This diploma thesis deals with the psychosocial problems of patients treated for chronic hepatitis C. The aim of the thesis was to map the problems arising during this treatment and to divide them into biological, psychological, and social problems and problems leading to a change in the patient's quality of life. The disease is also assessed in relation to risky behaviour - a history of substance dependence. The work should also show how the individual components of the multidisciplinary team are involved in intervention during treatment. In the first part of the thesis, I describe the theoretical issues of hepatitis C as a consequence of intravenous drug dependence, and I deal with quality of life, the multidisciplinary team and psychosocial care with the help of professional literature. In the empirical part, I chose qualitative research through the interviewing method using the semi-structured interview technique. The research sample consisted of eight clients of the infectious disease ward treated for or shortly after chronic hepatitis C. The data analysis was evaluated by the data categorization method. The results showed a very demanding, mainly physically, course of treatment with a significant impact on the mental and social function of the patient. The reason why the clients had turned to addictive substances was varied, from a curiosity in youth, through addiction as a consequence of trauma from sexual abuse in childhood, to addiction as a consequence of leaving a children's home without the adequate social preparedness and assistance. The components of the multidisciplinary team that intervened the most were healthcare, psychiatry, psychology - psychotherapy, the District Social Security Administration, and the Labour Office. This work identifies the issues that are not widely spoken of. It has shown us that not only addiction to addictive substances is dangerous for the individuals, but that the health problems do not end even after the treatment of their addiction, and the clients have to undergo a rather demanding treatment in order to eliminate these problems. However, on a society-wide level, it is desirable that as many of these clients as possible be treated with a positive result, even if they are drawing large amounts from the general health insurance. The results could serve as materials for the prevention of socio-pathological phenomena, for educational activities in schools or for institutions in, for example, K-centres, which provide help to addictive substance users.

This thesis deals with the Czech and international ideas applied in the "Strategy of Reform of Psychiatric Care" issued in 2013 by the Ministry of Health of the Czech Republic. The main starting point of this work is the fact that the care of people with mental illness in Czech and international environment is oriented on the biological treatment of the patient with psycho- pharmaceuticals and that there is a deficit in the area of psychosocial treatment. International and Czech mental health policy seeks to promote a bio-psycho-social approach to patient's care. However, current psychiatry continues to be involved in conducting clinical research focused on the efficiency of psycho-pharmaceuticals. These studies are driven and sponsored mainly by the pharmaceutical industry. But international and Czech policies are still not able to adequately reflect this situation within the field of psychiatry. The Czech Republic has not so far paid attention to mental health issues and has lagged behind the other developed countries in this area. The empirical part of this work is divided into two parts. The first part of the research focuses on the Czech and international ideas applied in the "Strategy of Reform of Psychiatric Care" issued in 2013 by Ministry of Health. The methods used here are - content...

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022. / Mental illness is a high burden of disease especially in Low- and Medium-Income Countries (LMICs) like South Africa. In many LMICs, there is a paucity of Mental Health Professionals (MHCPs). As a result, people with mental illness call their faith healers or religious/spiritual leaders (pastors in this study) when experiencing mental health problems. Pastors are more accessible, share the same religious/spiritual beliefs about mental illness with their congregants and often provide religious/spiritual solutions to those who consult with them. Thus, they are often preferred over MHCPs. However, pastors are rarely involved as partners in community based mental health programs. While mental illness is mainly clinically diagnosed and recognised by MHCPs using the DSM-5 and ICD-10 codes, less is known in South Africa with regards to the views of pastors with regards to their notions of what mental illness is. Thus, it may be complex for Pentecostal pastors to clearly distinguish between spirit possession and mental illness as much as it is complex for MHCPs who struggle with accommodating their patients’ religious/spiritual beliefs. Religious/spiritual beliefs are significant in many Africans seeking mental health recovery. However, less has been explored in South Africa in the area of religion/spirituality and its relevance in the practice of clinical psychology. Western based psychotherapeutic methods of intervention which exclude the religious/spiritual domain of African clients continue to dominate the practise of psychology in Africa. Given the above, this study aimed to explore and understand selected Pentecostal pastors’ perception and treatment of mental illness. The research objectives were, namely: (1) to establish the notions held by Pentecostal pastors’ regarding what mental illness is (2) to establish Pentecostal pastors’ perception of what causes mental illness; (3) to determine Pentecostal pastors’ perceptions of how and by whom mental illness can be recognised, diagnosed, treated and managed; (4) To determine Pentecostal pastors’ views regarding their own roles in the management of mental illness; and (5) To canvass and describe Pentecostal pastors’ perceptions about collaboration for purposes of an intervention programme aimed at providing a holistic care and treatment of religious/spiritual patients. The study was qualitative, and the exploratory research approach was adopted. The research was informed by the Bio-Psycho-Social-Spiritual (BPSS) model. Purposive sampling was used to select nineteen (19) participants. In-depth semi-structured interviews were conducted. Data were analysed using Thematic Analysis (TA). The following six major themes emerged from the analysed data: (i) Notions of mental illness; (ii) Causes of mental illness;(iii) Recognition and diagnosis of mental illness (iv) Notions on the treatment and management of mental illness; (v) Perceived roles in the treatment and management of mental illness; (vi) Views regarding collaboration with MHCPs. The participants held a multifactorial view of mental illness. They were limited in their understanding of mental illness and perceived it mainly to be madness (psychosis). The participants’ perception of mental illness was influenced by their theological (Pentecostal) as well as their cultural backgrounds (Black Africans). The participants indicated that they lacked training in mental health issues. As such, they were not opposed to collaborating with MHCPs. They mentioned that their roles included counselling, prayer, support, and referral. This study also discovered that Pentecostal pastors upheld three treatment approaches of mental illness namely: The Full-Collaborative Approach; The Partial-Collaborative Approach and the Non-Collaborative Approach. Findings of the study were discussed, and recommendations were made including the proposed intervention programme between pastors and MHCPs with the aim of facilitating a referral process and collaboration between the two professions. / National Institute for the Humanities and Social Sciences (NIHSS), and South African Humanities Deans Association (SAHUDA)

1. Unterschiedliche Definitionen der Gesundheit mit verschiedenen Betrachtungsweisen (WHO: Der Mensch eine biopsychosoziale Einheit. Schulmedizin: ohne klinischen und paraklinischen Befund mit Orientierung an kritikbedürftigen Referenzmittelwerten) führt bei Fachleuten, Behörden und Laien zu Verwirrungen, wenn es um die Beurteilung gesundheitlicher Schäden geht. 2. Es wurde die Aufgabe gestellt zu prüfen, welche der beiden Definitionen der Realität näher kommt. 3. Mittels der chronopsychobiologischen Regulationsdiagnostik, des Dreiphasenentspannungstests (Hecht und Balzer 2001), wurden unter dem Aspekt der beiden Gesundheitsdefinitionen drei Gruppen untersucht (je 40 Probanden). - klinisch Gesunde (klinisch Gesunde nach Schulmedizin ) - Gesunde nach Definition der WHO - Probanden mit nichtorganische Insomnie (ohne pathologische klinische und paraklinische Befunde) 4. Die mit den verwendeten Methoden gewonnenen Daten wiesen aus, dass zwischen den klinisch Gesunden und den Probanden mit nichtorganischer Insomnie weitgehend größere Ähnlichkeiten bestehen. Beide Gruppen zeigten aber zu der Gruppe der Gesunden nach WHO-Definition, welche die biopsychosoziale Einheit des Menschen berücksichtigt, noch hochsignifikante Unterschiede. Die Gruppe der klinisch Gesunden kann daher auf Grund unserer Ergebnisse nicht den Anspruch erheben, real gesund zu sein. 5. Mit der Bezugnahme auf die Internationale Klassifikation der Krankheiten (ICD 10F) haben die von uns untersuchten klinisch Gesunden und die nichtorganischen Insomniker eine mehr oder weniger stark ausgeprägte Symptomatik von psychischen Störungen. Dies müsste bei der Beurteilung von Schadstoff-, Lärm-, und EMF-Wirkungen auf den Menschen, wie auch bei den klinisch-pharmakoloischen Untersuchungen beachtet werden. Die in der Arbeit erzielten Ergebnisse bedürfen durch weitere Untersuchungen eine Fundierung. Sie signalisieren aber sowohl unter praktischen als auch unter theoretischen Aspekten einen dringenden Forschungsbedarf. / 1. Differing definitions of health using different criterea (WHO: The human being as a bio- psycho-social unit versus classical medicine: without clinical and paraclinical results based on suspect reference values) bring confusion to experts, authorities and laymen when assessing health damages. 2. The given task was to check which of the two definitions is closer to reality. 3. Using the chrono-psycho-biological diagnostic of regulation, the three-phase-relaxation test (Hecht and Balzer 2001), three groups were examined considering the aspects of the two health definitions (40 test subjects in the study group). - clinically healthy (clinically healthy per classical medicine definition) - healthy per definition of the WHO - test persons with non organic insomnia (i.e. no pathological or paraclinical findings) 4. The data gained from the employed methods revealed bigger similarities between clinically healthy persons and those with non organic insomnia. Both groups still showed highly significant differences to the group which fulfils the definition of the WHO regarding a human as a bio-psycho-social unit. As a result of this study, persons, though classified as "clinically healthy" might nevertheless not absolutely be healthy in reality. 5. In reference to the international classification of illnesses (ICD 10 F) the groups examined, both of clinically healthy and those with non organic insomnia, have more or less severe psychological symptoms. This should be taken into account when assessing the effects of pollution, noise, and EMF as well as clinical pharmacological studies. These present findings still need broader confirmation by further investigations. However, they clearly indicate, for practical and theoretical considerations, an urgent need for further research.

Facilitating forgiveness: an NLP approach to forgiving is an attempt at uncovering features of the blocks that prevent people to forgive. These blocks to forgiveness can be detected in the real life situations of the six individuals who told me their stories. The inner thoughts, feelings and the subsequent behaviour that prevented them from forgiving others is clearly uncovered in their stories. The facilitation process highlights the features that created the blocks in the past thus preventing forgiveness to occur. The blocks with their accompanying features reveal what needs to be clarified or changed in order to eventually enable the hurt individuals to forgive those who have hurt them. The application of discourse analysis to the stories of hurt highlights the links between the real life stories of the individuals within their contexts with regard to unforgiveness to the research findings of the existing body of knowledge, thereby creating a complexly interwoven comprehensive understanding of the individuals' thoughts, feelings, and behaviours in conjunction with their developmental phases within their socio-cultural contexts. Neuro-linguistic-programming (NLP) is the instrument with which forgiving is facilitated in the six individuals who expressed their conscious desire to forgive, because they were unable to do so on their own. Their emotions had the habit of keeping them in a place in which they were forced to relive the hurtful event as if it were happening in the present. Arresting the process of reliving negative emotions requires a new way of being in this world. The assumption that this can be learnt is based on the results from a previous study, in which forgiveness was uncovered by means of the grounded theory approach as a cognitive process (Von Krosigk, 2000). The results from the previous research in conjunction with the results and insights from this research study are presented in the form of a grounded theory model of forgiveness. / Psychology / D. Litt. et Phil. (Psychology)

The number of students with learning disabilities entering the higher education system in South Africa is increasing dramatically. At the same time, the misconceptions about disabilities can have distressing consequences for disabled students. A thorough understanding of current staff attitudes and knowledge of learning disabilities will assist when setting up interventions aimed at improving perceptions. This qualitative, phenomenological case study uses the bio-psycho-social model of disability to explore staff perceptions at the University of the Witwatersrand. Interviews with staff members showed that a wide range of opinions and attitudes exist. Although perceptions varied between participants, the main findings indicated that they presented a poor understanding of what disability, and in particular, learning disability means. The conclusion was drawn that Wits University should be proactive in empowering their staff by providing them with opportunities to learn about disabilities. This investment in staff development should ultimately lead to a richer campus life where all students feel welcome. / Educational Studies / M. Ed. (Adult Education)

The number of students with learning disabilities entering the higher education system in South Africa is increasing dramatically. At the same time, the misconceptions about disabilities can have distressing consequences for disabled students. A thorough understanding of current staff attitudes and knowledge of learning disabilities will assist when setting up interventions aimed at improving perceptions. This qualitative, phenomenological case study uses the bio-psycho-social model of disability to explore staff perceptions at the University of the Witwatersrand. Interviews with staff members showed that a wide range of opinions and attitudes exist. Although perceptions varied between participants, the main findings indicated that they presented a poor understanding of what disability, and in particular, learning disability means. The conclusion was drawn that Wits University should be proactive in empowering their staff by providing them with opportunities to learn about disabilities. This investment in staff development should ultimately lead to a richer campus life where all students feel welcome. / Educational Studies / M. Ed. (Adult Education)

Das Krankheitsbild der Adipositas hat sich weltweit zu einem relevanten Gesundheitsproblem entwickelt. Die bariatrische Chirurgie wird zunehmend als wirkungsvolle Behandlung bei schwer ausgeprägter Adipositas eingesetzt. Jedoch ist über die Rolle psychologischer Variablen im bariatrischen Behandlungsverlauf noch wenig bekannt. Die vorliegende Dissertation untersucht Einfluss und Veränderung patientenberichteter Gesundheitsmerkmale in der chirurgischen Adipositastherapie. Dazu werden in einer naturalistischen Beobachtungsstudie Patienten mit schwerer Adipositas vor und im Durchschnitt zwei Jahre nach einer bariatrischen Operation (OP) befragt. Ziele der Arbeit sind 1) die Charakterisierung adipöser Patienten vor OP hinsichtlich bio-psycho-sozialer Variablen; 2) die Identifikation möglicher Einflussvariablen auf den gewichtsbezogenen Behandlungserfolg nach OP; 3) die Untersuchung von Auswirkungen der OP auf das Essverhalten; und 4) die Analyse von Veränderungen in der essstörungsbezogenen Psychopathologie und in der gesundheitsbezogenen Lebensqualität nach OP. Die Ergebnisse der bariatrischen Patienten werden im Vergleich zu denen konservativ behandelter Patienten betrachtet. Die Ergebnisse zeigen, dass Patienten mit bariatrischem Behandlungswunsch eine somatisch und psychisch belastete Patientengruppe darstellen. Die bariatrische OP führt im zweiten postoperativen Jahr zu einer nachhaltigen und klinisch bedeutsamen Gewichtsreduktion. Der präoperative Body-Maß-Index, das Bildungsniveau und aktives Problembewältigungsverhalten sind mit dem Gewichtsverlust nach OP assoziiert. Im Vergleich zur konservativen Behandlung berichten die Patienten, die sich der OP unterziehen, über stärker ausgeprägte Verbesserungen in ihrem Essverhalten und eine Steigerung ihrer Lebensqualität. Auf Basis der Befunde wird ein routinemäßiges Monitoring der somatischen und psychischen Situation der Patienten nach bariatrischer OP empfohlen, um die gezeigten Behandlungserfolge optimal zu sichern. / Obesity has become a relevant global health problem. Bariatric surgery is an effective treatment for severe obesity. However, while the number of operations performed continues to increase, the role of psychological variables throughout the bariatric surgery pathway remains uncertain. The present dissertation investigates the patient-reported health status as it impacts and results from bariatric surgery. In a naturalistic observational study, patients with severe obesity are assessed before and, on average, two years after the surgical treatment. Main aims are 1) to characterize obese patients prior to bariatric surgery in terms of biological, psychological and socio-demographic variables; 2) to identify possible predictors for the postoperative weight-related treatment success after bariatric surgery; 3) to examine changes in eating behaviors; and 4) to analyze changes in eating-related psychopathology and in health-related quality of life (HRQoL). The outcomes of surgical patients are compared with those of conservatively treated patients for the same follow-up period. The findings show that bariatric surgery candidates represent a vulnerable patient group with high physical and psychological burden. In the second postoperative year after bariatric surgery, a sustainable and clinically meaningful weight reduction is achieved. The preoperative body mass index, education level and active coping behavior are associated with weight loss after surgery. Compared with conservative treatment, patients who undergo bariatric surgery report not only greater improvements in their eating behavior and eating-related psychopathology but also an increase in their HRQoL. Based on the results, the provision of a routine monitoring of the somatic and psychological situation of patients following bariatric surgery is recommended to secure longer-term treatment success.

Facilitating forgiveness: an NLP approach to forgiving is an attempt at uncovering features of the blocks that prevent people to forgive. These blocks to forgiveness can be detected in the real life situations of the six individuals who told me their stories. The inner thoughts, feelings and the subsequent behaviour that prevented them from forgiving others is clearly uncovered in their stories. The facilitation process highlights the features that created the blocks in the past thus preventing forgiveness to occur. The blocks with their accompanying features reveal what needs to be clarified or changed in order to eventually enable the hurt individuals to forgive those who have hurt them. The application of discourse analysis to the stories of hurt highlights the links between the real life stories of the individuals within their contexts with regard to unforgiveness to the research findings of the existing body of knowledge, thereby creating a complexly interwoven comprehensive understanding of the individuals' thoughts, feelings, and behaviours in conjunction with their developmental phases within their socio-cultural contexts. Neuro-linguistic-programming (NLP) is the instrument with which forgiving is facilitated in the six individuals who expressed their conscious desire to forgive, because they were unable to do so on their own. Their emotions had the habit of keeping them in a place in which they were forced to relive the hurtful event as if it were happening in the present. Arresting the process of reliving negative emotions requires a new way of being in this world. The assumption that this can be learnt is based on the results from a previous study, in which forgiveness was uncovered by means of the grounded theory approach as a cognitive process (Von Krosigk, 2000). The results from the previous research in conjunction with the results and insights from this research study are presented in the form of a grounded theory model of forgiveness. / Psychology / D. Litt. et Phil. (Psychology)

This thesis analyzes the Cuban medical adaptation in Venezuela called Misión Barrio Adentro (MBA) and seeks to answer the question of whether MBA shows promise as a health system that improves medical accessibility for impoverished and marginalized populations. In many cases MBA succeeds by: utilizing a free universal health care system; locating health centres in previously underserved areas; providing medical education scholarships to populations from non-traditional backgrounds; creating a catchment system based on medical accessibility; scaling up the medical workforce to 60,000 community doctors by 2019; and broadening the very praxis of what health means in a Latin American social medicine approach. However, some challenges remain including issues of corruption, fragmentation, and polarization. Issues regarding internal and external migration of Misión Sucre-trained physicians remain to be comprehensively evaluated. However, the capacitation of non-traditional medical personnel, imbued with conciencia, is significant and could well become an important example for other countries.