Thesis (MA(Psychology))-University of Pretoria, 2006. / Abstract in English. Includes bibliographical references. Available on the Internet via the World Wide Web.

Thesis (MSW(Social Work))-University of Pretoria, 2008. / Includes bibliographical references.

Thesis (MA(Science of Religion and Missiology)--University of Pretoria, 2006. / Includes bibliographical references (p. 129-133)

Learners affected and infected by HIV/AIDS have been given priority status in the development of inclusive education. The Department of Education should develop and support the personal and professional self of educators as torch bearers of its educational policy. This inquiry attempted to understand educators’ teaching experiences to establish what educational and psychological support was needed to better include such learners. The information obtained may enable District Based Support Team’s (DBST’s) and School Based Support Team’s (SBST’s), as well as educational psychologists to develop educators, as limited research has been done in this regard. In this inquiry the data collection methods included 16 questionnaires completed by educators, an individual interview with a principal as well as two focus group interviews (with educators, and then with SBST and School Management Teams (SMT’s) members combined). Collages were visual representations of educators’ experiences and aided group discussions. Data obtained was analysed using the constant comparative method to determine the common themes and sub themes describing educators’ experiences over and above the identified educational and psychological support they needed to better include child-headed family learners within their classrooms. The findings presented suggest orphan status awareness at schools cannot be taken for granted. In coping with the effects of orphan-hood, learners presented with characteristic barriers such as: learning difficulties, incomplete school work and homework, failure to participate, school absenteeism, hunger, concentration difficulties, tiredness and sleeping in class, neglected appearance, behavioural difficulties, signs of sexual abuse, and accelerated adulthood. Efforts to create supportive learning environments included: impartial treatment, learning support provision, accessing support services and meeting basic needs for food, clothing, love, belongingness, reassurance, motivation and encouragement. Educators iii related accompanying negative psychological experiences (i.e. feeling sadness, distress and pain, as well as being emotionally drained and experiencing a sense of frustration at not knowing how to help or feeling unable to help). Identified educational and psychological support included: capacity building through contextualized and customized in-service training programmes, financial incentives and motivation, improved resources, increased governmental involvement, accessing multidisciplinary support services, community support and self care. Educators need to be supported and developed within a framework of whole school development if the goals of building health promoting schools within an inclusive education system are to be realised. Recommendations included: (i) Compelling stakeholders and health professionals to inform school and district based support teams of a learner’s orphan status. (ii) Building pre-service and in-service capacities through modules or customized workshops, on the identification, support and referral of learners from child-headed homes, basic counselling skills as well as self care awareness and educator burn out. (iii) Schools must develop financial incentives and motivation schemes by fund raising, obtaining sponsorships and ‘granting leave’ to deserving educators. Resource sharing was also encouraged. (iv) Government should conduct needs analyses at grass roots level to ensure equitable support service provision relative to the number of learners from child-headed homes at a school. (v) Educational psychologists or school counselors on behalf of school based support teams can co-ordinate Community Building Approach principles as one way of sharing the burden of care amongst interested stakeholders and community members. / Prof. Jace Pillay

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.

The human immunodeficiency virus/acquired immune-deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. “AIDS, (Acquired Immune Deficiency Syndrome), has devastated the social and economic fabric of African societies, made orphans of a whole generation of children and become the epicentre of the HIV/AIDS pandemic” (Fassin, 2007: 76). Like the virus itself, the AIDS crisis mutates rapidly. Children who are AIDS orphans living in South Africa, as in other African countries, suffer from recurrent psychological trauma. It starts with the illness and death of their parents and is followed by cycles of poverty, malnutrition, stigma, exploitation, sickness and often sexual abuse. The figures concerning those affected, which are staggering, offer various predictions regarding the number of orphans left in the wake of the pandemic. Between 1990 and 2003, the number of orphaned children rose from fewer than 1 million to more than 12 million in sub-Saharan Africa (UNICEF, 2005: 68). South Africa is severely affected by the AIDS pandemic, with the largest number of HIV infections in the world, a total of 5.7 million (RSA, 2010: 10), affecting approximately 3.2 million women and 280 000 children aged from 0 to14 years. There is a significant variation in HIV prevalence per province, with the Eastern Cape (EC) reportedly having an average prevalence rate of 28 percent. Hence South Africa is likely to be the country with highest percentage of children orphaned by AIDS within its population. Orphanhood is a major consequence of the AIDS pandemic in South Africa with an estimated 2.2 million AIDS-orphaned children, 11,188 per 100,000 by 2015. Most children who are AIDS orphans living in township communities live predominantly uncared for and unsupported. Therefore the purpose of this research study was to develop strategies to provide care and support to children who are AIDS orphans living in township communities. To achieve the purpose of this research study, a qualitative, exploratory, descriptive and contextual design was used by the researcher to gain insight from health and social care practitioners who render care and support to children who are AIDS orphans living in these communities. The data from in-depth interviews with the health and social care practitoners was used by the researcher to develop strategies to provide care and support to children who are AIDS orphans living in township communities. The study comprised the following four phases: Phase One: During this phase, the researcher will present an overview of the current legislative framework policies at an international, national and provincial level, regarding the the rights of children living in South Africa. Phase Two: During this phase data from two research populations were collected and analysed. As the research process of this study dealt with two groups of participants, namely in group one health care practitioners and group two comprised social workers and psychologists, who work in the township communities to provide care and support to children who are AIDS orphans living in these communities. The researcher discussed each group separately in the discussion of phase two of the study. Phase Three: Comprised the themes identified in the data gathered from the transcribed in-depth interviews, the field notes as well as the reflective journals were cross-validated to ensure trustworthiness of the data which was then organised into a conceptual framework. The conceptual framework was used to clarify the relationships of the concepts and the themes identified during the research process and also used to link the gathered data to previously established models and theories (Schneider, 2004: 133). Phase Four: The last phase of the research design, focused on the development of the “Steps of progression strategies” to provide holistic care and support to children who are AIDS orphans living in township communities. This was done making use of the themes identified during data analysis and the literature sources used throughout this research process. The evaluation criteria of Chinn and Kramer (2008: 237-248) were used to evaluate the strategies. It is therefore concluded that the researcher succeeded in achieving the purpose of this study because strategies which were understandable, clear, simple, applicable and significant to nursing practice have been developed for use by the Department of Health and Department of Social Development as well as primary health and social care practitioners to provide holistic care and support to children who are AIDS orphans living in township communities in South Africa.

M.Sc.(Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009 / The purpose of this research was to investigate job satisfaction and the impact of HIV and AIDS on nurses in a public hospital in Gauteng. The problems that generated this study included absenteeism, low morale and negativity of nurses working with patients in the presence of the HIV/AIDS crisis. A quantitative research method was used. The sample size comprised 248 nurses from all categories. The Measure of Job Satisfaction was the framework used which covers issues such as remuneration, security, growth, social and supervisory aspects. The framework for the HIV/AIDS section of the research was the Government policy on HIV/AIDS. Results showed job satisfaction was adversely affected by staff shortages, workload, frustrations with management, remuneration, lack of developmental opportunities and equipment. Analysis of the open-ended responses showed ambivalence amongst nurses towards nursing HIV/AIDS patients. Some expressed sadness and fear while others found their caring role fulfilled. The study indicated that facilitating development of staff, improving management skills, providing staff and equipment will all impact positively on job satisfaction. In addition, a deliberate effort needs to be made to plan debriefing/counselling services for nurses as well as ongoing HIV training.

HIV/AIDS has done a great damage to families and their children. Due to HIV/AIDS, grandmothers find themselves caring for their sick children, grandchildren and orphaned grandchildren. Because of the large number of AIDS orphans, the existing pool of community-based support has become saturated. Therefore these children now have to fend for themselves. They are forced to become heads of the households and breadwinners. In this situation the older children have to assume the role of looking after their siblings. Death caused by HIV/AIDS leaves children vulnerable, in great distress and poverty. The stigma and discrimination related to the HIV/AIDS pandemic has resulted in the isolation of infected persons and their family members. Sometimes the isolation continues until and even after the children become orphans. It is a fact that HIV/AIDS orphans as heads of households are undergoing traumatic experiences. On the psychological level children are traumatized by the illness of their parent(s). Because of the high rate of unemployed and pervasive poverty in this country many families are reluctant to take in orphans. Other problems are: the cost of treating illnesses caused by HIV/AIDS places a huge economic burden on families. After death, funeral expenses contribute to the toll exacted by HIV/AIDS. It becomes increasingly impossible for families and communities to absorb the cost and support the large numbers of children alone. Some women hesitate to take in the orphaned children of their relatives because they fear that their husbands will abuse the children Investigation into the existing literature reveals that previous studies concentrated mostly on the educational, psychosocial and emotional needs of people with HIV/AIDS. Studies on child headed households’ deals primarily with children’s rights and the accessibility of social grants for children infected and affected by HIV/AIDS. Although not much was available statistically, for the purpose of this study I have identified several households headed by children, whether the cause of this was HIV/AIDS or misfortunes such as parental suicide or accidents. This study has focused on the experiences of HIV/AIDS orphans in child headed households. This study has also investigated whether HIV/AIDS orphans suffer more deeply psychologically and emotionally than children who have been orphaned by other circumstances other than AIDS. This study highlights the many difficulties and setbacks experienced by HIV/AIDS orphans who become heads of households after the death of their parents. An exploratory research design was utilised and qualitative approach was followed. Five households were chosen as samples that complied with requirements of this study. Participants in these households were between ages 13 and 18 years old. The information gathered by means of literature and empirical research reveals that the children affected by HIV/AIDS are not only physically impoverished, but also psychologically, socially and spiritually. They suffer from fear, depression, stress, anxiety, stigmatisation and discrimination, isolation, and are often scorned by peers. HIV/AIDS orphans experience psychological trauma on account of witnessing their parent’s illness and death (or departure), carrying the responsibility of caring for sick parents, and after their death, for siblings. The socio-economic circumstances of HIV/AIDS orphans in child headed household often force them to drop out of school, in order to find ways of providing for the family. The traumatic experience of HIV/AIDS orphans and children who have been orphaned to other circumstances, are similar. The following themes can be considered for future research:<ul> <li>Stress experienced by HIV/AIDS orphans in child headed households due to HIV/AIDS</li>. <li>The role of churches in identifying and supporting orphans in child headed households</li>.</ul> / Dissertation (MTheol(Practical Theology))--University of Pretoria, 2006. / Practical Theology / unrestricted

HIV/AIDS epidemic has caused much devastation and has left many children destitute and in need of care and supervision. The present study investigated the psychological impact of caring on non-professional caregivers of HIV/AIDS orphans and children affected by HIV/AIDS. General systems theory stands as the epistemological framework informing the study. The study made use of a qualitative phenomenological approach to explore the lived experiences of eight non-professional caregivers who participated in the study .From the themes that were abstracted it was evident that caring for HIV/AIDS orphans is emotionally, physically and mentally strenuous for the caregivers. It was better recommended that caregivers be given recognition for their challenging work and be included in the planning and development of programmes that affect their caregiving role. Furthermore emotional, psycho-social, and income-generating skills support programmes including training and educational programmes should be implemented. This will alleviate the distress inherent to the caregiving role and to equip them with the necessary skills for handling the demands of their work. / Psychology / M.A. (Clinical Psychology)

Thesis (MPA (School of Public Management and Planning))--Stellenbosch University, 2008. / The role of Community Health Workers (CHWs) in the HIV/AIDS Programme is directly dependent on the support systems provided by nurses, NGOs, the community, institutional frameworks, and government funding and stress management institutions. The Home-based caregivers that work in the HIV/AIDS Programme are CHWs who need maximum support from the above- mentioned institutions. The community is also reeling with the aggravating consequences of HIV/AIDS. CHWs play a role in trying to take care of the HIV patients within the home environment. People are cared for by the people they associate with and people who live with them. In order for CHWs to maximise their contribution to the HIV/AIDS Programme, there should be commitment from all stakeholders involved in the programme. Forty-one people from formal and non-formal structures took part in the study. The formal structures refer to clinics and hospitals, whereas informal structures refer to Home-based care (HBC) groups, volunteers, NGOs and international donor agencies. The study was conducted over a period of eight weeks. The study was conducted at Cork, Calcutta and Mkhuhlu clinics, and Mkhuhlu Home-based care and on USAID field officers. The results of the study suggested that with support systems from the relevant institutions, CHWs are able to carry their community obligations in an effective and efficient manner. These findings have positive relationship implications towards the reduction of HIV infections in the community. Hospitals that are faced with overcrowding also benefit in a way, when terminally ill patients are cared for at HBC centres.