M.A. / The aim of organizations working with street children is to reunite the children with their families and communities. Previous research pertaining to street children has focused on the causes and extent of the street child phenomenon, life on the streets, programmes for street children, and host communities (localities where children sleep on the streets). The focus of this study is on source communities (neighbourhoods where the children’s families are located). The attitudes of source communities towards children who are returning to their families is indicative of the level of support these children are likely to experience within the community. The aim of this study has been to explore the attitudes of role-players within a source community towards former street children. The role-player groups identified for the study were educators, neighbours, youth groups, church groups, peers and spaza shop owners. These role-players were perceived as the ones that the children were likely to interact with directly. Focus group discussions were held with educators, neighbours, youth group representatives, church group representatives and peers. Individual interviews were held with spaza shop owners for logistical reasons. For the purpose of this study the concept “attitudes” was understood as having both cognitive and affective components. The study took place in Refilwe, a satellite of Cullinan. The conclusions drawn from this study were as follows: 1. Attitudes towards former street children seem to be based on participants’ perceptions of children living on the streets. 2. Lack of accurate information about street children contributed to the rejection and labelling of the children. 3. There was a widespread assumption that street children inevitably become involved in crime. 4. Fears were expressed that children returning from the street would influence other children in the community negatively. 5. There was ambivalence about whether or not the child could be trusted once he returned home. 6. Participants believed that it was important for the child to return home. 7. Several role-players were identified as being responsible for the child’s well-being and his reintegration into the community. 8. The return of former street children was perceived as an additional burden on an already under-resourced community. 9. Participants perceived a need for programmes to prepare the child, the family and the community. The following recommendations were made: 1. A survey of the attitudes of other source communities would be useful in identifying common themes. 2. Organizations working with street children need to organize awareness campaigns in order to educate source communities about street children. 3. It is important to involve the community in the preparation for the children’s return home 4. Community development programmes are needed in Refilwe. Employment opportunities and additional resources would increase the community’s capacity to care for vulnerable groups. 5. A full-time social service office needs to be established in Refilwe. The focus group discussions unleashed the raising of a range of social issues. The seriousness of these issues warranted the inclusion of a chapter on additional findings. / Ms. H.F. Ellis

Due to the increasing availability of ART (antiretroviral therapy),HIV is starting to be seen as a chronic disease. This has several effects on families, one of which is the need to disclose their HIV status to children who were born with the illness. Potential barriers and available support structures with regards to paediatric HIV disclosure need to be considered before specific guidelines can be given to caretakers and health care providers. This study aimed to explore and describe the patterns of paediatric HIV disclosure or non-disclosure using a sample of caretakers or parents of children/adolescents who were born with HIV. The Disclosure Decision Making Model (DDMM) was used as a framework to understand the decision-making process that leads to either disclosure or non-disclosure. Qualitative data was gathered by means of in-depth, semi-structured interviews, conducted in English. Ten participants were recruited from a community health care centre that offers HIV counselling and testing in the Nelson Mandela Bay Health District. Data gathered was transcribed and analysed using thematic analysis. Lincoln and Guba’s model was used to determine the trustworthiness of the data. The two themes that emerged from the study were (1) caretakers wish to disclose HIV status to the child but identified barriers to doing this and, (2) caretakers identified factors that helped them to disclose the child’s status. This study provides a more in-depth understanding of the factors that influence disclosure in a resource-limited setting in the Eastern Cape.

The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.

This study began with the authors' interest in the Portland Public Schools' program for Emotionally Handicapped children. Originally, the researchers were interested in assessing behavioral characteristics and changes among children in that program and in relating these variables to the kind and extent of parental involvement. Such a study was particularly timely, it was felt, since some schools were considering eliminating the parent involvement component of the program and there was discussion of phasing out the entire program as it then existed in favor of "mainstreaming." The researchers soon discovered the paucity of research information relating to program effects on children after their termination and realized that program changes might well happen for political and subjective reasons in the absence of research data. Unfortunately, recent changes in Oregon Law relating to confidentiality, in addition to administrative arid funding difficulties in the schools forced an upper level decision to curtail outside research in the school system. In September of 1976 the authors were left with an interest and a partially formulated research design but no program within which to apply their design. At this point the researchers contacted the Childrens' Psychiatric Day Treatment Center in Portland (C.P.D.T.C.) and presented a preliminary plan for research to that agency's Administrative Committee. They received the agency's approval to pursue research relating to children who had been in that program and were able to begin the present study. in early October. The present study undertakes to measure behavior changes among the forty-one children who had left the Center during the previous two years and to relate the stability of these changes to subsequent events in the childrens' home lives and to the degree of their parents' involvement in their treatment.

No description available.

At present not enough is known about the health of preschool children in the poorer communities of Cape Town. This study, was undertaken to assess the health and health care of preschool children in one such community: that of the Hout Bay harbour township. A clinic and community-based surveillance programme was devised to make this assessment. Data were obtained by monitoring the records at the Community Health Centre in the township. A study sample of 214 children from the community was also selected by random stratified cluster sampling. This sample was assessed by means of a questionnaire and a full physical examination. Analysis of data was performed on the IBM main-frame computer. A large number of medical problems were identified on screening the community sample. Most of these problems were minor ones and could be managed appropriately at the Health Centre. On the basis of the referral patterns and the small number of newly diagnosed functionally important health problems, the provision of health care in-the area was considered to be adequate. The high immunisation rate in the preschool children and the excellent attendance figures at the child health clinics indicates that the services provided are well utilised by the population. Dental caries was found to be a major health problem in the area. A strong case for the introduction of a dental health educational programme and for the fluoridisation of drinking water can made on the basis of these findings. An ongoing health screening programme would be beneficial. It could be accomplished by utilising appropriately trained nursing personnel.

The present study employed a family systems approach to investigate the effects of level of autism severity on family functioning as mediated by parental coping. Participants were mothers of children with autism who were volunteers in an ongoing research program conducted within a university-based treatment center (N=146). Gilliam Autism Rating Scale, Second Edition (GARS-2) scores were available for all of the children and, as part of the broader program, parents completed the Coping Scale for Adults, which assesses a range of coping styles, and the Family Environment Scale, which provides positive and negative indicators of family functioning. Data analyses indicated that nonproductive coping significantly mediated the relationship between level of autism severity and family cohesion and conflict. Results also suggested that level of autism severity was negatively related to family conflict. The study further examined the use of specific coping styles on family cohesion and conflict. Evaluation of findings suggest that parents who have a child diagnosed with severe autism may be employing maladaptive coping strategies, such as wishful thinking, blaming one's self, or avoiding the situation. Implications for intervention approaches for individuals working with families of children with autism are suggested.

Thesis (MEdPsych)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autism or Autism Spectrum Disorder (ASD) is a condition that presently affects approximately 1 out of every 110 children globally and indications are that the prevalence thereof is steadily on the rise. ASD is a complex neurological condition that impairs social interaction, communication and behaviour. Research on the wide-ranging effects of ASD and its unique characteristics in each child with ASD is widely available. Several studies allude to the fact that ASD has an impact on the family unit, but very few researchers have investigated the experience in the Western Cape Province, South Africa, from a sibling's perspective. The current situation leaves researchers, parents and siblings with very little data on the subject and inadequate support is available to address the specific needs of siblings. The aim of this study was to investigate siblings' views on living with a brother/sister with ASD. The central research question relates to the experiences of siblings of children with ASD. Sub-questions were focused on exploring their perceptions of ASD; relationships with brothers/sisters with ASD, peers and parents; sibling responsibilities and worries; and the extent of the pressure they experience as a result of the related added responsibilities. This is a qualitative study within an interpretive/constructivist research paradigm. The study was guided by an ecosystemic perspective as the theoretical framework. The methods of data collection comprised semi-structured interviews with siblings of children with ASD and open-ended questionnaires for parents. The qualitative research methods embraced the uniqueness of each sibling's experience and allowed participants the freedom to express this. Eight participants were purposefully selected for this study. The participants were between the ages of seven and seventeen years and each one had a brother who had been diagnosed with ASD. All the siblings lived with the brother with ASD and their parents in the Western Cape Province of South Africa. Siblings were from different genders, as well as diverse socio-economic and cultural groups. All the parents of the siblings were biological parents and in all cases were married with no visible signs of marital stress. Several principles were adhered to in this study, to ensure that the research was ethical. Several important themes emerged from the study. These include the siblings' need for information pertaining to ASD; worries and feelings of guilt experienced by siblings as a direct result of ASD; responsibilities that siblings feel obliged to take on; the nature of relationships with a brother with ASD, parents and peers; the need for support structures; and an indication of the type of support that siblings require. / AFRIKAANSE OPSOMMING: Outisme of Outistiese Spektrum Versteuring is 'n toestand wat tans na raming 1 uit 110 kinders wêreldwyd affekteer en dit wil voorkom asof die getalle stelselmatig toeneem. Outisme is 'n komplekse neurologiese versteuring wat 'n impak op sosiale interaksie, kommunikasie en gedrag het. Navorsing in die kompleksiteite van Outisme in kinders is redelik vrylik beskikbaar en navorsers dui aan dat die kondisie ook 'n impak op die gesin het. Tans is daar baie min navorsing wat op die ervarings of belewenis van sibbe van kinders met Outisme in die Wes-Kaap, Suid Afrika, fokus. Die gevolg hiervan is 'n daadwerklike tekort aan data tot die beskikking van navorsers, ouers en sibbe ten einde gepaste ondersteuning aan sibbe te bied. Die doel van hierdie studie was om die sibbe van kinders met Outisme se oogpunt en ervarings te ondersoek. Die sentrale navorsingsvraag het beoog om te ontdek wat sibbe se belewenis van hul lewe saam met 'n broer/suster met Outisme behels. Ondergeskikte vrae hou verband met die sib se persepsie van Outisme; verhoudings met 'n broer/suster met Outisme, eweknieë en ouers; die sib se verantwoordelikhede en meegaande kommer en druk; ondersteuning wat tans beskikbaar is; en die ondersteuning waaraan sibbe 'n behoefte toon. Die studie is kwalitatief van aard binne 'n interpretiwistiese/konstruktiwistiese navorsingsparadigma. Die onderliggende teoretiese raamwerk van hierdie studie is die ekosistemiese perspektief. Data is ingesamel deur middel van semi-gestruktureerde onderhoude met sibbe, asook oop-einde vraelyste aan ouers. Kwalitatiewe navorsingsmetodes het die uniekheid van elke sib se ervaring in ag geneem en sibbe toegelaat om hulle ervarings vrylik uit te druk. Agt deelnemers is doelgerig gekies vir die studie. Die deelnemers was tussen die ouderdomme van sewe en sewentien jaar oud en elk het 'n broer wat met Outisme gediagnoseer is. Die sibbe bly tans saam met hul ouers en 'n broer met Outisme in die Wes-Kaap, Suid Afrika. Die sibbe het vanuit verskillende geslagte, asook verskeie sosio-ekonomiese en kulturele agtergronde gekom. Die ouers van die sibbe was almal biologiese ouers, steeds getroud met geen merkbare spanning in die huwelik nie. Verskeie etiese beginsels is in die studie gehandhaaf ten einde etiese korrektheid te verseker. Verskeie belangrike temas het na vore gekom. Dit sluit die volgende in: 'n Behoefte by die sibbe aan inligting rakende Outisme; sibbe se ervaring van bekommernisse en skuldgevoelens as 'n direkte gevolg van Outisme; verantwoordelikhede wat deur sibbe aanvaar word; die aard van verhoudinge met die broer met Outisme, ouers en gelykes; die behoefte aan ondersteuning; en 'n aanduiding van die tipe ondersteuning wat deur sibbe verlang word.

In England around 68,000 children are currently looked after by the state. Sixty two per cent of this population are admitted to care or accommodation in response to abuse and neglect. As the United Nations Convention on the Rights of the Child acknowledges, the state has a unique responsibility for these children and is expected to ensure their safety, wellbeing and development. Underpinned by a rights-based framework the publications in the thesis make an original contribution to social work research, policy and practice, in respect of looked after children nationally and internationally. Three cohering theoretical strands - the new sociology of childhood, attachment theory and focal theory, and different methodological lenses, (from participatory research with young people to cross-national analysis of administrative data), are employed to advance understanding of the balance of protective, provisional and participatory rights ( 3 Ps ) for these children and young people. The work focuses upon their life pathways at two key stages in the lifespan: early infancy and adolescence into adulthood. Consistent with the theoretical underpinnings of the research, the methodological approach employed in two of the four core studies sought to promote children s active participation in the research process, and to give them a voice . The participatory peer methodology adopted moved beyond involving care experienced young people in interviewing their peers, to training and engaging them in several major aspects of the research cycle, including analysis of the data and the design and write up of the findings, to produce accessible peer research reports for young people. At the national level the work undertaken demonstrates how a needs-based discourse, and orientation towards considering looked after children as objects of concern, can mean that young children s protective rights may be prioritised in policy and practice, at the expense of their provisional and participatory rights. Children s participation rights are also constrained due to assumptions about the (in)capacities of younger children to express their wishes and feelings. In this context parents rights tend to be prioritised at the expense of the rights of the child. Whereas parents rights may take precedence when children are young, in adolescence the rights of parents are more peripheral. Cross-national comparisons reveal variations in how young people s provisional, participatory and protective rights are balanced as young people negotiate the transition from care to adulthood in western societies, as well as different drivers for reform. Empirical research on recent policy developments in England also illuminates the tensions and dilemmas professionals can face as they attempt to protect and provide for young people, whilst recognising their evolving capabilities and their right to autonomy and active participation in decision making processes. Finally, the studies highlight that young people with the most complex care histories may be denied the right to decide for themselves if they want to remain in foster or residential care into early adulthood.

The aim of this study was to investigate factors that influence the burden of caregiving on the caregivers of children with cerebral palsy (CP) in Windhoek, Namibia. Ethical approval was obtained from researcher’s university and Namibia Ministry of Health and Social Services ethics committee. A quantitative, non-experimental, descriptive and cross-sectional design in the form of a survey was used. Total population sampling technique was used to draw 91 respondents drawn from the patient register at the two public hospitals in Windhoek. A questionnaire adapted from the Zarit Burden Interview (ZBI) was used to collect data. Data which was obtained was complete and the researcher paid consistent attention to the data collection process. The results showed the following characteristics to be significantly related to increased burden among caregivers; living in the same household as a child with cerebral palsy, marital status, knowledge and understanding of cerebral palsy, ethnic group and caregiver having previously been treated for a physical ailment. It was recommended that the social grant and housing policies be reviewed, and support groups for caregivers and community awareness on cerebral palsy be introduced. / Health Studies / M. P. H. (Public Health)