Paper one is a metasynthesis of studies exploring mothers' experiences of recovery from postnatal mental illness. Four databases were systematically searched using key words and index terms to identify the qualitative literature exploring mothers' experiences of recovery from postnatal mental illness. Fourteen studies met the inclusion criteria and were critically appraised and synthesised. These papers reported the views of 395 women's experiences of recovery from postnatal mental illness. Five core themes emerged from the synthesis to describe four key processes that facilitate recovery. This experience begins with recognising the problem through crisis and relational distress. Women then go through the process of seeking help which consists of subthemes of accepting help and help to access help. The next process in the in the journey is achieving recovery which includes subthemes of sharing with others like me, coping strategies and noticing recovery. The final process of maintaining recovery consists of incorporating coping strategies into daily life; acquiring a different model of motherhood and processing the experience. The role of the family was interwoven through each stage of recovery. Recommendations were made for professionals who come into contact with this group of women and their families. The review highlighted gaps in the existing evidence and made recommendations for future research. The findings and limitations were discussed with reference to the existing literature. Paper two explored the role of the baby in 12 mothers' experiences of recovery from psychosis after childbirth. A thematic analysis of the data identified three core themes that described the role of the baby in the mothers' recovery. Findings revealed that the baby was central to women's recovery and could be experienced as both helpful and unhelpful. The baby interacted with the mother; increasing self efficacy and reducing emotional distress. The baby could act as a barrier to recovery by increasing the women's emotional distress and hindering access to help and self care. The findings recommended that women receive specialist treatment in mother and baby units where they can access interventions that support parent-infant interactions. The findings of the study add to the existing evidence base on recovery from psychosis after childbirth and highlighted areas for future research. Paper three is a critique of the research carried out in Papers one and two. This paper discussed the rationale for the research design in both papers. Approaches to data sampling and data analysis are reviewed with reference to researcher reflexivity. The search strategy and critical appraisal of techniques of the metasynthesis are also critiqued. Paper three closes with personal reflections and conclusions drawn from both papers.

Studies of attachment in the community suggest that most people have secure attachment styles, but as many as 40% may have an insecure attachment style (Bakermans-Kranenburg & van Ijzendoorn 2009). Frightening parental behaviour has been found to predict disorganised attachment in infants, which in turn is associated with clinical disturbance in adolescence (Van Ijzendoorn, Schuengel & Bakermans-Kranenburg, 1999). Insecure attachment has been found to be disproportionately more common in many psychiatric disorders than the general population: including substance misuse, eating disorders, and Personality Disorder (PD). Transgenerational transmission of attachment has become widely researched over recent years and evidence has shown that a mother's attachment style can predict the attachment style of her infant (Ward, Ramsay, Turnbull, Steele, Steele, & Treasure, 2001). Research has found that a mothers' ability to mentalize about her own early attachment relationships has important implications in her transition to becoming a mother. Motherhood can be challenging for mothers who have good mental health, therefore women with poor mental health may find the transition to motherhood especially stressful. The aim of the current study was to give voice to mothers who have been silenced in many ways, to learn from their struggles and to help services develop more effective ways to reach 'hard to reach' vulnerable mothers. The Adult Attachment Interview (AAI; George, Kaplan, & Main, 1984) was conducted with eight mothers who were attending a Mentalization-Based Treatment (MBT; Bateman & Fonagy, 2004) group designed for mothers who had caused harm to their children and had subsequently had them removed from their care. Thematic Analysis was used to analyse the AAI transcripts and five main themes emerged: 'Love and loss', 'Change and confusion', 'Families and normality', 'Safety and boundaries' and 'Strength and vulnerability'. The findings contribute to the field of maternal mental health research and clinical implications are discussed at an individual, organisational and societal level.

OBJECTIVE: This study investigated how upper limb post-operative patients defined quality care. We specifically assessed the following three aims: (1) determining patient expectations following upper limb surgery, (2) identifying patient recognized barriers to receiving quality care, and (3) analyzing patient identified areas of improvement in patient education. METHOD: In total, 52 patients, aged 19 – 89 years (mean age: 48 years) who received upper limb surgery were surveyed with an open-ended questionnaire during their six to eight week post-operative visit at Stanford Medicine Outpatient Center in Redwood City or Stanford Orthopaedic Surgery Clinic in Los Gatos. Responses were electronically transcribed to REDcap, Research Electronic Data Capture System, for analysis of responses to demographic questions. Open-ended questions were evaluated by thematic analysis until data saturation was reached. RESULTS: Thematic analysis of open-ended responses revealed three main themes: (1) Pain, (2) Function; and (3) Patient Unpreparedness. Both pain and function involved pre- and post-operative factors. Of our three identified themes, elimination of pain and regaining function were the two main health-outcomes that upper limb patients identified as successful treatments of their condition. Patient unpreparedness was recognized as a main barrier in patients receiving quality care and an important area to improve patient education about their problem and treatment. CONCLUSION: By understanding the desired health outcomes and limitations in achieving those outcomes for post-operative upper limb patients, we can improve how medical care is practiced. Our results highlighted that both process and outcome domains of care are important elements in patients’ definition of quality care when seeking medical treatment for their upper limb problems. Specifically, patients identified that elimination of pain and regaining function were important health outcomes during their care. In order to achieve those desired health-outcomes, we recognized that improvements need to be made with regard to patient education about their health condition and treatment process, in order to foster better physician-patient communication. Overall, our findings support the need for continued focus on patient-centered care to ensure the delivery of quality healthcare to all patients.

Theory and research supports the implementation of cognitive and behavioural interventions (CBI’s) to address social, emotional and behavioural difficulties (SEBD) in children. The literature argues that schools are an ideal place in which to implement such interventions. As part of a county initiative, school staff were trained and offered follow up support by 2 Educational Psychologists (EPs) around the use of school-based CBI to support children who have SEBD. The 10 participants (from 5 schools) in this research were part of this initiative: they received 4 sessions of training followed by either monthly individual supervision, or group supervision, around their use of CBI. Training and supervision targeted implementation of key CB competences, selected from a competency framework recommended by ‘Improving Access to Psychological Therapies’ (IAPT, 2011). The research explored staff perceptions around the CB competences that they implemented, their methods of implementation and the barriers and facilitators to their implementation. The research used a mixed methodology design. Qualitative data was analysed using thematic analysis and quantitative data was analysed using descriptive statistics. Data was gathered through interviews, supervision sessions, intervention diaries and training evaluations. Exploration of facilitators and barriers to implementation was based on Durlak and DuPre’s (2008) model of intervention implementation. Facilitators/barriers discrete from this model were also identified. Identification and exploration of such factors can assist in ensuring quality implementation of school-based interventions in the future. This study demonstrates how school staff can implement a range of CB competences and through multi-levels of intervention in schools. The potential role of the EP in supporting school staff to implement CBI is also discussed.

Permanent exclusion is a serious disciplinary measure and the Department for Children, Schools and Families (DCSF, 2008) advises that in most cases it is to be the last resort after a range of measures have been tried to improve a pupil’s behaviour. Following permanent exclusion the local authority (LA) takes responsibility for a pupil’s education and for most cases seeks to reintegrate the pupil into a new school. However the process of reintegration of permanently excluded pupils into mainstream school is regarded as difficult and research has shown that second permanent exclusions frequently occur fairly soon after entering a new school. In the last four years a ‘Hard To Place Pupil Protocol’ (HTPPP) has been published in all LAs as a statutory document. This seeks to encourage all schools to admit a fair share of excluded pupils in a timely manner. There has been no published research on this protocol to date. This study adopts a qualitative case study methodology, influenced by a social constructionist epistemological stance. The participants and methods utilised include interviews with reintegrating pupils, their parents and school staff supporting them, LA reintegration officers and headteachers. Additional methods included a focus group with members of the educational psychology team, a survey to secondary school staff, documentary evidence from pupil files and LA documents, educational psychologist (EP) case work evaluation and a reflexive research diary. This study includes analysis of the findings and presents pertinent themes emerging from the data. The results section indicates that the HTPPP has been effective in increasing the number of pupils being reintegrated. However there are some areas identified as being problematic. These include: decision making, perceived fairness of the protocol, the role of parents and the relationship between the protocol and permanent exclusion. The findings indicate that there are a number of factors that can facilitate or hinder a reintegration. These include: school support, communication, individual pupil attributes, sense of belonging, familial and societal factors and the impact of previous events including the original exclusion. The research findings indicate that EPs recognise their role in supporting the reintegration process through the application of psychological theory and knowledge, supporting complex cases, helping to change perspectives of the ‘problem’, working school staff and obtaining and championing the voice of the child. School staff consider the role of the EP as providing consultation around advice and strategies, it is also about providing a current assessment of a pupil’s educational needs, offering individual therapeutic work with the pupil, supporting home-school relations and enabling a third party perspective. The discussion relates the themes to previous literature and identifies some variation in terms of the factors that facilitate or hinder reintegration, and concluded by questioning the feasibility of establishing such factors. The evidence collected to determine effectiveness of the HTPPP is helpful to establish the way in which it might be adapted to operate in the future. By considering the role of an EP in supporting the process, it is anticipated that the research will contribute to evidence based practice in this area.

The present study was a qualitative research study aimed to explore and describe the role of the lecturer in the subjective well-being of first-year education students. This research utilised secondary data that was collected for a prior study, comprising essays completed by first-year education students at the University of Pretoria. 125 students from randomly selected modules participated in the original study. The narratives concerned how the students described their lecturers as motivating and demotivating. The narratives, completed by male and female students, were selected based on lengthy, content-rich narratives. An inductive thematic analysis was completed to explore and analyse the data from a qualitative, interpretivist perspective. The five dimensions of the PERMA model (Positive emotions, Engagement, Relationships, Meaning and Accomplishment) guided and were used as the theoretical framework of the present study to help understand students’ subjective well-being (Seligman, 2011). Three themes emerged from the students’ descriptions of their lecturers as motivating. The findings suggest that the students were motivated when their lecturers utilised effective teaching approaches, facilitated a positive student-lecturer relationship and when students felt satisfied with their learning. One theme emerged where the students described their lecturer as demotivating; this was the case when their lecturers used ineffective teaching approaches. All five dimensions of the PERMA model were identified when students felt motivated by their lecturers, while two dimensions of the PERMA model were identified when students felt demotivated by their lecturers. There is a need for lecturer training programmes aimed at increasing the awareness of the lecturers’ role in student motivation and student subjective well-being, as well as teaching practises that aim to promote student motivation. Consequently, student subjective well-being can be valuable to universities in improving students’ academic success as well as their subjective well-being. / Dissertation (MEd)--University of Pretoria, 2019. / Educational Psychology / MEd / Unrestricted

This qualitative study aimed to explore the constructions of childhood depression as portrayed in South African women's interest magazines. Departing from a postmodern paradigm and utilising a social constructionist framework, these magazines were regarded as part of larger mass media discourses on childhood depression. The magazines contribute to the construction of 'truths' about childhood depression in its audience. To explore the research question, three of the highest circulating magazines in South Africa containing texts related to childhood depression were identified. The magazines were aimed not only at women, but at both English- and Afrikaans-speaking women, and at African, Caucasian, and possibly Coloured women. The hardcopies of these magazines were sourced from the publisher for a period of approximately two years each. A total of 20 articles that spoke to childhood depression were identified in these magazines. Two forms of analysis were used in a mutually enriching and recursive manner. The contextual analysis allowed an enriched insight into the context of the articles. The thematic analysis gave way to themes and subthemes to emerge. It was found that although perceptions in these articles were most often in line with professional psychological knowledge, at times it failed to speak to uniquely South African concerns regarding childhood depression, and often reified problematic discourses. It was concluded that mass media may be a powerful tool to employ by government organisations, health professionals, and social scientists, to address problematic mental health discourses in South Africa. / Mini Dissertation (MA)--University of Pretoria, 2017. / Psychology / MA / Unrestricted

Doctor Educationis / The overarching purpose of this research study was to ascertain the deliberations preservice mathematics teachers engage with when they construct alternative mathematical models for social phenomena. The study is situated within the mathematical competencies and, in particular, on the evaluation competency with the possibility of developing alternative models flowing from the evaluation. Twenty fourth-year pre-service mathematics teachers participated in the completion of three different mathematical modelling tasks on which the analysis was based. The data collected was analysed qualitatively. The researcher exploited a thematic analysis design to investigate how pre-service mathematics teachers build alternative models.

Background: First responders (firefighters, paramedics, and police officers) are often exposed to potentially psychologically traumatic events. When combined with insufficient social support and reduced help-seeking behaviours, such exposures may increase the risk of mental health challenges, particularly among paramedics who report the highest rates of mental disorders. Objective: The current study used the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR) to identify critical barriers and facilitators to help-seeking and accessing mental health care, and the feasibility and sustainability of a first responder clinic. Methods: Semi-structured qualitative interviews included 11 paramedics (frontline, mid-and-senior management, and union), recruited using purposive and snowball sampling. Interviews were analyzed using content and thematic analyses. The TDF and CFIR guided study design, interview content, data collection, and analysis. Results: Barriers included the complexities of stigma, confidentiality, cultural competency, and trust. Conclusions: The findings will be instrumental in developing evidence-based approaches to mental health care for paramedics.

This study aimed to explore the experiences of middle managers in the implementation of the Balanced Scorecard (BSC) at a public organisation in Botswana. The BSC is regarded as the most widely used tool in measuring organisational performance globally. The public organisation in Botswana has followed global best practice and implemented the BSC to measure organisational performance; however, the organisation is repeatedly unable to meet its set objectives. To gain an improved understanding of managers’ experiences of using the BSC, face-to-face, semi-structured interviews were conducted with eight middle managers at the public organization. Interview data were thematically analysed yielding five key themes: inconsistencies in training, the culture of the organisation, lack of communication, use of information technology and the disparity between individual and organisational performance. Based on the study findings, recommendations are offered to conduct needs analyses prior to introducing new systems, to assess the viability of such a system, and automating the balanced scorecard to reduce fatigue.