Cancer is a potentially life-threatening disease, which affects millions of people worldwide. It is multifaceted in nature and can lead to impairment in a person‟s physical, social and emotional functioning (Beatty, Oxlad, Koczwara, & Wade, 2008). Multidimensional treatment, with highly specialised professionals, equipment and services is thus needed for the effective treatment thereof (Mathews, West, & Buehler, 2009). Patients treated within the private and public healthcare sectors of South Africa have vastly differing treatment experiences. Only about 20% of the South African population has access to and can afford treatment within the private healthcare sector (Somdyala, Bradshaw, Gelderblom, & Parkin, 2010). While private sector patients have access to information, social workers and support groups, those in the public sector face life-threatening waiting times and a lack of empathy by public sector staff, weighed down by patient numbers and a lack of resources (Pillay 2002; Bateman, 2011). A study previously conducted by the researchers highlighted cancer patients‟ perceptions and experiences of treatment as being one of the most prominent themes influencing patients‟ overall cancer experience (Venter, Venter, Botha, & Strydom, 2008). This, coupled with the fact that the majority of research studies previously conducted in South Africa generally focused on the biomedical aspects of cancer (Albrecht, 2009), make exploring patients and healthcare professionals‟ perceptions and experiences of cancer treatment in a South African context potentially valuable. The thesis consists of three sub-studies reported in three manuscripts. The aim of the first article was to provide a narrative literature review exploring cancer survivorship and management in the South African context by scrutinising research previously conducted on cancer treatment. The aim of the second and the third article was to explore patients and healthcare professionals‟ perceptions and experiences of cancer treatment in the private and public healthcare sectors in the Eastern Cape, South Africa. A 100 participants were purposively sampled from a government-funded hospital (n = 30 patients; n = 22 healthcare professionals) and a private treatment facility (n = 30 patients; 18 healthcare professionals). Data was collected by making use of both qualitative (self-report questionnaire consisting of open-ended questions; interviews) and quantitative (Needs Evaluation Questionnaire) measures. A qualitative content and statistical analysis was conducted. Findings indicate that despite the expressed need for treatment to move towards a more biopsychosocial approach, the majority of the healthcare professionals in the current study are still primarily following a biomedical approach. Findings also indicate that the majority of the difficulties and frustrations experienced could be seen as being contextual problems and were not necessarily related to cancer treatment per se. Poor availability of resources and the South African population‟s diverse characteristics were responsible for the majority of the difficulties reported. Differing cultural beliefs, language barriers, illiteracy and unemployment were al seen as negatively influencing the treatment process. This is consistent with Serin et al. (2004), who reported that there is a significant relationship between the systemic nature of medical issues and the social, material and psychological difficulties cancer patients‟ experience. The systemic nature of healthcare needs highlighted in the current study emphasises the necessity for cancer treatment in South Africa to employ a more biopsychosocial approach. True collaboration between healthcare professionals working towards a common goal should thus be considered as being the ideal. Considering the socioeconomic divide and resource discrepancy between the private and public healthcare sectors in South Africa, credence must be given to the allocation of resources in the public sector. If this incongruity is to be addressed, there would have to be cooperation at government level. Assistance with regard to the allocation of funds, as well as the meticulous monitoring of the distribution thereof, is needed. Funding should be used to increase human and technical resources, as well as for staff development. Equitable care for all cancer patients, regardless of their socioeconomic status, is the ideal. The following recommendations on how to improve overall cancer care, in both sectors, can also be made: existing treatment sites need to be updated and additional sites developed; continuous research needs to be conducted; funds need to be allocated towards the development of effective transport and translation services; cultural diversity should be taken into account when developing awareness campaigns and treatment plans; healthcare professionals need to adopt a holistic approach during which attention is given to communication, establishing rapport and patient participation; and lastly healthcare professionals should also be encouraged to pay attention to their own healthcare needs as well. / PhD (Psychology), North-West University, Potchefstroom Campus, 2014

Cancer is a potentially life-threatening disease, which affects millions of people worldwide. It is multifaceted in nature and can lead to impairment in a person‟s physical, social and emotional functioning (Beatty, Oxlad, Koczwara, & Wade, 2008). Multidimensional treatment, with highly specialised professionals, equipment and services is thus needed for the effective treatment thereof (Mathews, West, & Buehler, 2009). Patients treated within the private and public healthcare sectors of South Africa have vastly differing treatment experiences. Only about 20% of the South African population has access to and can afford treatment within the private healthcare sector (Somdyala, Bradshaw, Gelderblom, & Parkin, 2010). While private sector patients have access to information, social workers and support groups, those in the public sector face life-threatening waiting times and a lack of empathy by public sector staff, weighed down by patient numbers and a lack of resources (Pillay 2002; Bateman, 2011). A study previously conducted by the researchers highlighted cancer patients‟ perceptions and experiences of treatment as being one of the most prominent themes influencing patients‟ overall cancer experience (Venter, Venter, Botha, & Strydom, 2008). This, coupled with the fact that the majority of research studies previously conducted in South Africa generally focused on the biomedical aspects of cancer (Albrecht, 2009), make exploring patients and healthcare professionals‟ perceptions and experiences of cancer treatment in a South African context potentially valuable. The thesis consists of three sub-studies reported in three manuscripts. The aim of the first article was to provide a narrative literature review exploring cancer survivorship and management in the South African context by scrutinising research previously conducted on cancer treatment. The aim of the second and the third article was to explore patients and healthcare professionals‟ perceptions and experiences of cancer treatment in the private and public healthcare sectors in the Eastern Cape, South Africa. A 100 participants were purposively sampled from a government-funded hospital (n = 30 patients; n = 22 healthcare professionals) and a private treatment facility (n = 30 patients; 18 healthcare professionals). Data was collected by making use of both qualitative (self-report questionnaire consisting of open-ended questions; interviews) and quantitative (Needs Evaluation Questionnaire) measures. A qualitative content and statistical analysis was conducted. Findings indicate that despite the expressed need for treatment to move towards a more biopsychosocial approach, the majority of the healthcare professionals in the current study are still primarily following a biomedical approach. Findings also indicate that the majority of the difficulties and frustrations experienced could be seen as being contextual problems and were not necessarily related to cancer treatment per se. Poor availability of resources and the South African population‟s diverse characteristics were responsible for the majority of the difficulties reported. Differing cultural beliefs, language barriers, illiteracy and unemployment were al seen as negatively influencing the treatment process. This is consistent with Serin et al. (2004), who reported that there is a significant relationship between the systemic nature of medical issues and the social, material and psychological difficulties cancer patients‟ experience. The systemic nature of healthcare needs highlighted in the current study emphasises the necessity for cancer treatment in South Africa to employ a more biopsychosocial approach. True collaboration between healthcare professionals working towards a common goal should thus be considered as being the ideal. Considering the socioeconomic divide and resource discrepancy between the private and public healthcare sectors in South Africa, credence must be given to the allocation of resources in the public sector. If this incongruity is to be addressed, there would have to be cooperation at government level. Assistance with regard to the allocation of funds, as well as the meticulous monitoring of the distribution thereof, is needed. Funding should be used to increase human and technical resources, as well as for staff development. Equitable care for all cancer patients, regardless of their socioeconomic status, is the ideal. The following recommendations on how to improve overall cancer care, in both sectors, can also be made: existing treatment sites need to be updated and additional sites developed; continuous research needs to be conducted; funds need to be allocated towards the development of effective transport and translation services; cultural diversity should be taken into account when developing awareness campaigns and treatment plans; healthcare professionals need to adopt a holistic approach during which attention is given to communication, establishing rapport and patient participation; and lastly healthcare professionals should also be encouraged to pay attention to their own healthcare needs as well. / PhD (Psychology), North-West University, Potchefstroom Campus, 2014

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Thesis (Ph. D.)--Université René Descartes-Paris V, 1979. / Includes bibliographical references (p. [475]-480) and index.

Thesis (doctoral)--University of Uppsala, 1983. / Includes bibliographical references (p. 38-46).

Proefschrift Universiteit Maastricht. / Auteursnaam op omslag: Chris Ingelse. Bibliogr.; p. 383-397. Met lit. opg. - Met samenvatting in het Engels.

Thesis (doctoral)--Albert-Ludwigs-Universität, Freiburg (Breisgau), 2001/2002.