Optimisation of pharmacological management of diabetes mellitus in a primary health care setting
- Authors: Dickason, Beverley Janine
- Date: 2007
- Subjects: Diabetes , Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10161 , http://hdl.handle.net/10948/846 , http://hdl.handle.net/10948/d1012902 , Diabetes , Diabetes -- Treatment
- Description: Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
- Full Text:
- Date Issued: 2007
- Authors: Dickason, Beverley Janine
- Date: 2007
- Subjects: Diabetes , Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10161 , http://hdl.handle.net/10948/846 , http://hdl.handle.net/10948/d1012902 , Diabetes , Diabetes -- Treatment
- Description: Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
- Full Text:
- Date Issued: 2007
Perceptions of selected beneficiaries regarding government grants for sustainable development projects
- Authors: Gwam, Zukiswa Sylvia
- Date: 2007
- Subjects: Sustainable development -- South Africa , Government aid -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9989 , http://hdl.handle.net/10948/517 , Sustainable development -- South Africa , Government aid -- South Africa
- Description: The overall aim of the study was to explore and describe the perceptions of beneficiaries of government grants for the sustainability of development projects. A qualitative method was used following an explorative and descriptive design, as the researcher seeks to understand paradigm shifts from a welfare perspective to a developmental perspective. The qualitative approach is most suitable when the aim of the researcher is to understand a phenomenon from the point of view of participants (Creswell, 1998:17) and to elicit thought processes and feelings (Straus and Corbin, 1998:11). The methods of data collection included in-depth semi-structured interviews, field notes as well as the use of focus groups. The semi-structured interviews allowed the researcher to ask specific questions in an open-ended manner when necessary. Data analysis was done according to Tesch’s eight steps for analyzing qualitative research data (Creswell, 1994: 154-155). Guba’s model was used to assess the trustworthiness of research findings for ensuring trustworthiness in qualitative research (Krefting, 1990: 214-222). It is envisaged that this study will provide insights into the perceptions of beneficiaries of government social development grants. Findings indicate that a great deal of skills development for sustainability of development projects is needed, and will be used for further research in the area of social development.
- Full Text:
- Date Issued: 2007
- Authors: Gwam, Zukiswa Sylvia
- Date: 2007
- Subjects: Sustainable development -- South Africa , Government aid -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9989 , http://hdl.handle.net/10948/517 , Sustainable development -- South Africa , Government aid -- South Africa
- Description: The overall aim of the study was to explore and describe the perceptions of beneficiaries of government grants for the sustainability of development projects. A qualitative method was used following an explorative and descriptive design, as the researcher seeks to understand paradigm shifts from a welfare perspective to a developmental perspective. The qualitative approach is most suitable when the aim of the researcher is to understand a phenomenon from the point of view of participants (Creswell, 1998:17) and to elicit thought processes and feelings (Straus and Corbin, 1998:11). The methods of data collection included in-depth semi-structured interviews, field notes as well as the use of focus groups. The semi-structured interviews allowed the researcher to ask specific questions in an open-ended manner when necessary. Data analysis was done according to Tesch’s eight steps for analyzing qualitative research data (Creswell, 1994: 154-155). Guba’s model was used to assess the trustworthiness of research findings for ensuring trustworthiness in qualitative research (Krefting, 1990: 214-222). It is envisaged that this study will provide insights into the perceptions of beneficiaries of government social development grants. Findings indicate that a great deal of skills development for sustainability of development projects is needed, and will be used for further research in the area of social development.
- Full Text:
- Date Issued: 2007
Physical characteristics as performance indicators in surfing
- Hayselden, Kirsten Jacqui-Anne
- Authors: Hayselden, Kirsten Jacqui-Anne
- Date: 2007
- Subjects: Surfing -- South Africa , Athletic ability , Physical fitness -- Testing
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10097 , http://hdl.handle.net/10948/662 , Surfing -- South Africa , Athletic ability , Physical fitness -- Testing
- Description: The aim of this study was to identify indictors of performance in surfing. Therefore the objectives of the study were to determine the following: {u100085} Anthropometric measures such as: height, weight, body proportions; {u100085} Flexibility measures such as: back extension, hip flexion, ankle plantarflexion and dorsiflexion; {u100085} Core stability; {u100085} Dynamic balance; {u100085} Explosive leg power; {u100085} Which of the physical characteristics measured discriminate between elite and non-elite surfers. To achieve the aim and objectives of this study, the literature pertaining to excellence in surfing, and the theory surrounding talent identification and the many factors that can contribute to success in sport, were reviewed. Potential criteria important for performance in surfing were identified and appropriate tests to assess these criteria were selected. An ex post facto quasi experimental design was used to assess which of the identified criteria best discriminated between elite and non-elite surfboard riders. The test battery included a personal information questionnaire and the assessment of: anthropometric variables, flexibility, core stability, dynamic balance and explosive leg power. These abovementioned physical characteristics were identified from the literature as the factors most important to success in surfing. Fifty five (55) surfers were assessed of which 28 were elite surfers and 27 were non-elite surfers. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences tested for statistical and practical significance. The variables of height, age started surfing, core stability, dynamic balance, number of days surfed per week and number of hours surfed per day were found to most discriminate between the elite and non-elite participants. Finally, a stepwise discriminant analysis was used to determine classification functions that could be used for future prediction purposes. The variables included in the discriminant analyses included height, age started surfing, number of years surfing, core stability and dynamic balance. To verify the prediction model a jack-knife procedure was performed. The results from the jack-knife procedure indicated that 85.5 perecent of the entire sample was correctly classified while 92.9 percent of the elite sample and 77.8 percent of the non-elite sample were correctly classified. Thus, the discriminant functions obtained can be used for predictive purposes.
- Full Text:
- Date Issued: 2007
- Authors: Hayselden, Kirsten Jacqui-Anne
- Date: 2007
- Subjects: Surfing -- South Africa , Athletic ability , Physical fitness -- Testing
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10097 , http://hdl.handle.net/10948/662 , Surfing -- South Africa , Athletic ability , Physical fitness -- Testing
- Description: The aim of this study was to identify indictors of performance in surfing. Therefore the objectives of the study were to determine the following: {u100085} Anthropometric measures such as: height, weight, body proportions; {u100085} Flexibility measures such as: back extension, hip flexion, ankle plantarflexion and dorsiflexion; {u100085} Core stability; {u100085} Dynamic balance; {u100085} Explosive leg power; {u100085} Which of the physical characteristics measured discriminate between elite and non-elite surfers. To achieve the aim and objectives of this study, the literature pertaining to excellence in surfing, and the theory surrounding talent identification and the many factors that can contribute to success in sport, were reviewed. Potential criteria important for performance in surfing were identified and appropriate tests to assess these criteria were selected. An ex post facto quasi experimental design was used to assess which of the identified criteria best discriminated between elite and non-elite surfboard riders. The test battery included a personal information questionnaire and the assessment of: anthropometric variables, flexibility, core stability, dynamic balance and explosive leg power. These abovementioned physical characteristics were identified from the literature as the factors most important to success in surfing. Fifty five (55) surfers were assessed of which 28 were elite surfers and 27 were non-elite surfers. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences tested for statistical and practical significance. The variables of height, age started surfing, core stability, dynamic balance, number of days surfed per week and number of hours surfed per day were found to most discriminate between the elite and non-elite participants. Finally, a stepwise discriminant analysis was used to determine classification functions that could be used for future prediction purposes. The variables included in the discriminant analyses included height, age started surfing, number of years surfing, core stability and dynamic balance. To verify the prediction model a jack-knife procedure was performed. The results from the jack-knife procedure indicated that 85.5 perecent of the entire sample was correctly classified while 92.9 percent of the elite sample and 77.8 percent of the non-elite sample were correctly classified. Thus, the discriminant functions obtained can be used for predictive purposes.
- Full Text:
- Date Issued: 2007
Postnatal women's experiences of the prevention of mother-to-child transmittion of HIV programme
- Authors: Links, Nomvuyiseko
- Date: 2007
- Subjects: AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10042 , http://hdl.handle.net/10948/545 , http://hdl.handle.net/10948/d1011704 , AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Description: This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.
- Full Text:
- Date Issued: 2007
- Authors: Links, Nomvuyiseko
- Date: 2007
- Subjects: AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10042 , http://hdl.handle.net/10948/545 , http://hdl.handle.net/10948/d1011704 , AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Description: This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.
- Full Text:
- Date Issued: 2007
Referral of pregnant women from district hospitals to a reigonal hospital in the Eastern Cape Province
- Authors: Mugerwa-Sekawabe, Edward
- Date: 2007
- Subjects: Medical referral -- South Africa -- Eastern Cape , Medical referral
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10002 , http://hdl.handle.net/10948/831 , Medical referral -- South Africa -- Eastern Cape , Medical referral
- Description: There is a perception that some of the pregnant women referred from district to regional hospitals should have been managed at the former hospitals. To establish the truth of this perception, a quantitative, exploratory, descriptive and contextual study was undertaken to determine to what extent pregnant women admitted to a regional hospital are appropriately referred from district hospitals according to criteria described in the Guidelines for Maternity Care in South Africa and in the Primary Health Care Package for South Africa. Maternity case records of two hundred and eighty pregnant women admitted to a regional hospital in the Eastern Cape Province following referral from district hospitals between 1 July 2005 and 31 December 2005 were reviewed and analysed. The majority of these women were referred for medical complications, previous caesarean section, failure to progress in labour, obstructed labour, preterm baby and eclampsia. The commonest reasons cited for the transfer of these patients were shortage of maternity care providers in maternity units and lack of expertise at district hospital level. A lack of drugs and equipment were less commonly cited as the reason. Criteria for referral from district to regional hospitals were fulfilled in only 78 (34.2%) of the referrals. This low level of fulfillment of the criteria is attributed to the apparent lack of feedback processes between district and regional hospitals. This in turn limits the opportunity to develop competencies and skills of staff at these maternity units. To address this issue a referral strategy for implementation in the Eastern Cape Province was developed and presented in this study.
- Full Text:
- Date Issued: 2007
- Authors: Mugerwa-Sekawabe, Edward
- Date: 2007
- Subjects: Medical referral -- South Africa -- Eastern Cape , Medical referral
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10002 , http://hdl.handle.net/10948/831 , Medical referral -- South Africa -- Eastern Cape , Medical referral
- Description: There is a perception that some of the pregnant women referred from district to regional hospitals should have been managed at the former hospitals. To establish the truth of this perception, a quantitative, exploratory, descriptive and contextual study was undertaken to determine to what extent pregnant women admitted to a regional hospital are appropriately referred from district hospitals according to criteria described in the Guidelines for Maternity Care in South Africa and in the Primary Health Care Package for South Africa. Maternity case records of two hundred and eighty pregnant women admitted to a regional hospital in the Eastern Cape Province following referral from district hospitals between 1 July 2005 and 31 December 2005 were reviewed and analysed. The majority of these women were referred for medical complications, previous caesarean section, failure to progress in labour, obstructed labour, preterm baby and eclampsia. The commonest reasons cited for the transfer of these patients were shortage of maternity care providers in maternity units and lack of expertise at district hospital level. A lack of drugs and equipment were less commonly cited as the reason. Criteria for referral from district to regional hospitals were fulfilled in only 78 (34.2%) of the referrals. This low level of fulfillment of the criteria is attributed to the apparent lack of feedback processes between district and regional hospitals. This in turn limits the opportunity to develop competencies and skills of staff at these maternity units. To address this issue a referral strategy for implementation in the Eastern Cape Province was developed and presented in this study.
- Full Text:
- Date Issued: 2007
Resilience in families living with a Type I diabetic child
- Authors: Coetzee, Mariska
- Date: 2007
- Subjects: Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9922 , http://hdl.handle.net/10948/665 , Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Description: Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.
- Full Text:
- Date Issued: 2007
- Authors: Coetzee, Mariska
- Date: 2007
- Subjects: Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9922 , http://hdl.handle.net/10948/665 , Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Description: Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.
- Full Text:
- Date Issued: 2007
Resilience in families where a member is living with schizophrenia
- Authors: Haddad, Jason
- Date: 2007
- Subjects: Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9928 , http://hdl.handle.net/10948/654 , Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Description: Schizophrenia cuts across all racial, gender, and socioeconomic lines. Schizophrenia affects 1 percent of the population in Ireland: 35000 people (Schultz & Andreason, 1999); and affects 1.4 - 4.6 percent per 1000 people in the USA: 2.8 million - 9.8 million people (Jabelensky, 2004). In South Africa the figure is approximately 1 percent of the population or 500 000 people (Nicholas, Malcolm, Krosigk & Pillay, 2003). The median age of onset is 21.4 years for men and 26.8 years for women (Daubenton & van Rensburg, 2001), with only 10-20 percent recovering fully after the first psychotic episode (Saddock & Saddock, 2003). The schizophrenic patient is often unable to continue life as before diagnosis, and may progressively need more care as the years pass. Deinstitutionalization over the course of a number of decades has resulted in responsibility for care of mentally-ill individuals shifting to the individual’s family. The struggles faced by such a family can be overwhelming as they struggle with this responsibilty due to lack of training, lack of knowledge and insufficient professional support (Winefield & Harvey, 1994). The stress on the caregivers is often magnified as their support structures around them may ‘shut down’ out of fear of the schizophrenic illness (Williams & Mfoafo-M’Carthy, 2006). The characteristic symptoms used to define schizophrenia include various forms of delusions, hallucinations, thought disorders and abnormalities in emotional expression, social interaction, attention, volition and drives. The functional decline of the schizophrenic individual leads not only to social difficulties, but also economic difficulties that may cripple a family (Fadden, Bebbington & Kuipers, 1987). When first diagnosed, some families may be so overwhelmed by the ‘label’ given to their family member, that they see little hope or way to move forward. One explanation is offered by an American psychiatrist whose own son was diagnosed with schizophrenia, “We experience this terrible feeling of loss and grief for the son we knew. There is also this terrible loss of expectations. We feel cheated out of watching him mature…it is a mourning without end because, of course, Gary is not dead at all. He is very much still with us, seeming eternally twelve years old, needing constant care and attention” (Willick, 1994, p.14). Providing such care is associated with high levels of distress. Accordingly, much attention has been given to understanding the pressures faced by family members, with the hope of understanding how coping resources may be strengthened to sustain these care-giving relationships (Harvey, Burns, Fahy, Manley & Tattan, 2001). However, despite gains in understanding the needs of a schizophrenic family member once out of the hospital environment, care-giving relationships can still break down. The individual with the illness is often left more vulnerable to relapse, recurrent hospitalizations, homelessness and other negative outcomes (Jewel & Stein, 2002). The stress of not only interacting with the afflicted family member, but also with the grief associated with the illness, places an incredible strain on the day-to-day functioning of that family (Pollio, North, Reid, Miletic & McClendon, 2006). From the brief review provided, it is evident that research has been conducted regarding the stressors, strains and difficulties of caregivers of schizophrenic family members. However, the strengths of these families are under-investigated, and the current study will attempt to start filling this void.
- Full Text:
- Date Issued: 2007
- Authors: Haddad, Jason
- Date: 2007
- Subjects: Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9928 , http://hdl.handle.net/10948/654 , Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Description: Schizophrenia cuts across all racial, gender, and socioeconomic lines. Schizophrenia affects 1 percent of the population in Ireland: 35000 people (Schultz & Andreason, 1999); and affects 1.4 - 4.6 percent per 1000 people in the USA: 2.8 million - 9.8 million people (Jabelensky, 2004). In South Africa the figure is approximately 1 percent of the population or 500 000 people (Nicholas, Malcolm, Krosigk & Pillay, 2003). The median age of onset is 21.4 years for men and 26.8 years for women (Daubenton & van Rensburg, 2001), with only 10-20 percent recovering fully after the first psychotic episode (Saddock & Saddock, 2003). The schizophrenic patient is often unable to continue life as before diagnosis, and may progressively need more care as the years pass. Deinstitutionalization over the course of a number of decades has resulted in responsibility for care of mentally-ill individuals shifting to the individual’s family. The struggles faced by such a family can be overwhelming as they struggle with this responsibilty due to lack of training, lack of knowledge and insufficient professional support (Winefield & Harvey, 1994). The stress on the caregivers is often magnified as their support structures around them may ‘shut down’ out of fear of the schizophrenic illness (Williams & Mfoafo-M’Carthy, 2006). The characteristic symptoms used to define schizophrenia include various forms of delusions, hallucinations, thought disorders and abnormalities in emotional expression, social interaction, attention, volition and drives. The functional decline of the schizophrenic individual leads not only to social difficulties, but also economic difficulties that may cripple a family (Fadden, Bebbington & Kuipers, 1987). When first diagnosed, some families may be so overwhelmed by the ‘label’ given to their family member, that they see little hope or way to move forward. One explanation is offered by an American psychiatrist whose own son was diagnosed with schizophrenia, “We experience this terrible feeling of loss and grief for the son we knew. There is also this terrible loss of expectations. We feel cheated out of watching him mature…it is a mourning without end because, of course, Gary is not dead at all. He is very much still with us, seeming eternally twelve years old, needing constant care and attention” (Willick, 1994, p.14). Providing such care is associated with high levels of distress. Accordingly, much attention has been given to understanding the pressures faced by family members, with the hope of understanding how coping resources may be strengthened to sustain these care-giving relationships (Harvey, Burns, Fahy, Manley & Tattan, 2001). However, despite gains in understanding the needs of a schizophrenic family member once out of the hospital environment, care-giving relationships can still break down. The individual with the illness is often left more vulnerable to relapse, recurrent hospitalizations, homelessness and other negative outcomes (Jewel & Stein, 2002). The stress of not only interacting with the afflicted family member, but also with the grief associated with the illness, places an incredible strain on the day-to-day functioning of that family (Pollio, North, Reid, Miletic & McClendon, 2006). From the brief review provided, it is evident that research has been conducted regarding the stressors, strains and difficulties of caregivers of schizophrenic family members. However, the strengths of these families are under-investigated, and the current study will attempt to start filling this void.
- Full Text:
- Date Issued: 2007
Service provider's perceptions of the quality and accessiblity of health services under social health insurance in Dar-Es-Salaam
- Authors: Chomi, Eunice Nahyuha
- Date: 2007
- Subjects: Health insurance -- Tanzania , Medical personnel -- Insurance requirements -- Tanzania
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10079 , http://hdl.handle.net/10948/489 , Health insurance -- Tanzania , Medical personnel -- Insurance requirements -- Tanzania
- Description: Social health insurance is a form of health care financing that has gained increased attention in African countries in the past decade. Tanzania introduced social health insurance by the establishment of the National Health Insurance Fund (NHIF) in 1999 with, inter alia, the objective of improvement of the quality and availability of health services. The goal of this study was to determine the perceptions of services providers on the quality and accessibility of health services following the introduction of social health insurance. A qualitative approach was used to gain an insider's perspective from the service providers of how the services have changed following the introduction of the scheme. Individual interviews, observation and field notes were used to gather information on the quality and accessibility of health services under the policy of social health insurance. Data were analysed using Tesch's method of data analysis. The health workers generally perceived the fund as being beneficial to its members as it reduced the financial barriers to receiving health care. However, the objectives of the NHIF as a health financing mechanism were not adequately understood by the health workers. Although they perceived the quality of health services as having improved compared to previous years, they did not associate this improvement with the NHIF. The health workers also perceived accessibility of health services as having improved for insured patients but not for non-insured patients.
- Full Text:
- Date Issued: 2007
- Authors: Chomi, Eunice Nahyuha
- Date: 2007
- Subjects: Health insurance -- Tanzania , Medical personnel -- Insurance requirements -- Tanzania
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10079 , http://hdl.handle.net/10948/489 , Health insurance -- Tanzania , Medical personnel -- Insurance requirements -- Tanzania
- Description: Social health insurance is a form of health care financing that has gained increased attention in African countries in the past decade. Tanzania introduced social health insurance by the establishment of the National Health Insurance Fund (NHIF) in 1999 with, inter alia, the objective of improvement of the quality and availability of health services. The goal of this study was to determine the perceptions of services providers on the quality and accessibility of health services following the introduction of social health insurance. A qualitative approach was used to gain an insider's perspective from the service providers of how the services have changed following the introduction of the scheme. Individual interviews, observation and field notes were used to gather information on the quality and accessibility of health services under the policy of social health insurance. Data were analysed using Tesch's method of data analysis. The health workers generally perceived the fund as being beneficial to its members as it reduced the financial barriers to receiving health care. However, the objectives of the NHIF as a health financing mechanism were not adequately understood by the health workers. Although they perceived the quality of health services as having improved compared to previous years, they did not associate this improvement with the NHIF. The health workers also perceived accessibility of health services as having improved for insured patients but not for non-insured patients.
- Full Text:
- Date Issued: 2007
Social workers' experiences of HIV and AIDS intervention in Botswana
- Authors: Kesamang, Lefhoko
- Date: 2007
- Subjects: AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9987 , http://hdl.handle.net/10948/532 , AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Description: This study endeavoured to explore and describe the experiences of social workers in their intervention with HIV and AIDS clients within the Department of Clinical Services of the Ministry of Health in Botswana. The researcher undertook a qualitative research study, using an exploratory, descriptive and contextual design to explore these experiences as perceived by the social workers. The method of data collection included semi-structured face-to-face interviews, as this was deemed most appropriate to the nature of the study. Data analysis was undertaken according to the outline of Tesch (1990), as stated in Creswell (1994:155). The findings were reported as themes, sub-themes and categories emanating from the data-analysis process. In ensuring the trustworthiness of the findings, the researcher adhered to Guba’s (1981) model (in Krefting, 1991:251). The research findings were subjected to a literature control, and culminated in the compiling of the research report. The research findings centred around the following five themes: · experiences of intervention with HIV and AIDS clients; · challenges in HIV and AIDS intervention; · measures to alleviate challenges of HIV and AIDS intervention; · intervention strategies utilised by social workers; and · suggestions and advice to new social workers. The recommendations resulting from this research project proposed inter alia that social workers need to be trained in specific and specialised areas related to HIV and AIDS intervention in the health setting, and that the support structures and a holistic multidisciplinary service delivery approach need to be put in place to assist social workers to be able to meet the needs of the clients as well as their own needs. Key Words: participants, clients/patient, qualitative, HIV and AIDS, experiences, intervention, strategies.
- Full Text:
- Date Issued: 2007
- Authors: Kesamang, Lefhoko
- Date: 2007
- Subjects: AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9987 , http://hdl.handle.net/10948/532 , AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Description: This study endeavoured to explore and describe the experiences of social workers in their intervention with HIV and AIDS clients within the Department of Clinical Services of the Ministry of Health in Botswana. The researcher undertook a qualitative research study, using an exploratory, descriptive and contextual design to explore these experiences as perceived by the social workers. The method of data collection included semi-structured face-to-face interviews, as this was deemed most appropriate to the nature of the study. Data analysis was undertaken according to the outline of Tesch (1990), as stated in Creswell (1994:155). The findings were reported as themes, sub-themes and categories emanating from the data-analysis process. In ensuring the trustworthiness of the findings, the researcher adhered to Guba’s (1981) model (in Krefting, 1991:251). The research findings were subjected to a literature control, and culminated in the compiling of the research report. The research findings centred around the following five themes: · experiences of intervention with HIV and AIDS clients; · challenges in HIV and AIDS intervention; · measures to alleviate challenges of HIV and AIDS intervention; · intervention strategies utilised by social workers; and · suggestions and advice to new social workers. The recommendations resulting from this research project proposed inter alia that social workers need to be trained in specific and specialised areas related to HIV and AIDS intervention in the health setting, and that the support structures and a holistic multidisciplinary service delivery approach need to be put in place to assist social workers to be able to meet the needs of the clients as well as their own needs. Key Words: participants, clients/patient, qualitative, HIV and AIDS, experiences, intervention, strategies.
- Full Text:
- Date Issued: 2007
Social workers' experiences on the transformation of social welfare from a remedial approach to a developmental approach
- Authors: Mashigo, Boipuso Stephina
- Date: 2007
- Subjects: Social service -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9990 , http://hdl.handle.net/10948/559 , Social service -- South Africa
- Description: When the new democratic government came into power, much legislation, policies and strategies were transformed, included was the welfare system that was imbalanced, unjust, discriminatory and inappropriate. It was replaced by a developmental approach that is more just, equitable and appropriate system contained in the White Paper for Social Welfare (1997). Social workers were expected to reform their method of intervention. Consequently, this study will focus on the experiences of social workers as changes were brought into the approaches used in service delivery. The goal of the study is to explore and describe social workers’ experiences on the transformation of social welfare from a traditional remedial approach to a developmental approach. The study was conducted using the qualitative research approach. The research study made use of an explorative, descriptive and contextual design. The researcher used purposive and theoretical non-probability sampling methods to draw the sample. Data was collected through semi- structured interviews. The data was analyzed using Tesch’s eight steps in Creswell (1994:155) and was verified against four criteria that Guba in (Krefting, 1991) developed for testing the trustworthiness of a qualitative study. Based on the findings and conclusion of the study, recommendations were made to the management of the department of social development on how to address the challenges facing social workers on the implementation of the developmental approach. The results will be disseminated by means of a written research report.
- Full Text:
- Date Issued: 2007
- Authors: Mashigo, Boipuso Stephina
- Date: 2007
- Subjects: Social service -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9990 , http://hdl.handle.net/10948/559 , Social service -- South Africa
- Description: When the new democratic government came into power, much legislation, policies and strategies were transformed, included was the welfare system that was imbalanced, unjust, discriminatory and inappropriate. It was replaced by a developmental approach that is more just, equitable and appropriate system contained in the White Paper for Social Welfare (1997). Social workers were expected to reform their method of intervention. Consequently, this study will focus on the experiences of social workers as changes were brought into the approaches used in service delivery. The goal of the study is to explore and describe social workers’ experiences on the transformation of social welfare from a traditional remedial approach to a developmental approach. The study was conducted using the qualitative research approach. The research study made use of an explorative, descriptive and contextual design. The researcher used purposive and theoretical non-probability sampling methods to draw the sample. Data was collected through semi- structured interviews. The data was analyzed using Tesch’s eight steps in Creswell (1994:155) and was verified against four criteria that Guba in (Krefting, 1991) developed for testing the trustworthiness of a qualitative study. Based on the findings and conclusion of the study, recommendations were made to the management of the department of social development on how to address the challenges facing social workers on the implementation of the developmental approach. The results will be disseminated by means of a written research report.
- Full Text:
- Date Issued: 2007
Subtle racism amongst undergraduate learners after a decade of democracy
- Authors: Van der Westhuizen, Amanda
- Date: 2007
- Subjects: Racism in higher education -- South Africa -- Nelson Mandela Bay , Intergroup relations , Social interaction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9954 , http://hdl.handle.net/10948/d1018820
- Description: The concept of “race” has been the organising feature of South African society for more than three centuries. More recent social changes in the United States of America, Europe, Australia, and South Africa have lead to more subtle expressions of racism. The present study aimed to explore and describe subtle racism amongst undergraduate psychology learners at a tertiary institution in Nelson Mandela Metropolitan Municipality in 2004. The Subtle Racism Scale was used to measure anti-Black sentiment among a sample of 286 undergraduate psychology learners, obtained through non–probability, convenience sampling. Multiple regression analysis revealed the independent variables of race, age, and the race-age interaction were significantly associated with subtle racism of the participants. Research results demonstrated that participants’ level of estimated subtle racism varied according to the age and race of the participants, supporting the notion that racism in South Africa did not influence different age and race groups in a uniform manner.
- Full Text:
- Date Issued: 2007
- Authors: Van der Westhuizen, Amanda
- Date: 2007
- Subjects: Racism in higher education -- South Africa -- Nelson Mandela Bay , Intergroup relations , Social interaction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9954 , http://hdl.handle.net/10948/d1018820
- Description: The concept of “race” has been the organising feature of South African society for more than three centuries. More recent social changes in the United States of America, Europe, Australia, and South Africa have lead to more subtle expressions of racism. The present study aimed to explore and describe subtle racism amongst undergraduate psychology learners at a tertiary institution in Nelson Mandela Metropolitan Municipality in 2004. The Subtle Racism Scale was used to measure anti-Black sentiment among a sample of 286 undergraduate psychology learners, obtained through non–probability, convenience sampling. Multiple regression analysis revealed the independent variables of race, age, and the race-age interaction were significantly associated with subtle racism of the participants. Research results demonstrated that participants’ level of estimated subtle racism varied according to the age and race of the participants, supporting the notion that racism in South Africa did not influence different age and race groups in a uniform manner.
- Full Text:
- Date Issued: 2007
The coping resources and subjective well-being of dual-career Hindu mothers
- Authors: Prag, Hanita T
- Date: 2007
- Subjects: Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9932 , http://hdl.handle.net/10948/593 , Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Description: With the increasing number of women entering the labour force internationally, the role of women is changing. Consequently, researchers are pressed to investigate how females of all cultures balance their work and family responsibilities. Amongst Hindu couples, this issue can either be a source of tension or positive support. An overview of literature indicates that the psychological aspects of dual-career Hindu women have received little attention in South Africa. The current study aimed to explore and describe coping resources and the subjective well-being of full-time employed Hindu mothers. The study took the form of a non-experimental exploratory-descriptive design. Participants were selected through nonprobability convenience sampling. The sample of the study consisted of sixty full-time employed Hindu mothers between the ages of 25 and 45 years of age who had at least one dependent primary school child aged between 7 to 12 years. Various questionnaires were used to collect data for this study. These included a Biographical Questionnaire, The Coping Resources Inventory (CRI), The Satisfaction with Life Scale (SWLS), and The Affectometer 2 (AFM2). Data was analysed by means of descriptive statistics. Cronbach’s coefficient alphas were utilised to calculate the reliability of the scores of each questionnaire. A multivariate technique was used to determine the amount of clusters formed. A non-hierarchical partitioning technique known as K-means cluster analysis was utilised in this study. An analysis of variance (ANOVA) was utilised in order to compare the mean scores of the various clusters. A post-hoc analysis using the Scheffé test was computed to test for significant differences. Cohen’s d statistics was subsequently used to determine the practical significance of the differences found between the cluster means on each of the measures. The cluster analysis indicated three clusters that differed significantly from one another on all three measures. The results of the CRI indicated that the participants used cognitive and spiritual resources to assist them to cope with the transition from traditional to modern contemporary roles. It was also found that the participants with low coping resources had inferior subjective well-being compared to those who had average and high CRI scores. The findings indicated that the participants were generally satisfied with their lives and experienced high levels of positive affect and low levels of negative affect. However, as a group there was a trend for the participants to have experienced slightly lower levels of global happiness or slightly negative affect. The results of this study broadens the knowledge base of positive psychology with respect to the diverse cultures and gender roles within South Africa. Overall, this study highlighted the value and the need for South African research on the coping resources and subjective well-being of dual-career Hindu mothers.
- Full Text:
- Date Issued: 2007
- Authors: Prag, Hanita T
- Date: 2007
- Subjects: Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9932 , http://hdl.handle.net/10948/593 , Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Description: With the increasing number of women entering the labour force internationally, the role of women is changing. Consequently, researchers are pressed to investigate how females of all cultures balance their work and family responsibilities. Amongst Hindu couples, this issue can either be a source of tension or positive support. An overview of literature indicates that the psychological aspects of dual-career Hindu women have received little attention in South Africa. The current study aimed to explore and describe coping resources and the subjective well-being of full-time employed Hindu mothers. The study took the form of a non-experimental exploratory-descriptive design. Participants were selected through nonprobability convenience sampling. The sample of the study consisted of sixty full-time employed Hindu mothers between the ages of 25 and 45 years of age who had at least one dependent primary school child aged between 7 to 12 years. Various questionnaires were used to collect data for this study. These included a Biographical Questionnaire, The Coping Resources Inventory (CRI), The Satisfaction with Life Scale (SWLS), and The Affectometer 2 (AFM2). Data was analysed by means of descriptive statistics. Cronbach’s coefficient alphas were utilised to calculate the reliability of the scores of each questionnaire. A multivariate technique was used to determine the amount of clusters formed. A non-hierarchical partitioning technique known as K-means cluster analysis was utilised in this study. An analysis of variance (ANOVA) was utilised in order to compare the mean scores of the various clusters. A post-hoc analysis using the Scheffé test was computed to test for significant differences. Cohen’s d statistics was subsequently used to determine the practical significance of the differences found between the cluster means on each of the measures. The cluster analysis indicated three clusters that differed significantly from one another on all three measures. The results of the CRI indicated that the participants used cognitive and spiritual resources to assist them to cope with the transition from traditional to modern contemporary roles. It was also found that the participants with low coping resources had inferior subjective well-being compared to those who had average and high CRI scores. The findings indicated that the participants were generally satisfied with their lives and experienced high levels of positive affect and low levels of negative affect. However, as a group there was a trend for the participants to have experienced slightly lower levels of global happiness or slightly negative affect. The results of this study broadens the knowledge base of positive psychology with respect to the diverse cultures and gender roles within South Africa. Overall, this study highlighted the value and the need for South African research on the coping resources and subjective well-being of dual-career Hindu mothers.
- Full Text:
- Date Issued: 2007
The experience of AIDS orphans living in a township
- Authors: Frood, Sharron
- Date: 2007
- Subjects: Orphans -- South Africa , Children of AIDS patients -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10078 , http://hdl.handle.net/10948/505 , Orphans -- South Africa , Children of AIDS patients -- South Africa
- Description: One of the challenges facing health care professionals today is the phenomenon of rendering care to children who have been orphaned in the AIDS pandemic. The number of AIDS orphans in South Africa has risen out of all proportion and is causing existing health and social structures to become stretched in providing care to this vulnerable population of children. The objectives of this study are to explore and to describe the lived experience of children living in a township who have become AIDS orphans and to develop broad guidelines for Primary Health Care Nurses (PHCN’s), related professionals and partners involved in the care of AIDS orphans living in a township. The theoretical grounding of this study is found in Kotze’s Theory on Nursing Accompaniment (Kotzé, 1998:3). The proposed research design was based upon a qualitative study using an explorative, descriptive, contextual and phenomenological strategy of inquiry. Data was collected by means of in-depth interviews from a purposively selected sample and then analysed using the steps of qualitative data analysis proposed by Tesch (in Creswell, 1994). Guba’s model was used to assess the trustworthiness of the qualitative data. Based upon the findings, guidelines were developed to assist PHCN’s related professionals and partners involved in the care of AIDS orphans living in a township. Through this study the goal of the researcher was to give a voice to AIDS orphans living in a township and to represent accurately their lived experience.
- Full Text:
- Date Issued: 2007
- Authors: Frood, Sharron
- Date: 2007
- Subjects: Orphans -- South Africa , Children of AIDS patients -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10078 , http://hdl.handle.net/10948/505 , Orphans -- South Africa , Children of AIDS patients -- South Africa
- Description: One of the challenges facing health care professionals today is the phenomenon of rendering care to children who have been orphaned in the AIDS pandemic. The number of AIDS orphans in South Africa has risen out of all proportion and is causing existing health and social structures to become stretched in providing care to this vulnerable population of children. The objectives of this study are to explore and to describe the lived experience of children living in a township who have become AIDS orphans and to develop broad guidelines for Primary Health Care Nurses (PHCN’s), related professionals and partners involved in the care of AIDS orphans living in a township. The theoretical grounding of this study is found in Kotze’s Theory on Nursing Accompaniment (Kotzé, 1998:3). The proposed research design was based upon a qualitative study using an explorative, descriptive, contextual and phenomenological strategy of inquiry. Data was collected by means of in-depth interviews from a purposively selected sample and then analysed using the steps of qualitative data analysis proposed by Tesch (in Creswell, 1994). Guba’s model was used to assess the trustworthiness of the qualitative data. Based upon the findings, guidelines were developed to assist PHCN’s related professionals and partners involved in the care of AIDS orphans living in a township. Through this study the goal of the researcher was to give a voice to AIDS orphans living in a township and to represent accurately their lived experience.
- Full Text:
- Date Issued: 2007
The experiences of caregivers in formal institutions caring for terminal AIDS patients
- Authors: Williams, Margaret
- Date: 2007
- Subjects: AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10033 , http://hdl.handle.net/10948/644 , AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Description: One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.
- Full Text:
- Date Issued: 2007
- Authors: Williams, Margaret
- Date: 2007
- Subjects: AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10033 , http://hdl.handle.net/10948/644 , AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Description: One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.
- Full Text:
- Date Issued: 2007
The experiences of volunteers involved in home-based care for people living with HIV/AIDS
- Sobuce, Ndabazovuyo Wellington
- Authors: Sobuce, Ndabazovuyo Wellington
- Date: 2007
- Subjects: AIDS patients -- Home care -- South Africa -- Lusikisiki , AIDS (Disease) -- Patients -- Home care -- South Africa -- Lusikisiki , HIV-positive persons -- Home care -- South Africa -- Lusikisiki , Home-based family services -- South Africa -- Lusikisiki
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9988 , http://hdl.handle.net/10948/608 , AIDS patients -- Home care -- South Africa -- Lusikisiki , AIDS (Disease) -- Patients -- Home care -- South Africa -- Lusikisiki , HIV-positive persons -- Home care -- South Africa -- Lusikisiki , Home-based family services -- South Africa -- Lusikisiki
- Description: HIV/AIDS is a pandemic infecting and affecting millions of people worldwide. South Africa is also severely affected by this disease. Because hospitals cannot cope with patients admitted daily especially with the influx caused by HIV/AIDS patients, the government has introduced home-based care of people living with HIV/AIDS. Amongst those who practice home-based care are the volunteers. This study is aimed at exploring and describing the experiences of volunteers involved in home-based care of people living with HIV/AIDS in the Lusikisiki Magisterial district in the former Transkei area of the Province of the Eastern Cape. The researcher used a qualitative methodology with the aim of finding out what it is like to be a volunteer involved in home-based care in a rural area. The data was collected by means of semi-structured one-to-one interviews or guided interviews. A total sample of thirteen research participants was acquired through purposive as well as snowball sampling. The interviews were guided by a number of broad question themes. Data was analyzed using Tesch’s framework of data analysis as described in Creswell (1994). The researcher used Guba’s model as outlined in Krefting (1991) to ensure trustworthiness of the research findings. A literature control was undertaken to find out what other researchers and authors say about the issues raised by the study. There were five themes that came out of the data analysis process and these themes are: o The experiences of volunteers with home-based care. o Factors facilitating the work of volunteers. o Problems encountered by volunteers. o Possible solutions to problems encountered. o Views of volunteers regarding home-based care. These broad themes were further reduced into sub-themes and categories. Based on the discussion of themes, sub-themes, and categories, some research findings were presented. The discussion of the themes, sub-themes and categories was supported by verbatim quotations from the participants. On the basis of research findings, conclusions and recommendations were made.
- Full Text:
- Date Issued: 2007
- Authors: Sobuce, Ndabazovuyo Wellington
- Date: 2007
- Subjects: AIDS patients -- Home care -- South Africa -- Lusikisiki , AIDS (Disease) -- Patients -- Home care -- South Africa -- Lusikisiki , HIV-positive persons -- Home care -- South Africa -- Lusikisiki , Home-based family services -- South Africa -- Lusikisiki
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9988 , http://hdl.handle.net/10948/608 , AIDS patients -- Home care -- South Africa -- Lusikisiki , AIDS (Disease) -- Patients -- Home care -- South Africa -- Lusikisiki , HIV-positive persons -- Home care -- South Africa -- Lusikisiki , Home-based family services -- South Africa -- Lusikisiki
- Description: HIV/AIDS is a pandemic infecting and affecting millions of people worldwide. South Africa is also severely affected by this disease. Because hospitals cannot cope with patients admitted daily especially with the influx caused by HIV/AIDS patients, the government has introduced home-based care of people living with HIV/AIDS. Amongst those who practice home-based care are the volunteers. This study is aimed at exploring and describing the experiences of volunteers involved in home-based care of people living with HIV/AIDS in the Lusikisiki Magisterial district in the former Transkei area of the Province of the Eastern Cape. The researcher used a qualitative methodology with the aim of finding out what it is like to be a volunteer involved in home-based care in a rural area. The data was collected by means of semi-structured one-to-one interviews or guided interviews. A total sample of thirteen research participants was acquired through purposive as well as snowball sampling. The interviews were guided by a number of broad question themes. Data was analyzed using Tesch’s framework of data analysis as described in Creswell (1994). The researcher used Guba’s model as outlined in Krefting (1991) to ensure trustworthiness of the research findings. A literature control was undertaken to find out what other researchers and authors say about the issues raised by the study. There were five themes that came out of the data analysis process and these themes are: o The experiences of volunteers with home-based care. o Factors facilitating the work of volunteers. o Problems encountered by volunteers. o Possible solutions to problems encountered. o Views of volunteers regarding home-based care. These broad themes were further reduced into sub-themes and categories. Based on the discussion of themes, sub-themes, and categories, some research findings were presented. The discussion of the themes, sub-themes and categories was supported by verbatim quotations from the participants. On the basis of research findings, conclusions and recommendations were made.
- Full Text:
- Date Issued: 2007
The impact of pharmaceutical care services on the management of asthma patients in a primary health care clinic
- Authors: Mostert, Zhan
- Date: 2007
- Subjects: Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10154 , http://hdl.handle.net/10948/574 , http://hdl.handle.net/10948/d1011711 , Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Description: Optimal management of a chronic disease, like asthma, requires the active participation of patients. To achieve this, patients require education about asthma. Many of the recommended components of asthma care and management might not be effective without adequate patient education. Pharmacists in community, hospital and clinic practice are well placed to provide continued information and reinforcement of key messages, in order to improve compliance with medication and the outcomes of asthma management plans. Pharmacists may be able to increase medication adherence with patient counselling and monitoring systems and by facilitating communication with physicians. However, regardless of this, it remains uncertain whether pharmacist-patient interactions improve patient outcomes, and in spite of recommendations for teamwork and a multidisciplinary approach in the education of asthma patients, medical doctors and nurses are still largely responsible for carrying out the greatest part of patient education. The objectives of this study were therefore to determine the impact of pharmaceutical care services at a primary health care level on the management and well-being of asthmatic patients; to determine the effect of complex or multi-faceted pharmaceutical interventions, in patients with asthma, on lung function, asthma knowledge, attitudes and perceived self-management efficacy, asthma related quality of life and asthma control; and to determine the extent to which pharmacotherapeutic interventions, with regards to medication changes and dosage changes, are accepted and implemented by doctors. A randomised-control study was conducted at a primary health care clinic in the Eastern Cape. A total of 120 patients were allocated to two groups of sixty patients each (a Control Group and an Intervention Group). Baseline values were measured and follow-up interviews and post-intervention data collection were conducted three months afterwards for each group. Patients in the Control Group were attended to by the clinic staff as usual. Patients in the Intervention Group were educated on their disease by a pharmacist. The use of a customised 500ml plastic bottle as a spacer was suggested and each patient’s medication was evaluated against the Standard Treatment Guidelines for the management of asthma in adults at the primary health care level and where necessary, prescribing recommendations were made. Following assessment of the medication regimens of the patients in the Intervention Group, a total of 49 prescribing recommendations were made, of which 73 percent were accepted by both the doctor and patient. After educating the patients in the Intervention Group on inhaler technique, a significant improvement in technique was observed at the 3-month follow-up assessment (p<0.05). Using a short form of the Asthma Quality of Life Questionnaire (AQLQ(S)), a significant improvement post-intervention in mean total quality of life score (p<0.05) and mean average quality of life score (p<0.05) in the Intervention Group, were demonstrated. An improvement in mean activity limitation score in the Intervention Group post-intervention was also recorded for the activity limitation subscale of the AQLQ(S) (p<0.05). On measuring changes in asthma related knowledge, attitudes and self-efficacy, using a questionnaire (KASE-AQ), a significant improvement in mean knowledge score in the Intervention Group after the intervention (p<0.05) was also shown. With regards to lung function, both vital capacity (percent FVC) and expiratory flow volumes (percent FEV1) improved significantly in the Intervention Group (p<0.05). This study therefore demonstrated that multi-faceted pharmacist interventions, including medication assessment, asthma education, education on inhaler technique and the provision of medication aids in the form of spacers, can significantly improve the management of asthma patients and improve their well-being and quality of life.
- Full Text:
- Date Issued: 2007
- Authors: Mostert, Zhan
- Date: 2007
- Subjects: Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10154 , http://hdl.handle.net/10948/574 , http://hdl.handle.net/10948/d1011711 , Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Description: Optimal management of a chronic disease, like asthma, requires the active participation of patients. To achieve this, patients require education about asthma. Many of the recommended components of asthma care and management might not be effective without adequate patient education. Pharmacists in community, hospital and clinic practice are well placed to provide continued information and reinforcement of key messages, in order to improve compliance with medication and the outcomes of asthma management plans. Pharmacists may be able to increase medication adherence with patient counselling and monitoring systems and by facilitating communication with physicians. However, regardless of this, it remains uncertain whether pharmacist-patient interactions improve patient outcomes, and in spite of recommendations for teamwork and a multidisciplinary approach in the education of asthma patients, medical doctors and nurses are still largely responsible for carrying out the greatest part of patient education. The objectives of this study were therefore to determine the impact of pharmaceutical care services at a primary health care level on the management and well-being of asthmatic patients; to determine the effect of complex or multi-faceted pharmaceutical interventions, in patients with asthma, on lung function, asthma knowledge, attitudes and perceived self-management efficacy, asthma related quality of life and asthma control; and to determine the extent to which pharmacotherapeutic interventions, with regards to medication changes and dosage changes, are accepted and implemented by doctors. A randomised-control study was conducted at a primary health care clinic in the Eastern Cape. A total of 120 patients were allocated to two groups of sixty patients each (a Control Group and an Intervention Group). Baseline values were measured and follow-up interviews and post-intervention data collection were conducted three months afterwards for each group. Patients in the Control Group were attended to by the clinic staff as usual. Patients in the Intervention Group were educated on their disease by a pharmacist. The use of a customised 500ml plastic bottle as a spacer was suggested and each patient’s medication was evaluated against the Standard Treatment Guidelines for the management of asthma in adults at the primary health care level and where necessary, prescribing recommendations were made. Following assessment of the medication regimens of the patients in the Intervention Group, a total of 49 prescribing recommendations were made, of which 73 percent were accepted by both the doctor and patient. After educating the patients in the Intervention Group on inhaler technique, a significant improvement in technique was observed at the 3-month follow-up assessment (p<0.05). Using a short form of the Asthma Quality of Life Questionnaire (AQLQ(S)), a significant improvement post-intervention in mean total quality of life score (p<0.05) and mean average quality of life score (p<0.05) in the Intervention Group, were demonstrated. An improvement in mean activity limitation score in the Intervention Group post-intervention was also recorded for the activity limitation subscale of the AQLQ(S) (p<0.05). On measuring changes in asthma related knowledge, attitudes and self-efficacy, using a questionnaire (KASE-AQ), a significant improvement in mean knowledge score in the Intervention Group after the intervention (p<0.05) was also shown. With regards to lung function, both vital capacity (percent FVC) and expiratory flow volumes (percent FEV1) improved significantly in the Intervention Group (p<0.05). This study therefore demonstrated that multi-faceted pharmacist interventions, including medication assessment, asthma education, education on inhaler technique and the provision of medication aids in the form of spacers, can significantly improve the management of asthma patients and improve their well-being and quality of life.
- Full Text:
- Date Issued: 2007
The medicinal chemistry of cyclo (Ser-Ser) and cyclo (Ser-Tyr)
- Authors: Kritzinger, André Louis
- Date: 2007
- Subjects: Cyclic peptides , Peptide drugs -- Therapeutic use , Haematostasis , Pharmaceutical chemistry
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10155 , http://hdl.handle.net/10948/537 , http://hdl.handle.net/10948/d1011712 , Cyclic peptides , Peptide drugs -- Therapeutic use , Haematostasis , Pharmaceutical chemistry
- Description: Cyclic dipeptides are widely used as models for larger peptides because of their simplicity and limited conformational freedom. Some cyclic dipeptides have been shown to produce antiviral, antibiotic and anti-tumour activity (Milne et al., 1998). In this study the cyclic dipeptides, cyclo(Ser-Ser) and cyclo(Ser-Tyr), were synthesised from their corresponding linear precursors using a modified phenolinduced cyclisation procedure. The phenol-induced cyclisation procedure resulted in good yields and purity of the cyclic dipeptides. Quantitative analysis and evaluation of the physicochemical properties of the cyclic dipeptides was achieved by using high-performance liquid chromatography, scanning electron microscopy, thermal analysis and X-ray powder diffraction. The structures of the synthesised cyclic dipeptides were elucidated using infrared spectroscopy, mass spectrometry, nuclear magnetic resonance spectroscopy and molecular modelling. The study aimed to determine the biological activity of cyclo(Ser-Ser) and cyclo(Ser-Tyr) with respect to their anticancer, antimicrobial, haematological and cardiac effects. Anticancer studies revealed that cyclo(Ser-Ser) and cyclo(Ser- Tyr) inhibited the growth of HeLa (cervical cancer), HT-29 (colon cancer) and MCF (breast cancer) cancer cell lines. Both cyclic dipeptides also inhibited the growth of certain selected Gram-positive, Gram-negative and fungal microorganisms in the antimicrobial study. Although the inhibition of growth in the anticancer and antimicrobial studies was statistically significant, the clinical relevance is questionable, since the inhibition produced by both cyclic dipeptides was very limited compared to other pre-existing anticancer and antimicrobial agents. Cyclo(Ser-Tyr) exhibited significant activity in the haematological studies, where it increased the rate of calcium induced-coagulation, and decreased the rate of streptokinase-induced fibrinolysis. Both cyclic dipeptides, however, failed to produce any significant effects on thrombin-substrate binding and ADPinduced platelet aggregation. Cardiac studies revealed that cyclo(Ser-Ser) and especially cyclo(Ser-Tyr) reduced the heart rate, coronary flow rate and ventricular pressure of isolated rat hearts.
- Full Text:
- Date Issued: 2007
- Authors: Kritzinger, André Louis
- Date: 2007
- Subjects: Cyclic peptides , Peptide drugs -- Therapeutic use , Haematostasis , Pharmaceutical chemistry
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10155 , http://hdl.handle.net/10948/537 , http://hdl.handle.net/10948/d1011712 , Cyclic peptides , Peptide drugs -- Therapeutic use , Haematostasis , Pharmaceutical chemistry
- Description: Cyclic dipeptides are widely used as models for larger peptides because of their simplicity and limited conformational freedom. Some cyclic dipeptides have been shown to produce antiviral, antibiotic and anti-tumour activity (Milne et al., 1998). In this study the cyclic dipeptides, cyclo(Ser-Ser) and cyclo(Ser-Tyr), were synthesised from their corresponding linear precursors using a modified phenolinduced cyclisation procedure. The phenol-induced cyclisation procedure resulted in good yields and purity of the cyclic dipeptides. Quantitative analysis and evaluation of the physicochemical properties of the cyclic dipeptides was achieved by using high-performance liquid chromatography, scanning electron microscopy, thermal analysis and X-ray powder diffraction. The structures of the synthesised cyclic dipeptides were elucidated using infrared spectroscopy, mass spectrometry, nuclear magnetic resonance spectroscopy and molecular modelling. The study aimed to determine the biological activity of cyclo(Ser-Ser) and cyclo(Ser-Tyr) with respect to their anticancer, antimicrobial, haematological and cardiac effects. Anticancer studies revealed that cyclo(Ser-Ser) and cyclo(Ser- Tyr) inhibited the growth of HeLa (cervical cancer), HT-29 (colon cancer) and MCF (breast cancer) cancer cell lines. Both cyclic dipeptides also inhibited the growth of certain selected Gram-positive, Gram-negative and fungal microorganisms in the antimicrobial study. Although the inhibition of growth in the anticancer and antimicrobial studies was statistically significant, the clinical relevance is questionable, since the inhibition produced by both cyclic dipeptides was very limited compared to other pre-existing anticancer and antimicrobial agents. Cyclo(Ser-Tyr) exhibited significant activity in the haematological studies, where it increased the rate of calcium induced-coagulation, and decreased the rate of streptokinase-induced fibrinolysis. Both cyclic dipeptides, however, failed to produce any significant effects on thrombin-substrate binding and ADPinduced platelet aggregation. Cardiac studies revealed that cyclo(Ser-Ser) and especially cyclo(Ser-Tyr) reduced the heart rate, coronary flow rate and ventricular pressure of isolated rat hearts.
- Full Text:
- Date Issued: 2007
The psychofortology of male and female patients undergoing infertility treatment
- Authors: Ferreira, Hendrina Jacoba
- Date: 2007
- Subjects: Adjustment (Psychology) , Stress (Psychology) -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9918 , http://hdl.handle.net/10948/674 , Adjustment (Psychology) , Stress (Psychology) -- South Africa
- Description: 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. While some research has been done on coping processes, and stress and depression levels in individuals on infertility treatment, very little literature is available regarding the coping resources and subjective well-being of individuals on infertility treatment. This psychofortigenic study aimed to explore and describe the coping resources, sense of coherence, satisfaction with life and life happiness of individuals undergoing infertility treatment. Furthermore, this study aimed to compare the coping resources, sense of coherence, satisfaction with life and happiness of males and females undergoing infertility treatment at a privately managed unit. It is imperative to view the results of this study from a gender-based perception as a previous study by Ferreira (2005) indicated significant differences in how males and females perceived infertility treatment. The sample in this study consisted of 62 voluntary participants from a privately managed health care unit in the Nelson Mandela Metropole. Participants were given a package of questionnaires to complete under the supervision of the researcher and research coordinator of the participating health care unit. The assessment consisted of a biographical questionnaire and four standardised paper and pencil measures. The participants’ coping resources were explored using Hammer and Marting’s (1988) Coping Resource Inventory (CRI), while Antonovsky’s (1987) Orientation to Life Scale was used to measure their sense of coherence (SOC-29). Overall satisfaction with life was assessed using Diener, Emmons, Larson and Griffin’s (1985) Satisfaction with Life Scale (SWLS), while Kamman and Flett’s (1993) Affectometer-2 (AFM-2) was utilized to measure the respondents’ subjective happiness. A quantitative, exploratory descriptive research design was employed in this study and the participants were chosen by means of a non-probability purposive sampling procedure. Data was analysed using descriptive statistics and independent t-testing. Further investigations were made through Chi square tests which enabled the researcher to draw inferences about differences based on cross tabulations. The reliability coefficient was obtained by calculating Cronbach’s coefficient alpha, which measured the internal consistency of the four standardized measures utilised in the present study. The results of the study revealed that participants generally experienced average levels of coping and subjective well-being as measured by the four assessment tools utilised during this study. On comparing the results of the male group and the female group of the particular sample it was found that although both groups obtained relatively average mean scores in general, the men scored slightly higher on the Coping Resources Inventory, Sense of Coherence and Affectometer-2, while the females scored slightly higher than the males on the Satisfaction with Life Scale.
- Full Text:
- Date Issued: 2007
- Authors: Ferreira, Hendrina Jacoba
- Date: 2007
- Subjects: Adjustment (Psychology) , Stress (Psychology) -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9918 , http://hdl.handle.net/10948/674 , Adjustment (Psychology) , Stress (Psychology) -- South Africa
- Description: 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. While some research has been done on coping processes, and stress and depression levels in individuals on infertility treatment, very little literature is available regarding the coping resources and subjective well-being of individuals on infertility treatment. This psychofortigenic study aimed to explore and describe the coping resources, sense of coherence, satisfaction with life and life happiness of individuals undergoing infertility treatment. Furthermore, this study aimed to compare the coping resources, sense of coherence, satisfaction with life and happiness of males and females undergoing infertility treatment at a privately managed unit. It is imperative to view the results of this study from a gender-based perception as a previous study by Ferreira (2005) indicated significant differences in how males and females perceived infertility treatment. The sample in this study consisted of 62 voluntary participants from a privately managed health care unit in the Nelson Mandela Metropole. Participants were given a package of questionnaires to complete under the supervision of the researcher and research coordinator of the participating health care unit. The assessment consisted of a biographical questionnaire and four standardised paper and pencil measures. The participants’ coping resources were explored using Hammer and Marting’s (1988) Coping Resource Inventory (CRI), while Antonovsky’s (1987) Orientation to Life Scale was used to measure their sense of coherence (SOC-29). Overall satisfaction with life was assessed using Diener, Emmons, Larson and Griffin’s (1985) Satisfaction with Life Scale (SWLS), while Kamman and Flett’s (1993) Affectometer-2 (AFM-2) was utilized to measure the respondents’ subjective happiness. A quantitative, exploratory descriptive research design was employed in this study and the participants were chosen by means of a non-probability purposive sampling procedure. Data was analysed using descriptive statistics and independent t-testing. Further investigations were made through Chi square tests which enabled the researcher to draw inferences about differences based on cross tabulations. The reliability coefficient was obtained by calculating Cronbach’s coefficient alpha, which measured the internal consistency of the four standardized measures utilised in the present study. The results of the study revealed that participants generally experienced average levels of coping and subjective well-being as measured by the four assessment tools utilised during this study. On comparing the results of the male group and the female group of the particular sample it was found that although both groups obtained relatively average mean scores in general, the men scored slightly higher on the Coping Resources Inventory, Sense of Coherence and Affectometer-2, while the females scored slightly higher than the males on the Satisfaction with Life Scale.
- Full Text:
- Date Issued: 2007
The psychofortology of post-graduate learners in the Faculty of Health Sciences at the Nelson Mandela Metropolitan University
- Authors: Smith, Greg
- Date: 2007
- Subjects: Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9931 , http://hdl.handle.net/10948/606 , http://hdl.handle.net/10948/d1011705 , Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Description: The years spent studying towards a degree represent many challenges to the learner1. These pressures increase once that learner moves into the post-graduate level of professional study. Faced with the pressure of having to perform suitably in order to remain on the programme, the learner finds himself or herself under conditions which may present as stress or illness, depending upon the availability of coping resources and strategies. This study adopted a psychofortigenic2 approach and explored and described the coping (i.e., coping resources and sense of coherence) and subjective well-being (i.e., satisfaction with life, happiness and general psychiatric health) of post-graduate learners in the following six departments of the Faculty of Health Sciences at the Nelson Mandela Metropolitan University (NMMU): Psychology; Human Movement Science and Sport Management; Environmental Health and Social Development Professions (incorporating MA Health and Welfare Management); Pharmacy; Nursing Science; Biomedical Technology and Radiography. An exploratory descriptive research design was used and the participants were selected by means of non-probability, convenience sampling. The sample consisted of 60 male and female masters and doctoral post-graduate learners in the Faculty of Health Sciences. Biographical data was gathered by means of the administration of a questionnaire. Hammer and Marting’s (1988) Coping Resources Inventory was used to measure the students’ available coping resources. Furthermore, Antonovsky’s (1987) Orientation to Life Scale was used to measure the construct of Sense of Coherence. The Satisfaction with Life Scale by Diener, Emmons, Larson and Griffin (1985) was used to assess the respondents’ overall satisfaction with life. Kamman and Flett’s (1983) Affectometer-2 was used to measure participants’ subjective global happiness. The General Health Questionnaire of Goldberg and Williams (1988) was used to measure the psychiatric morbidity or general psychiatric health of the participants. The data was analyzed using both descriptive statistics and cluster analysis. A Hotellings T² was computed with subsequent t-tests to draw inferences about differences in the means of established groups across the five measures. The results indicated that the participants were generally coping and experiencing subjective well-being. The results indicated two clusters to significantly differ from one another across the five measures. The first cluster could be characterized as high in psychofortology and presented with better coping and subjective well-being. The second cluster could be characterized as low in psychofortology and presented with poorer coping and subjective well-being.
- Full Text:
- Date Issued: 2007
- Authors: Smith, Greg
- Date: 2007
- Subjects: Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9931 , http://hdl.handle.net/10948/606 , http://hdl.handle.net/10948/d1011705 , Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Description: The years spent studying towards a degree represent many challenges to the learner1. These pressures increase once that learner moves into the post-graduate level of professional study. Faced with the pressure of having to perform suitably in order to remain on the programme, the learner finds himself or herself under conditions which may present as stress or illness, depending upon the availability of coping resources and strategies. This study adopted a psychofortigenic2 approach and explored and described the coping (i.e., coping resources and sense of coherence) and subjective well-being (i.e., satisfaction with life, happiness and general psychiatric health) of post-graduate learners in the following six departments of the Faculty of Health Sciences at the Nelson Mandela Metropolitan University (NMMU): Psychology; Human Movement Science and Sport Management; Environmental Health and Social Development Professions (incorporating MA Health and Welfare Management); Pharmacy; Nursing Science; Biomedical Technology and Radiography. An exploratory descriptive research design was used and the participants were selected by means of non-probability, convenience sampling. The sample consisted of 60 male and female masters and doctoral post-graduate learners in the Faculty of Health Sciences. Biographical data was gathered by means of the administration of a questionnaire. Hammer and Marting’s (1988) Coping Resources Inventory was used to measure the students’ available coping resources. Furthermore, Antonovsky’s (1987) Orientation to Life Scale was used to measure the construct of Sense of Coherence. The Satisfaction with Life Scale by Diener, Emmons, Larson and Griffin (1985) was used to assess the respondents’ overall satisfaction with life. Kamman and Flett’s (1983) Affectometer-2 was used to measure participants’ subjective global happiness. The General Health Questionnaire of Goldberg and Williams (1988) was used to measure the psychiatric morbidity or general psychiatric health of the participants. The data was analyzed using both descriptive statistics and cluster analysis. A Hotellings T² was computed with subsequent t-tests to draw inferences about differences in the means of established groups across the five measures. The results indicated that the participants were generally coping and experiencing subjective well-being. The results indicated two clusters to significantly differ from one another across the five measures. The first cluster could be characterized as high in psychofortology and presented with better coping and subjective well-being. The second cluster could be characterized as low in psychofortology and presented with poorer coping and subjective well-being.
- Full Text:
- Date Issued: 2007
The role of the community pharmacist in cardiovascular disease management
- Venter, Ignatius Johannes Erhardt
- Authors: Venter, Ignatius Johannes Erhardt
- Date: 2007
- Subjects: Pharmacist and patient -- South Africa -- Port Elizabeth , Phamaceutical services -- Patients , Cardiovascular system -- Diseases
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10150 , http://hdl.handle.net/10948/652 , Pharmacist and patient -- South Africa -- Port Elizabeth , Phamaceutical services -- Patients , Cardiovascular system -- Diseases
- Description: Cardiovascular disease contributes to mortality and morbidity statistics worldwide and in South Africa. The current focus in health care revolves around activities aimed at preventing the development of cardiovascular disease, rather than the treatment of disease. The identification of risk factors that can predispose a patient to the development of cardiovascular disease is an essential component of any cardiovascular disease management programme. It is necessary that in the management of these risk factors, they are not considered to be isolated, but inter-related. Through the provision of point-of-care cardiovascular risk screening and monitoring services as well as disease-related counselling, the community pharmacist, as a readily accessible source of healthcare, can play an essential role in the cardiovascular disease management process. The aim of this study was to describe the nature of the services provided by community pharmacists with respect to cardiovascular risk and disease management in the Nelson Mandela Metropole. The research design was a non-experimental, descriptive study using a crosssectional survey method. Data was obtained through the utilisation of a questionnaire. The questionnaire consisted of three sections and was administered to community pharmacies in the Nelson Mandela Metropole, that provided cardiovascular point-of-care screening services. The community pharmacists correctly identified cardiovascular risk factors such as obesity (76.6 percent; 36, n=47) and smoking (27.7 percent; 13, n=47). Other cardiovascular risk factors such as abdominal obesity (4.2 percent; 2, n=47), gender (2.1 percent; 1, n=47) and family history (4.2 percent; 2, n=47) were largely ignored by the pharmacists. Point-of-care testing services were readily available in the pharmacies, with all of the pharmacies providing blood glucose and blood pressure measurements. Blood cholesterol measurements were only provided in 87.8 percent (36, n=41) of the pharmacies. The services were generally provided in a clinic facility, with 90.2 percent (37, n=41) of the pharmacies having a clinic facility available. Pharmacists were involved in the provision of point-of-care services, with 85.4 percent (35, n=41) of the pharmacies indicating that the pharmacists participated. Pharmacists readily provided counselling prior (70.7 percent; 29, n=41) to and after (80.5 percent; 33, n=41) the conduction of the screening services on areas such as lifestyle modification and treatment options. Only 15 percent (7, n=47) of the pharmacists indicated that they were aware of Cardiovascular Risk Calculator Tools and none of the pharmacists indicated that they had utilised such a tool. Pharmacists recommended frequent monitoring (60.5 percent; 26, n=43) and lifestyle modification (67.4 percent; 29, n=43) to patients, if the result of their screening service was within normal limits. However, the majority of the pharmacists indicated that they would refer patients, if the results obtained were out of the normal range. Conclusions based on the findings indicated that the pharmacists are readily providing cardiovascular risk screening services. The pharmacists were also able to identify the presence of any risk factors that can lead to the development of cardiovascular disease in the patients. However, active pharmaceutical involvement in further cardiovascular disease monitoring seemed to be lacking. Recommendations were made on areas such as reimbursement for pharmaceutical care services, increased utilisation of support staff and Continuing Professional Development events that could assist in improving the role of the community pharmacist in cardiovascular disease management.
- Full Text:
- Date Issued: 2007
- Authors: Venter, Ignatius Johannes Erhardt
- Date: 2007
- Subjects: Pharmacist and patient -- South Africa -- Port Elizabeth , Phamaceutical services -- Patients , Cardiovascular system -- Diseases
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10150 , http://hdl.handle.net/10948/652 , Pharmacist and patient -- South Africa -- Port Elizabeth , Phamaceutical services -- Patients , Cardiovascular system -- Diseases
- Description: Cardiovascular disease contributes to mortality and morbidity statistics worldwide and in South Africa. The current focus in health care revolves around activities aimed at preventing the development of cardiovascular disease, rather than the treatment of disease. The identification of risk factors that can predispose a patient to the development of cardiovascular disease is an essential component of any cardiovascular disease management programme. It is necessary that in the management of these risk factors, they are not considered to be isolated, but inter-related. Through the provision of point-of-care cardiovascular risk screening and monitoring services as well as disease-related counselling, the community pharmacist, as a readily accessible source of healthcare, can play an essential role in the cardiovascular disease management process. The aim of this study was to describe the nature of the services provided by community pharmacists with respect to cardiovascular risk and disease management in the Nelson Mandela Metropole. The research design was a non-experimental, descriptive study using a crosssectional survey method. Data was obtained through the utilisation of a questionnaire. The questionnaire consisted of three sections and was administered to community pharmacies in the Nelson Mandela Metropole, that provided cardiovascular point-of-care screening services. The community pharmacists correctly identified cardiovascular risk factors such as obesity (76.6 percent; 36, n=47) and smoking (27.7 percent; 13, n=47). Other cardiovascular risk factors such as abdominal obesity (4.2 percent; 2, n=47), gender (2.1 percent; 1, n=47) and family history (4.2 percent; 2, n=47) were largely ignored by the pharmacists. Point-of-care testing services were readily available in the pharmacies, with all of the pharmacies providing blood glucose and blood pressure measurements. Blood cholesterol measurements were only provided in 87.8 percent (36, n=41) of the pharmacies. The services were generally provided in a clinic facility, with 90.2 percent (37, n=41) of the pharmacies having a clinic facility available. Pharmacists were involved in the provision of point-of-care services, with 85.4 percent (35, n=41) of the pharmacies indicating that the pharmacists participated. Pharmacists readily provided counselling prior (70.7 percent; 29, n=41) to and after (80.5 percent; 33, n=41) the conduction of the screening services on areas such as lifestyle modification and treatment options. Only 15 percent (7, n=47) of the pharmacists indicated that they were aware of Cardiovascular Risk Calculator Tools and none of the pharmacists indicated that they had utilised such a tool. Pharmacists recommended frequent monitoring (60.5 percent; 26, n=43) and lifestyle modification (67.4 percent; 29, n=43) to patients, if the result of their screening service was within normal limits. However, the majority of the pharmacists indicated that they would refer patients, if the results obtained were out of the normal range. Conclusions based on the findings indicated that the pharmacists are readily providing cardiovascular risk screening services. The pharmacists were also able to identify the presence of any risk factors that can lead to the development of cardiovascular disease in the patients. However, active pharmaceutical involvement in further cardiovascular disease monitoring seemed to be lacking. Recommendations were made on areas such as reimbursement for pharmaceutical care services, increased utilisation of support staff and Continuing Professional Development events that could assist in improving the role of the community pharmacist in cardiovascular disease management.
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- Date Issued: 2007