Submitted in fulfillment of the requirements for the M Tech: Nursing, Durban University of Technology, Durban, South Africa, 2017. / Child health has always been a global priority for decades; however, despite efforts to reduce the child mortality statistics, 5.9 million children under the age of five years have deceased in 2015. IMCI guidelines are used to assess, classify and treat sick children under the age of five years, however, despite the prevalent use of traditional medicine for this age group of children, the guidelines excludes the use of traditional medicine, hence the tendency exists to ignore such questions being asked. It is this gap in the history taking pertaining to sick children seeking health care at clinics that the researcher has identified, therefore, this study is intended to highlight the use of traditional medicine in children under the age of five years. The researcher’s methodology is a quantitative descriptive study by means of a self- developed structured questionnaire which was handed out to 183 caregivers attending a Gateway Clinic and 324 caregivers at Paediatric Out – Patient Department. The total sample size was 507 caregivers of children under the age of five years. Data was analysed using SPSS version 17. The data derived from this study indicated that although most caregivers would take their sick children to the clinic for first line treatment, there are a significant number who would rather use home remedies or seek care from traditional healers. The study reveals that 28.5% of caregivers were found to be administering traditional medicine with conventional medicine and 17.4% would do so concurrently. Evidence also revealed that 75.7% of the caregivers would disclose the use of traditional medicine for their children only if nurses enquired about it. Recommendations arising from the study findings are that the IMCI guidelines should incorporate a classification chart for use by health care professionals in order to identify children who were treated by traditional medicine preferably as “RED” - requiring urgent attention and possible admission to hospital, in view of the potential threat to life. Since the IMCI guidelines are also a teaching tool in nursing curricula, the assessment of sick children using traditional medicine will be incorporated into the formal teaching of nurses. Key words used were Integrated Management of Childhood Illnesses, effects and use of traditional medicine on children. / M

The purpose of this secondary analysis of Malone's (1993) study was to identify formal and informal resources used by families with an adult son with chronic mental or physical illness. It also explored the identified perceptions of health care providers by the families in this study. This study was guided by the Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 1993).The sample population was patients who were receiving outpatient care from Valley Mental Health Center and University Hospital Neurology Clinic in Salt Lake City, Utah, and families which met certain criteria. The data of 42 respondents of the original 68 in Malone's (1993) study were perused for trends and themes about the use of formal and informal resources and perceptions of health care professionals using the process of secondary analysis.Findings revealed that the outpatients and families used six formal resources and seven informal resources. Family resources accounted for 44 percent of the total utilization of informal resources by the respondents. Hospital/clinics accounted for 24.3 percent of the total formal resources used by the respondents. Findings also revealed that perceptions of health care professionals by the respondents was negative.With the increase of chronic illnesses, the recommendations and implications for nursing identify that patient education in the future will undoubtedly be the most vital and crucial component to an individual's success/failure to adjust to the chronic illness. With the additional knowledge base, prevention of unnecessary anxiety related to the chronic illness would promote a more positive environment for the patient. In addition, both the patient and family could make that smooth transition into the adaptation phase and function effectively with the chronic mental or physical illness. / School of Nursing

Thesis (MEdPsych)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Sexuality education forms part of the life skills learning area. Sexuality education has become a means of providing the information learners need so they can prevent or protect themselves against abuse and violence including rape. It also helps young people to develop coping strategies in their social lives. However, the approach in schools to sexuality education does not cater for the needs of individuals with an intellectual disability. This study aims, therefore to explore whether these individuals (those with intellectual disability) are provided in other ways with information relating to sexuality education. The reason for selecting this group is that research has found that individuals with intellectual disability are more vulnerable to abuse, rape and violence. Hence, equipping them with skills on how to deal and cope with those societal dangers is essential. This study does not focus on those individuals with intellectual disability who are at school but focuses on those that are out of school in the community. A questionnaire is used to determine whether these individuals are adequately provided with sexuality education. The participants of this study are the health care workers chosen because they are the people who are supposed to be interacting on a regular basis with these individuals. They are the people who provide individuals with an intellectual disability with medication and treatment. The findings of the study are that individuals with intellectual disability are not provided with information on sexuality education. It is a challenge, therefore, to all the service providers to equip and empower these individuals with information on sexuality issues so they can cope with the societal pressures. The study also explores the health workers' perceptions of and experiences with individuals with an intellectual disability. The findings of the study are that the health care workers have different perceptions of individuals with intellectual disability on issues of sexuality. Most of their decisions are based on the individual's level of intellectual disability, especially with regard to issues such as the right to have children and the desirability of sterilisation. / AFRIKAANSE OPSOMMING: Seksuele opvoeding vorm deel van die lewensvaardighede-leerarea. Seksuele opvoeding het 'n middel geword om kennis oor te dra aan leerders om hulle teen mishandeling en geweld, insluitende verkragting, te beskerm en te verhoed dat hulle daaraan blootgestel word. Dit rus jongmense ook toe om doeltreffender strategieë te ontwikkel vir hulle daaglikse verkeer met ander persone. Seksuele opvoeding op skool maak egter nie voorsiening vir persone met 'n intellektuele gestremdheid nie. Hierdie navorsingsprojek het dus ten doel om vas te stel of daar voorsiening gemaak word sodat hierdie persone (met 'n intellektuele gestremdheid) seksuele opvoeding op ander maniere kan bekom. Die rede waarom juis hierdie groep gekies word, is omdat navorsing getoon het dat persone met 'n intellektuele gestremdheid kwesbaarder is vir mishandeling, verkragting en geweld. Dit is noodsaaklik om hulle met vaardighede toe te rus om hierdie samelewingsgevare die hoof te bied. Hierdie navorsingsprojek fokus nie op persone wat op skool is nie, maar juis op dié wat in die gemeenskap is. 'n Vraelys word gebruik om vas te stel of hierdie persone voldoende seksuele opvoeding ontvang. Die deelnemers aan hierdie navorsingsprojek is gesondheidswerkers omdat hulle veronderstel is om op 'n gereelde grondslag met die betrokke individue in aanraking te kom. Húlle is die mense wat persone met intellektuele ongeskiktheid van medikasie en behandeling voorsien. Die bevindinge van hierdie projek is dat persone met intellektuele gestremdheid nie van seksuele opvoeding voorsien word nie. Dit is dus 'n uitdaging aan diensverskaffers om hierdie persone met kennis rakende kwessies oor seksualiteit toe te rus en te bemagtig sodat hulle groepsdruk beter kan hanteer. Die projek verken ook gesondheidswerkers se persepsies en ondervindinge aangaande persone met beperkte verstandelike vermoëns. Die bevindinge van hierdie navorsingsprojek toon dat gesondheidswerkers uiteenlopende persepsies het van persone met beperkte verstandelike vermoëns rakende kwessies rondom seksualiteit. Die meeste van hulle sienings is gebaseer op die persoon se vlak van intellektuele gestremdheid, veral rondom sake soos die reg om kinders te hê en die wenslikheid van sterilisasie.

This paper explores the utility of Weingarten's (2003) witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS. The research is embedded in Weingarten's theory of witnessing and narrative theory and practice. The literature review explores the shift from hospital-based care to community/home-based care which has led to family members assuming the role of caring for their family members with AIDS, an overview of the effects of caring for AIDS patients on caregivers and an overview of Weingarten's (2003) theory of witnessing with special emphasis on the witnessing positions and their consequences. Interviews, based on narrative theory and practice in which Weingarten's theory is rooted, gave access to the participants' experiences, which were then analysed and interpreted through a framework developed from the witnessing theory. This article demonstrates the utility of Weingarten's (2003) theory of witnessing to people who are caregivers to their own family members with AIDS. I argue that witness positions occupied by caregivers during witnessing determine whether the caregivers will experience compassion fatigue. The negative consequences related to compassion fatigue that will be reviewed could probably be prevented through active, intentional, compassionate witnessing.

Research has shown that children born low birth weight (i.e., ≤2500 grams) and/or premature (i.e., birth prior to 37 weeks gestation) are at increased risk of experiencing developmental delays, as well as long-standing executive functioning and academic challenges. Despite these well-known risks, children born low birth weight are under-enrolled nationally in Part C Early Intervention (EI) services intended to support developmentally vulnerable children. Little is known regarding why EI enrollment is low in this high risk population, especially given children born LBW are readily identifiable as at increased risk of delays at birth. This study explored EI referral outcomes from a high risk infant follow up program serving children with complex early medical histories that place them at increased risk of experiencing developmental delays to determine how many children referred to EI were ultimately evaluated and enrolled in the program. This explanatory sequential mixed methods study included a quantitative phase characterizing the EI referral outcome and a qualitative phase consisting of interviews with families to explore the parent/caregiver's experience of the EI referral process. Data analysis included descriptive statistics to characterize the sample and Pearson Chi Square and independent samples t-tests to investigate child characteristics associated with successful referral. Qualitative interviews were transcribed and coded for themes in an iterative and cyclical fashion. Results indicate that only 62% of the children who were referred for EI services were evaluated by the program, with about the same percentage of those evaluated being found eligible (67%). Of those who were not found eligible, about a third of children should have qualified based on previous testing and/or medical conditions. However, these qualifying medical conditions were often not clearly documented on the referral form, and not all forms included documentation of the scores from developmental testing. There were also a significant number (71%) of Oregon children referred to EI but never evaluated who were likely to have qualified based on medical history and/or results from developmental testing. There were several key themes identified following analysis of the qualitative interviews. Most critically, the parent/caregiver's perception of the need for the EI referral was identified as an essential factor in facilitating a successful connection to EI. Other key themes included the need to honor the many different demands placed on the caregivers of these high risk children, as well as the necessity of providing clear explanation of the purpose of both the visit to the high risk infant follow up program and the EI referral. The Chronic Care Model is used as a framework for discussing implications for practice.

Syftet denna studie var att undersöka omsorgspersonalens attityder kring psykisk ohälsa hos äldre, hur det arbetas kring psykiska ohälsa på äldreboenden och vad för verktyg de har för att motverka det. Samt att uppmärksamma ifall omsorgspersonalen kan se brister eller förbättringsområden inom äldreomsorgen och arbetet med äldres psykiska ohälsa. Studiens empiri samlades in genom 6 semistrukturerade intervjuer med undersköterskor, från olika kommuner och äldreboenden i Sverige. Den insamlade materialet har sedan tolkats och analyserats utifrån tidigare forskning, samt utifrån det teoretiska begreppet professioner och Fischbeins & Ajzens (1975) teori om överlagd handling. Resultatet visar att det finns blandade attityder hos deltagarna men alla var eniga om att psykisk ohälsa är vanligt hos äldre på äldreboenden. De flesta respondenterna menar att psykisk ohälsa hos äldre det är ett problem och något det behövs jobbas med, men att det hos andra respondenter fanns en attityd att psykisk ohälsa inte är ett problem utan en naturlig del av åldrandet. I empirin lyfts det fram att det inte finns tydliga handlingsplaner eller riktlinjer kring hur omsorgspersonalen inom äldreomsorgen ska bemöta psykisk ohälsa hos äldre. Empirin visar att omsorgspersonalen får information att de ska försöka ta sig tiden och prata med och lyssna på de äldre, men menar att den tiden inte finns. Detta är en av bristerna som uppmärksammast i studien. Utöver tiden är bristerna enligt respondenterna personalbrist, bristen på personal med lämplig utbildning och indragningar av aktiviteter för de äldre. Enligt respondenterna är lösningar för dessa brister och förbättringsområden inom äldreomsorgen att omsorgspersonalen får utbildning och kunskap inom psykisk ohälsa och bemötande för att kunna ge äldre en högre livskvalitet och meningsfull vardag. Att öka insatser såsom aktiviteter och sysselsättning för att bryta isoleringen hos de äldre och till sist lyfter de upp samtalsstöd för de boende men även personalen. Att de äldre kan få hjälp och stöttning av någon med rätt kompetens för att motverka deras psykiska ohälsa, och att personalen skulle kunna ha en ventilationskanal, där de kan öppna upp sig och få hjälp med att bearbeta jobbiga eller tunga saker som skett under arbetet. / The purpose of this study is to investigate how caregivers’ attitudes are towards mental illness amongst elderly, if there is any work being conducted towards mental illness in nursing homes andif the caregivers have any preventative tools to battle mental illness. Also, to observe if the caregivers could see deficiencies or areas that need improvement in the elderly care or in the work with elderly mental illness. The empirical parts of the study were collected through six semi-structured interviews with assistant nurses, from different municipalities and nursing homes in Sweden. The collected material has been interpreted and analyzed, based on earlier research, and through the theoretical concept of professions and Fischbeins and Ajzens (1975) theory of reasoned actions. Results show that there are mixed attitudes among the participants, though everyone agreed that mental illness is common amongst the elderly in nursing homes. The majority of the respondents mean that mental illness in the elderly is a problem and something that needs to be addressed, but other respondentsmeant that mental illness isn’t a problem but for a fact a natural part of aging. From the empirical results it is emphasized that there are no clear action plans or guidelines on how the nursing staff in nursing homes are supposed to respond to mental illness in the elderly. The empirical evidence shows that the nursing staff are given information that states that they should try to take the time to talk and listen to the elderly, but such time does not exist. That is one of the deficiencies that has been noted from the study. In addition to the lack of time the deficiencies are according to the caregivers because of staff shortage, lack of staff with appropriate education and withdrawal of activities. According to the respondents, the solutions of these deficiencies and areas of improvement in the elderly care are that the nursing staff receive more education and knowledge towards mental illness and treatment to be able to give the elderly a higher quality of life and a meaningful everyday life. Increased efforts with activities and meaningful occupation to break the seclusion of the elderly, and finally, respondents want to introduce conversational support for the residents and staff. The introduction of conversational support so that the elderly can get help from someone with the right education and skills to counteract their mental illness, and so that the nursing staff also could have a way to ventilate, so the staff can open up and get help with processing difficult or heavy things that happened during work.

The study focused on the attitudes and beliefs regarding perceived and actual burden experienced by Latino caregivers and their use of formal support services. It also looked at the needs of Latino caregivers and explored their beliefs about why they had taken on the caregiver role, the responsibilities the role entailed, and coping skills used by these caregivers. Participants were obtained from two Alzheimer's caregiver support groups in the East Los Angeles area, and an adult day health care center in the high desert area of San Bernardino county. The author used both qualitative interviews and quantitative questionnaires. The findings suggest that high beliefs about responsibility to the family and low levels of service use may contribute to the stress and strain that these caregivers feel. Latino caregivers have been providing a significant amount of care without the help of sufficient formal services. Recommendations for social work practice, policy and further research are provided. Statistics for the study were generated by using SPSS Graduate Pack 13 for Windows.