Introduction: There is growing evidence that many parents with learning disabilities, when given adequate support, can parent successfully. Childbirth is a significant life event that marks a woman's transition to motherhood and is a time when parents first learn to nurture their children. Postnatal care aims to facilitate this learning experience as well as promote the emotional and physical well-being of both infant and mother. To date, no research has explored the support mothers with learning disabilities receive during the postnatal period. To fill this gap in the research and help inform service provision, this study aims to explore how mothers with learning disabilities experience postnatal care. Method: Semi-structured interviews were carried out with six mothers with learning disabilities. The data were collected and analysed using Interpretative Phenomenological Analysis. Results: Mothers experiences of postnatal care were conceptualised within four superordinate themes: challenges of providing support, how support was delivered , learning to cope and challenges to building trust. All of these had accompanying subthemes. Discussion: The results are discussed in the context of relevant literature. Consistent with previous research which has been carried out with parents with learning disabilities, participants were found to be highly dependent on informal support. The participants acknowledged the value of professional input and their perceptions of how this support was delivered had important implications. Learning how to cope with the demands of their new role raised issues not dissimilar to those of parents without learning disabilities. Challenges, however, were faced in establishing trusting relationships with professionals. The findings were found to have implications for clinical practice which are described and suggestions for future research made. Conclusion: The findings suggest that participant informal supports play a key role during the initial stages of parenthood particularly with providing practical support in areas which present challenges. Professional input was valued when delivered according to the typical pathway of care post-birth. It is recommended that consideration is given to how the support is delivered to participants. This should essentially seek to empower parents rather than undermine them as how support was perceived by parents impacted on their subsequent engagement with professionals.

The main focus of this study was on making recommendations towards the refinement of REds that should increase its effectiveness in supporting educators affected by the HIV and AIDS pandemic towards coping resiliently with the challenges of the pandemic. The educators are affected by_ learners, colleagues, family members who are HIV positive or dying from AIDS-related illnesses, or teaching orphans and vulnerable learners made by HIV/AIDS pandemic. To achieve this aim, I followed a pm-experimental pre-test-post-test design. Within this design, I used qualitative methods of data collection, to comment on how successful REds was in encouraging participant resilience and to comment on how REds could be refined. Ten affected educators volunteered to take part in this study, being three males and seven females. Their ages ranged from 35-56 and they were all primary school educators. All the participants came from one school in the Eastern Free State province (Thabo Mofutsanyana district). REds was implemented in Thabo Mofutsanyana district because this is where I live and work and the school is accessible to me. The participants were all esothospeaking and adhered to Sesotho culture. They all taught AIDS orphans and vulnerable children. My findings from this study documented that participants seem to have benefitted from their participation in REds. In general the participants reported more resilient management of the challenges brought in by the HIV/AIDS disaster and although this cannot be finally linked to their participation in REds, participants in general they made such a link. REds need to be refined witl1 regard to content, language and activities that will do more to encourage assertiveness. / M.Ed., North-West University, Vaal Triangle Campus, 2010

The main focus of this study was on making recommendations towards the refinement of REds that should increase its effectiveness in supporting educators affected by the HIV and AIDS pandemic towards coping resiliently with the challenges of the pandemic. The educators are affected by_ learners, colleagues, family members who are HIV positive or dying from AIDS-related illnesses, or teaching orphans and vulnerable learners made by HIV/AIDS pandemic. To achieve this aim, I followed a pm-experimental pre-test-post-test design. Within this design, I used qualitative methods of data collection, to comment on how successful REds was in encouraging participant resilience and to comment on how REds could be refined. Ten affected educators volunteered to take part in this study, being three males and seven females. Their ages ranged from 35-56 and they were all primary school educators. All the participants came from one school in the Eastern Free State province (Thabo Mofutsanyana district). REds was implemented in Thabo Mofutsanyana district because this is where I live and work and the school is accessible to me. The participants were all esothospeaking and adhered to Sesotho culture. They all taught AIDS orphans and vulnerable children. My findings from this study documented that participants seem to have benefitted from their participation in REds. In general the participants reported more resilient management of the challenges brought in by the HIV/AIDS disaster and although this cannot be finally linked to their participation in REds, participants in general they made such a link. REds need to be refined witl1 regard to content, language and activities that will do more to encourage assertiveness. / M.Ed., North-West University, Vaal Triangle Campus, 2010

Magister Curationis - MCur / Parents undergo negative experiences that include parental anxiety, depression, and posttraumatic stress when their new-born babies are hospitalised in neonatal intensive care unit. During this stressful period, parents need assistance from staff in order to cope. A quantitative, descriptive survey design was used to describe parents’ perception of nursing support during their baby’s admission in neonatal intensive care units (NICU) at three selected private hospitals in the city of Cape Town in the Western Cape Province. A structured existing 21- item Likert type questionnaire, the Nurse-Parent Support Tool (NPST) was used to collect data from an all-inclusive sample of 85 parents with a response rate of 78.8% (n=67). The purpose of the questionnaire was to determine their perception of information giving and communication by nurses; emotionally supportive behaviours by nurses; care given support or instrumental support and to identify parents’ perception of esteem or appraisal support while in the NICU environment. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24. The findings of this study suggested that the overall mean score for parents’ perception of nursing support was high 4.6 (±0.5) out of a possible of 5. There was no significant difference in the overall mean perceived support score between the different facilities. No significant differences were found in terms of all the demographics characteristics with regard to perceptions of the support that was received, thus indicating that there was no relationship between the demographic variables and perception of support. The findings suggested that though high parental support was reported, the area of involving parents in the care of their babies i.e. letting them decide whether to stay or leave during procedures need improvement.

Objective: This research explores the critical need for individualized care planning to ensure maximum cost savings by providing a balance between individuals’ care needs and care wishes. The primary objective of this research is to identify common goals of care (GoC) expressed by long-term care residents (using the interRAI LTCF) and clients receiving community supportive services (using the interRAI CHA) or community mental health services (using the interRAI CMH). Methods: Three interRAI datasets were used to perform data analyses. The responses to the open-ended GoC item were quantified and grouped into common goal categories, which were then examined against the interRAI outcome measures and Clinical Assessment Protocols (CAPs). Demographic and clinical characterisitics were compared across the sample populations using the chi-square test. Logistic regression models were created to reveal variables that are predictive of not having a GoC recorded within each care setting. Results: Twenty-five GoC categories were created. Although the GoC responses were very diverse, many persons had no goal recorded. Nearly 70% of long-term care (LTC) residents and community support service (CSS) clients were unable to state a GoC. Different populations in different service settings had distinct GoC but had some commonalities as well such as goals that focused on general physical or mental health issues. GoC varied with the CAPs- the triggering of a CAP did not necessarily mean a corresponding GoC was noted. Each care sector had different predictor variables that were strongly associated with not having a GoC. Conclusions: There is not a “one size fits all” solution to care planning. The same goals and outcome measures are not appropriate or realistic for all persons. It is critical to incorporate self-reported goals into the development of effective and individualized care plans to ultimately improve one’s quality of life, satisfaction with care, and success in achieving desired outcomes of care.

Objective: This research explores the critical need for individualized care planning to ensure maximum cost savings by providing a balance between individuals’ care needs and care wishes. The primary objective of this research is to identify common goals of care (GoC) expressed by long-term care residents (using the interRAI LTCF) and clients receiving community supportive services (using the interRAI CHA) or community mental health services (using the interRAI CMH). Methods: Three interRAI datasets were used to perform data analyses. The responses to the open-ended GoC item were quantified and grouped into common goal categories, which were then examined against the interRAI outcome measures and Clinical Assessment Protocols (CAPs). Demographic and clinical characterisitics were compared across the sample populations using the chi-square test. Logistic regression models were created to reveal variables that are predictive of not having a GoC recorded within each care setting. Results: Twenty-five GoC categories were created. Although the GoC responses were very diverse, many persons had no goal recorded. Nearly 70% of long-term care (LTC) residents and community support service (CSS) clients were unable to state a GoC. Different populations in different service settings had distinct GoC but had some commonalities as well such as goals that focused on general physical or mental health issues. GoC varied with the CAPs- the triggering of a CAP did not necessarily mean a corresponding GoC was noted. Each care sector had different predictor variables that were strongly associated with not having a GoC. Conclusions: There is not a “one size fits all” solution to care planning. The same goals and outcome measures are not appropriate or realistic for all persons. It is critical to incorporate self-reported goals into the development of effective and individualized care plans to ultimately improve one’s quality of life, satisfaction with care, and success in achieving desired outcomes of care.

Thesis--University of Oklahoma. / Bibliography: leaves 71-73.

South Africa bears the largest burden of children living with HIV in Sub-Saharan Africa, with 450 000 of the continent's over 3 million children living with HIV estimated to be in the country (UNAIDS, 2013:87). Children living with HIV have various intrinsic biopsychosocial needs, and the meeting of these needs within drop-in-centres is primarily the responsibility of Social Auxiliary Workers, a ?frontline? category of social welfare workforce whose roles are viewed as critical in enabling the identification and facilitation of provision of health and other services. The study was informed by a concern that, in spite of their envisaged roles, Social Auxiliary Workers have very limited paediatric HIV knowledge, skills and experience. The goal of the study was to explore the perceptions of Social Auxiliary Workers on their role and competencies in addressing biopsychosocial needs of children living with HIV at drop-in-centres. The researcher conducted this study from a qualitative approach. The study was applied in a natural setting and a collective case study design was utilised. The work experiences of a purposive sample of participants that was randomly sampled were gathered by means of semi-structured one-on-one interviews. A total sample of 10 participants was drawn from a pool of 40 Social Auxiliary Workers who were employed in 18 drop-in-centres that are in Sedibeng District Municipality. The study's findings indicate that children living with HIV had many complex biological, psychological and social needs that were exacerbated by stigma, discrimination and non-disclosure of the children's HIV status by parents. This created underlying debilitating barriers for Social Auxiliary Workers to efficiently identify, and get children into treatment, care and social support services. The findings also revealed that Social Auxiliary Workers had limited, non-standardised and highly imperceptible HIV knowledge and skills to competently work with children living with HIV. Furthermore, findings showed that Social Auxiliary Workers face institutional and resource challenges that stem from poverty, insufficient financial resources within drop-in-centres and lack of structured large scale programmes to mobilise and educate communities on children and HIV. The study concluded that many of the biopsychosocial needs that children living with HIV face are not being comprehensively and sustainably addressed as Social Auxiliary Workers are not effective in their role, amongst other things, due to lack of skills and knowledge on how to address factors that contribute to the exclusion; and consequently, disproportionate low access of services by children living with HIV. The study proposes the training and capacitation of Social Auxiliary Workers on paediatric HIV so as to increase the depth and breadth of services rendered to children living with HIV. It is also important that regular and on-going supervision and debriefing opportunities for Social Auxiliary Workers should be strengthened to promote optimal consolidation of skills and knowledge. The provision of simplified practice guidelines and procedures should also be prioritised in order to ensure consistency in understanding amongst Social Auxiliary Workers of their role and obligations. Furthermore, it is recommended that Government and the Department of Social Development should consider scaling-up funding for drop-in-centres as well as implementation of HIV-related stigma and discrimination mitigation programmes in communities. / Mini Dissertation (MSW)--University of Pretoria, 2016. / Social Work and Criminology / MSW / Unrestricted

In organizations with decision makers across multiple hierarchical levels, conflicting objectives are commonly observed. The decision maker, or agent, at the highest level usually makes decisions in the interest of the organization, while a subordinate agent may have a conflict of interest between taking a course of action that is best for the organization and the course of action that is best for itself. The Multiscale Decision-Making (MSDM) model was established by Wernz (2008). The model has been developed to capture interactions in multi-agent systems, by integrating both the hierarchical and temporal scale of decisions made in organizations. This thesis contributes towards expanding the results in the hierarchical interaction domain of MSDM by extending the model to incorporate N decision alternatives and outcomes instead of two, and studying its effect on the interaction between agents. We consider decisions with uncertain outcomes, where the outcomes of the decisions made by agents lower in hierarchy affect the transition probabilities of the decisions made by agents above them in hierarchy. This leads to a game theoretic situation, where the lower-level agents need to be sufficiently incentivized in order to shift their best response strategy to one in the interest of their superior and the organization. Mathematical expressions for the optimal incentives at each hierarchical level are developed. We analyze systems with agents interacting across two and three organizational levels. We then study the effect of introducing the cost of taking an action on the optimal incentives. We discuss a health care application of MSDM. / Master of Science

<p>This thesis deals with a very important issue in South African society, i.e. the provision of financial and non-cash support to older persons. Older persons in South Africa can be described as a sizeable but vulnerable group requiring specific protection. Section 27 of the South African Constitution of 1996 obliges the state to take reasonable legislative and other measures within available resources to progressively realise the right of access to social security. Hence, the steps taken by the state to promote older persons&rsquo / right of access to social security and to protect their right to dignity need to be evaluated. The legislative framework for the provision of financial and non-cash support to older persons currently is fragmented into various statutes dealing with retirement income, state grants to older persons and care and support services for older persons. Therefore, the current legislation lacks an integrated approach to the provision of support and care to older persons, as well as a central principle on which to base future legislation concerning older persons. One such principle that could potentially be adopted is intergenerational solidarity, which can be described as the solidarity between the active working-age population, as one generation, from which benefits flow to older persons as the other. This thesis evaluates whether intergenerational solidarity should form the basis of South African legislation on the provision of retirement income and the provision of care and support to older persons, and if so, whether it in fact does. If the answer to the latter is in the negative, the thesis further examines whether the current process to reform the retirement income system and related legislation in South Africa would be a suitable platform to introduce the concept of intergenerational solidarity to legislation concerning older persons.</p>