic product (GDP) for each country, as recommended by the World Health Organisation (WHO). Multivariable analysis was then used to develop the pricing index, which considers survival benefit, per capita GDP and income dispersion as measured by the Gini coefficient as predictor variables. Results: Higher survival benefits were associated with elevated drug prices, especially in wealthier countries such as Canada and Spain. For a nation like Argentina with a per capita GDP of $15,000 and a Gini coefficient of 51, it is estimated that for a drug which provides a 4 month survival benefit in mCRC, the value based price would be $US 630 per dose. In contrast, the same drug in a wealthier country like Norway could command a price of $US 2,775 and still be considered cost effective according to the WHO criteria. Conclusions: A global pricing index was presented that can be used to estimate a value based price in different countries for new drugs in mCRC. The application of this index to estimate a price based on cost effectiveness would be a good starting point for opening dialogue between the key stakeholders and a better alternative to governments’ mandated price cuts.
- Full Text:
- Date Issued: 2012
Histopathological changes in male wistar rats maintained on a water-based sutherlandia frutescens extract
- Authors: Wickens, Nicolas John
- Date: 2012
- Subjects: Rats -- Physiology , Rats as laboratory animals
- Language: English
- Type: Thesis , Doctoral , DTech
- Identifier: http://hdl.handle.net/10948/4742 , vital:20670
- Description: In this study a standardized 46 week chronic drinking water toxicity protocol was used to elucidate the toxic potential of Sutherlandia frutescens (S. frutescens) using histopathologic, morphometric and transmission electron microscopic analysis. The histopathologic changes in the duodenum, heart, kidney, liver, lung, pancreas and spleen of male Wistar rats were evaluated. Fifty-four rats were randomly divided into four groups: Group 1 – Normal diet control (ND control), n=7, Group 2 – Normal diet + plant extract (ND + p), n=9, Group 3 – High fat diet control (HFD control), n=19Group 4 – High fat diet + p (HFD + p), n=19In the high fat group male Wistar rats were fed ±55 g/day of a specialised high fat diet over a 46 week period to induce obesity and an insulin resistant state. The treatment groups (groups 2 and 4) received a dose concentration of a tea extract of the S. frutescens plant in their drinking water daily. This study showed that the consumption of S. frutescens significantly reduces weight gain in male Wistar rats on a chronic high fat diet (p≤0.001 vs. HFD control group). S. frutescens appears to propagate periportal and centrilobular glycogen storage in rat hepatocytes in the experimental groups as exemplified by a significantly (p≤0.0001 vs. control groups) increased incidences of Periodic Acid Schiff (PAS) positive staining S. frutescens also reduced intracellular lipid accumulation as made evident by the significantly lower incidence of epicardial adipose tissue (EAT), hepatic steatosis and pancreatic interstitial fat. Obesity was associated with increased fibrotic lesions such as myocardial perivascular fibrosis, centrilobular hepatic fibrosis and pancreatic periductal fibrosis. Obesity associated hypertension contributed to the widespread and significant increase in the average lesion severity of arterial congestion in all organs in the HFD control group. Pulmonary infection was equally prevalent in all rats. Despite the complex histopathology in all groups, differences in the control groups, such as, the presence of a conservative polymorphonuclear leukocyte (PMNL) infiltration, substantial intra-alveolar oedema and focal arterial wall hypertrophy in the control groups was highly suggestive of Sendai viral infection. However histopathologic evidence, in the treatment groups, suggested chronic recurrent viral infection with superimposed Mycoplasma pulmonis (M. pulmonis) bacterial infection. The impact of advanced suppurative pulmonary infection was widespread and exemplified by increased lesion incidences of spontaneous murine progressive cardiomyopathy (MCP) and spontaneous chronic progressive nephropathy (CPN) among others. In conclusion S. frutescens administered for 46 weeks to male Wistar rats significantly lowered intracellular lipid accumulation and obesity associated myocardial, renal, hepatobiliary, pulmonary and pancreatic histopathology. Moreover, duodenal, cardiovascular, hepatobiliary, pulmonary, renal, pancreatic and splenic tissue did not show histopathologic evidence of direct plant extract associated toxicity or carcinogenicity.
- Full Text:
- Date Issued: 2012
- Authors: Wickens, Nicolas John
- Date: 2012
- Subjects: Rats -- Physiology , Rats as laboratory animals
- Language: English
- Type: Thesis , Doctoral , DTech
- Identifier: http://hdl.handle.net/10948/4742 , vital:20670
- Description: In this study a standardized 46 week chronic drinking water toxicity protocol was used to elucidate the toxic potential of Sutherlandia frutescens (S. frutescens) using histopathologic, morphometric and transmission electron microscopic analysis. The histopathologic changes in the duodenum, heart, kidney, liver, lung, pancreas and spleen of male Wistar rats were evaluated. Fifty-four rats were randomly divided into four groups: Group 1 – Normal diet control (ND control), n=7, Group 2 – Normal diet + plant extract (ND + p), n=9, Group 3 – High fat diet control (HFD control), n=19Group 4 – High fat diet + p (HFD + p), n=19In the high fat group male Wistar rats were fed ±55 g/day of a specialised high fat diet over a 46 week period to induce obesity and an insulin resistant state. The treatment groups (groups 2 and 4) received a dose concentration of a tea extract of the S. frutescens plant in their drinking water daily. This study showed that the consumption of S. frutescens significantly reduces weight gain in male Wistar rats on a chronic high fat diet (p≤0.001 vs. HFD control group). S. frutescens appears to propagate periportal and centrilobular glycogen storage in rat hepatocytes in the experimental groups as exemplified by a significantly (p≤0.0001 vs. control groups) increased incidences of Periodic Acid Schiff (PAS) positive staining S. frutescens also reduced intracellular lipid accumulation as made evident by the significantly lower incidence of epicardial adipose tissue (EAT), hepatic steatosis and pancreatic interstitial fat. Obesity was associated with increased fibrotic lesions such as myocardial perivascular fibrosis, centrilobular hepatic fibrosis and pancreatic periductal fibrosis. Obesity associated hypertension contributed to the widespread and significant increase in the average lesion severity of arterial congestion in all organs in the HFD control group. Pulmonary infection was equally prevalent in all rats. Despite the complex histopathology in all groups, differences in the control groups, such as, the presence of a conservative polymorphonuclear leukocyte (PMNL) infiltration, substantial intra-alveolar oedema and focal arterial wall hypertrophy in the control groups was highly suggestive of Sendai viral infection. However histopathologic evidence, in the treatment groups, suggested chronic recurrent viral infection with superimposed Mycoplasma pulmonis (M. pulmonis) bacterial infection. The impact of advanced suppurative pulmonary infection was widespread and exemplified by increased lesion incidences of spontaneous murine progressive cardiomyopathy (MCP) and spontaneous chronic progressive nephropathy (CPN) among others. In conclusion S. frutescens administered for 46 weeks to male Wistar rats significantly lowered intracellular lipid accumulation and obesity associated myocardial, renal, hepatobiliary, pulmonary and pancreatic histopathology. Moreover, duodenal, cardiovascular, hepatobiliary, pulmonary, renal, pancreatic and splenic tissue did not show histopathologic evidence of direct plant extract associated toxicity or carcinogenicity.
- Full Text:
- Date Issued: 2012
Self-perceived professional identity of pharmacy educators
- Authors: Burton, Susan
- Date: 2012
- Subjects: Academic identity , Communities of practice , Identity (Philosophical concept) , Pharmacy -- Study and teaching , Pharmacy
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10139 , http://hdl.handle.net/10948/d1008352 , Academic identity , Communities of practice , Identity (Philosophical concept) , Pharmacy -- Study and teaching , Pharmacy
- Description: The philosophy of pharmaceutical care, which defines a patient-centred approach to practice, has been embraced and upheld by national and international pharmaceutical organisations for two decades. However, pharmacists have been slow to change their practice and implement a pharmaceutical care approach. It has been suggested that amongst other factors, short-comings in pharmaceutical education have contributed to this reluctance of the profession to transform practice. Efforts to address these short-comings in pharmaceutical education have focused on the curriculum and pedagogic practices, and not on the pharmacy educators themselves. Palmer (1998) asserts that “good teaching cannot be reduced to technique; good teaching comes from the identity and integrity of the teacher”. In essence, "we teach who we are" and good teachers have one common trait: “a strong sense of personal identity that infuses their work”. This study identified, described and analysed the self-perceived professional identities of pharmacy educators within the South African context. This included ascertaining factors and contexts which contributed to participants’ self-perception of their professional identity. In an effort to understand the influence the educators have on practice and on changing practice and vice-versa, the attitudes, beliefs and behaviours of participants regarding the philosophy and practice of pharmaceutical care, and pharmaceutical education were also explored. Situated within a constructivist-interpretive, qualitative paradigm and making use of methodological triangulation, this study was conducted in three phases, each employing a different qualitative method to collect data. The first phase made use of narrative analysis to gain an in-depth understanding of pharmacy educators’ perceived professional identities and to explore how their experiences, across various contexts, have formed their professional identities. In-depth individual narrative interviews were used to provide a forum in which the participants could reflect upon and tell their professional life-story. This phase of the study also made use of the exploration of metaphors to further investigate the participants’ professional identity and, more particularly, their images of themselves as “teacher” and role model for students. A maximum variation, purposeful sampling approach was used to recruit eight pharmacy academics - one from each school or faculty of pharmacy in South Africa, as participants in this phase of the study. The second and third phases explored more widely, the insights gained from the first phase and the formation of professional identity, attitudes, beliefs and practices of pharmacy educators in South Africa. Two focus groups were employed during the second phase and the study sample was broadened to include a further ten pharmacy educators. In the third phase, a purpose-designed, qualitative questionnaire was used to extend the study sample to all pharmacy educators in South Africa. A convenience sampling approach was used in both the second and third phases of the study. Thematic analysis and interpretation of the narrative interview and focus group transcripts and the questionnaire responses were conducted using qualitative data analysis software – Atlas.ti®. A multiplicity of self-perceived professional identities was described. However, all of these were multi-faceted and could be situated on a continuum between pharmacist identity on one end and academic identity on the other. In addition, six key determinants were recognised as underpinning the participants’ self-perception of their professional identity. These included three structural determinants: expected role; knowledge base; and practice, and three determinants relating to the emotional dimensions and agency of professional identity: professional status; passions; and satisfiers. The professional identity of the participants had been formed through membership of multiple pharmacy-related communities of practice and continued to be sustained through a nexus of multi-membership. There was extensive support by the participants for the concept of pharmaceutical care; however, it did not impact extensively on their role as pharmacy educators. Furthermore, many expressed concern around the use of the term ‘pharmaceutical care’: its definition; its lack of penetration into, and implementation within the practice environment; and even its relevance to the South African healthcare context. Many of the participants perceived the professional development of future pharmacists to be integral to their role as educators, and was often their source of greatest professional satisfaction. However, concern was also expressed at the dissonance that students were perceived to experience, sometimes, because of the incongruities that they are taught and what they experience in practice. This study has afforded pharmacy educators in South Africa an opportunity to understand better “who” they are as professionals, and to reflect on their role as educators and as role models for future pharmacist. Moreover, the findings contribute to a collective understanding of the professional identity of pharmacy educators and socialisation of pharmacy students into the profession. The insights and recommendations emerging from the study have the potential to make academic pharmacy a more attractive career choice which may have positive implications for the future attraction and retention of pharmacists to academic posts within universities.
- Full Text:
- Date Issued: 2012
- Authors: Burton, Susan
- Date: 2012
- Subjects: Academic identity , Communities of practice , Identity (Philosophical concept) , Pharmacy -- Study and teaching , Pharmacy
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10139 , http://hdl.handle.net/10948/d1008352 , Academic identity , Communities of practice , Identity (Philosophical concept) , Pharmacy -- Study and teaching , Pharmacy
- Description: The philosophy of pharmaceutical care, which defines a patient-centred approach to practice, has been embraced and upheld by national and international pharmaceutical organisations for two decades. However, pharmacists have been slow to change their practice and implement a pharmaceutical care approach. It has been suggested that amongst other factors, short-comings in pharmaceutical education have contributed to this reluctance of the profession to transform practice. Efforts to address these short-comings in pharmaceutical education have focused on the curriculum and pedagogic practices, and not on the pharmacy educators themselves. Palmer (1998) asserts that “good teaching cannot be reduced to technique; good teaching comes from the identity and integrity of the teacher”. In essence, "we teach who we are" and good teachers have one common trait: “a strong sense of personal identity that infuses their work”. This study identified, described and analysed the self-perceived professional identities of pharmacy educators within the South African context. This included ascertaining factors and contexts which contributed to participants’ self-perception of their professional identity. In an effort to understand the influence the educators have on practice and on changing practice and vice-versa, the attitudes, beliefs and behaviours of participants regarding the philosophy and practice of pharmaceutical care, and pharmaceutical education were also explored. Situated within a constructivist-interpretive, qualitative paradigm and making use of methodological triangulation, this study was conducted in three phases, each employing a different qualitative method to collect data. The first phase made use of narrative analysis to gain an in-depth understanding of pharmacy educators’ perceived professional identities and to explore how their experiences, across various contexts, have formed their professional identities. In-depth individual narrative interviews were used to provide a forum in which the participants could reflect upon and tell their professional life-story. This phase of the study also made use of the exploration of metaphors to further investigate the participants’ professional identity and, more particularly, their images of themselves as “teacher” and role model for students. A maximum variation, purposeful sampling approach was used to recruit eight pharmacy academics - one from each school or faculty of pharmacy in South Africa, as participants in this phase of the study. The second and third phases explored more widely, the insights gained from the first phase and the formation of professional identity, attitudes, beliefs and practices of pharmacy educators in South Africa. Two focus groups were employed during the second phase and the study sample was broadened to include a further ten pharmacy educators. In the third phase, a purpose-designed, qualitative questionnaire was used to extend the study sample to all pharmacy educators in South Africa. A convenience sampling approach was used in both the second and third phases of the study. Thematic analysis and interpretation of the narrative interview and focus group transcripts and the questionnaire responses were conducted using qualitative data analysis software – Atlas.ti®. A multiplicity of self-perceived professional identities was described. However, all of these were multi-faceted and could be situated on a continuum between pharmacist identity on one end and academic identity on the other. In addition, six key determinants were recognised as underpinning the participants’ self-perception of their professional identity. These included three structural determinants: expected role; knowledge base; and practice, and three determinants relating to the emotional dimensions and agency of professional identity: professional status; passions; and satisfiers. The professional identity of the participants had been formed through membership of multiple pharmacy-related communities of practice and continued to be sustained through a nexus of multi-membership. There was extensive support by the participants for the concept of pharmaceutical care; however, it did not impact extensively on their role as pharmacy educators. Furthermore, many expressed concern around the use of the term ‘pharmaceutical care’: its definition; its lack of penetration into, and implementation within the practice environment; and even its relevance to the South African healthcare context. Many of the participants perceived the professional development of future pharmacists to be integral to their role as educators, and was often their source of greatest professional satisfaction. However, concern was also expressed at the dissonance that students were perceived to experience, sometimes, because of the incongruities that they are taught and what they experience in practice. This study has afforded pharmacy educators in South Africa an opportunity to understand better “who” they are as professionals, and to reflect on their role as educators and as role models for future pharmacist. Moreover, the findings contribute to a collective understanding of the professional identity of pharmacy educators and socialisation of pharmacy students into the profession. The insights and recommendations emerging from the study have the potential to make academic pharmacy a more attractive career choice which may have positive implications for the future attraction and retention of pharmacists to academic posts within universities.
- Full Text:
- Date Issued: 2012
Core self-evaluations, racial evaluation and learning amongst Zulu students at the university of Zululand
- Authors: Dodd Nicole Marguerite
- Date: 2011
- Subjects: Zulu (African people) -- Ethnic identity , Self-evaluation , Ethnicity
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9879 , http://hdl.handle.net/10948/d1008398 , Zulu (African people) -- Ethnic identity , Self-evaluation , Ethnicity
- Description: Core Self-Evaluations [CSE] are a person’s estimation of his/her own worth and ability (Judge & Scott 2009). This in turn, is related to Racial Evaluation which is a person’s internal evaluation of his/her racial identity (Diller, 2010). The Employment Equity Act (55 of 1998) makes provision for the employment of equity candidates who can acquire skills in a reasonable amount of time. This requires individuals to be able to learn and then achieve in outcomes-based assessment. Core Self-Evaluations and Racial Evaluation can have an impact on how individuals perceive themselves, and how they perform in education, training and development (Hanley & Noblit, 2009). This study explored the relationship between Core Self-Evaluation, Racial Evaluation, Learning and Outcomes-Based Assessment using an experimental design. The Core Self-Evaluation scores in this study (n=230) were consistent with levels found internationally (Broucek, 2005). There was positive Racial Evaluation, with a relationship existing between Racial Evaluation and Core Self-Evaluations. This means that part of a person’s identity as an individual is related to Racial Evaluation, with that Racial Evaluation being positive amongst young Zulu students at the University of Zululand. There was a statistically significant, but small correlation between Learning and Core Self- Evaluation and a relationship was also found between CSE and Outcomes-Based Assessment results. When Core Self-Evaluation is higher, Learning tends to be more likely. The same pattern does not hold for Outcomes-Based Assessment results. Among Zulu students, lower CSE is linked to improved Outcomes-Based Assessment results. Racial Evaluation has a small relationship with CSE. However, efforts to remedy apartheid may be directed towards socio-economic development and need not focus on boosting Racial Evaluation when it comes to young Zulu adults.
- Full Text:
- Date Issued: 2011
- Authors: Dodd Nicole Marguerite
- Date: 2011
- Subjects: Zulu (African people) -- Ethnic identity , Self-evaluation , Ethnicity
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9879 , http://hdl.handle.net/10948/d1008398 , Zulu (African people) -- Ethnic identity , Self-evaluation , Ethnicity
- Description: Core Self-Evaluations [CSE] are a person’s estimation of his/her own worth and ability (Judge & Scott 2009). This in turn, is related to Racial Evaluation which is a person’s internal evaluation of his/her racial identity (Diller, 2010). The Employment Equity Act (55 of 1998) makes provision for the employment of equity candidates who can acquire skills in a reasonable amount of time. This requires individuals to be able to learn and then achieve in outcomes-based assessment. Core Self-Evaluations and Racial Evaluation can have an impact on how individuals perceive themselves, and how they perform in education, training and development (Hanley & Noblit, 2009). This study explored the relationship between Core Self-Evaluation, Racial Evaluation, Learning and Outcomes-Based Assessment using an experimental design. The Core Self-Evaluation scores in this study (n=230) were consistent with levels found internationally (Broucek, 2005). There was positive Racial Evaluation, with a relationship existing between Racial Evaluation and Core Self-Evaluations. This means that part of a person’s identity as an individual is related to Racial Evaluation, with that Racial Evaluation being positive amongst young Zulu students at the University of Zululand. There was a statistically significant, but small correlation between Learning and Core Self- Evaluation and a relationship was also found between CSE and Outcomes-Based Assessment results. When Core Self-Evaluation is higher, Learning tends to be more likely. The same pattern does not hold for Outcomes-Based Assessment results. Among Zulu students, lower CSE is linked to improved Outcomes-Based Assessment results. Racial Evaluation has a small relationship with CSE. However, efforts to remedy apartheid may be directed towards socio-economic development and need not focus on boosting Racial Evaluation when it comes to young Zulu adults.
- Full Text:
- Date Issued: 2011
Development and testing of liposome encapsulated cyclic dipeptides
- Authors: Kilian, Gareth
- Date: 2011
- Subjects: Peptide antibiotics , Peptide drugs -- Therapeutic use , Peptides -- Synthesis , Antibacterial agents -- Therapeutic use -- Testing , Cyclic peptides , Liposomes
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10136 , http://hdl.handle.net/10948/1397 , Peptide antibiotics , Peptide drugs -- Therapeutic use , Peptides -- Synthesis , Antibacterial agents -- Therapeutic use -- Testing , Cyclic peptides , Liposomes
- Description: Cyclic dipeptides have been well characterized for their multitude of biological activities, including antimicrobial and anticancer activities. Cyclo(His-Gly) and cyclo(His-Ala) have also recently been shown to possess significant anticancer activity against a range of cell lines, despite the limitations of these two molecules with respect to their physicochemical properties. Low Log P results in poor cell permeability which can often be problematic for drugs with intracellular mechanisms of action. It can also results in poor biodistribution, and theoretical Log P values for cyclo(His-Gly) and cyclo(His-Ala) were extremely low making them ideal candidates for inclusion into a nanoparticulate drug delivery system. The aim of this study was therefore to formulate and evaluate liposome-encapsulated cyclic dipeptides that increase the tumour-suppressive actions of the cyclic dipeptides, while showing a high degree of specificity for tumour cells. While liposomes are relatively simple to prepare, inter batch variation, low encapsulation and poor stability are often problematic in their production and this has lead to very few liposomal products on the market. This study aimed at using a comprehensive statistical methodology in optimizing liposome formulations encapsulating cyclo(His-Gly) and cyclo(His-Ala). Initial screening of potential factors was conducted using a 25-1 fractional factorial design. This design made use of two levels for each of the five factors and abbreviated the design to minimize runs. Although not much information is provided by these types of designs, the design was sufficient in identifying two critical factors that would be studies further in a more robust design. The two factors selected, based on the screening study, were cholesterol and stearylamine content. These two factors were then used in designing a response surface methodology (RSM) design making use of a central composite rotatable vii design (CCRD) at five levels (-1.5, -1, 0, 1, 1.5) for each factor in order to better understand the design space. Various factors influenced the measured responses of encapsulation efficiency, zeta potential, polydispersity index, cellular uptake and leakage, but most notable were the adverse effects of increasing stearylamine levels on encapsulations efficiency and cholesterol levels on leakage for both cyclo(His-Gly) and cyclo(His-Ala) liposomes. Optimized formulations were derived from the data and prepared. Fair correlation between the predicted and measured responses was obtained. The cytotoxic activity of the encapsulated cyclic dipeptides were assessed against HeLa and MCF-7 cells and found to have limited improvement in activity. However, modification of the polyethylene glycol (PEG) grafted to the liposome surface in order to target folate receptors showed good benefit in significantly decreasing the IC50 values recorded in all cells lines tested, particularly low folate HeLa cells with the lowest IC50 being recorded as 0.0962 mM for folate targeted cyclo(His-Ala). The results therefore indicate that hydrophilic cyclic dipeptides are ideal candidates for inclusion into targeted drug delivery systems such as liposomes. Key words: Liposomes, cyclo(His-Gly), cyclo(His-Ala), cyclic dipeptides, HeLa, MCF-7, folate receptors, factorial design, response surface methodology (RSM), central composite rotatable design (CCRD).
- Full Text:
- Date Issued: 2011
- Authors: Kilian, Gareth
- Date: 2011
- Subjects: Peptide antibiotics , Peptide drugs -- Therapeutic use , Peptides -- Synthesis , Antibacterial agents -- Therapeutic use -- Testing , Cyclic peptides , Liposomes
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:10136 , http://hdl.handle.net/10948/1397 , Peptide antibiotics , Peptide drugs -- Therapeutic use , Peptides -- Synthesis , Antibacterial agents -- Therapeutic use -- Testing , Cyclic peptides , Liposomes
- Description: Cyclic dipeptides have been well characterized for their multitude of biological activities, including antimicrobial and anticancer activities. Cyclo(His-Gly) and cyclo(His-Ala) have also recently been shown to possess significant anticancer activity against a range of cell lines, despite the limitations of these two molecules with respect to their physicochemical properties. Low Log P results in poor cell permeability which can often be problematic for drugs with intracellular mechanisms of action. It can also results in poor biodistribution, and theoretical Log P values for cyclo(His-Gly) and cyclo(His-Ala) were extremely low making them ideal candidates for inclusion into a nanoparticulate drug delivery system. The aim of this study was therefore to formulate and evaluate liposome-encapsulated cyclic dipeptides that increase the tumour-suppressive actions of the cyclic dipeptides, while showing a high degree of specificity for tumour cells. While liposomes are relatively simple to prepare, inter batch variation, low encapsulation and poor stability are often problematic in their production and this has lead to very few liposomal products on the market. This study aimed at using a comprehensive statistical methodology in optimizing liposome formulations encapsulating cyclo(His-Gly) and cyclo(His-Ala). Initial screening of potential factors was conducted using a 25-1 fractional factorial design. This design made use of two levels for each of the five factors and abbreviated the design to minimize runs. Although not much information is provided by these types of designs, the design was sufficient in identifying two critical factors that would be studies further in a more robust design. The two factors selected, based on the screening study, were cholesterol and stearylamine content. These two factors were then used in designing a response surface methodology (RSM) design making use of a central composite rotatable vii design (CCRD) at five levels (-1.5, -1, 0, 1, 1.5) for each factor in order to better understand the design space. Various factors influenced the measured responses of encapsulation efficiency, zeta potential, polydispersity index, cellular uptake and leakage, but most notable were the adverse effects of increasing stearylamine levels on encapsulations efficiency and cholesterol levels on leakage for both cyclo(His-Gly) and cyclo(His-Ala) liposomes. Optimized formulations were derived from the data and prepared. Fair correlation between the predicted and measured responses was obtained. The cytotoxic activity of the encapsulated cyclic dipeptides were assessed against HeLa and MCF-7 cells and found to have limited improvement in activity. However, modification of the polyethylene glycol (PEG) grafted to the liposome surface in order to target folate receptors showed good benefit in significantly decreasing the IC50 values recorded in all cells lines tested, particularly low folate HeLa cells with the lowest IC50 being recorded as 0.0962 mM for folate targeted cyclo(His-Ala). The results therefore indicate that hydrophilic cyclic dipeptides are ideal candidates for inclusion into targeted drug delivery systems such as liposomes. Key words: Liposomes, cyclo(His-Gly), cyclo(His-Ala), cyclic dipeptides, HeLa, MCF-7, folate receptors, factorial design, response surface methodology (RSM), central composite rotatable design (CCRD).
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- Date Issued: 2011