The relationship of spirituality, self-transcendence, and social support to morale in chronically ill elderly was the focus of this research study. The research was based upon a developmental framework of aging. Individuals answered questionnaires regarding their perspectives on the above variables to determine how significantly the variables related to feelings of morale. Findings revealed that self-transcendence and social support were significantly correlated with morale in this population. No significant relationship between spirituality and morale was found. Self-transcendence and social support together accounted for 45% of the variance in predicting morale in the chronically ill elderly. Findings also revealed existing relationships between spirituality and gender, education level and social support, and length of illness and social support.

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Having a chronic illness may feel alienating, yet examination of the literature shows limited research on social connectedness and health. In order to contribute to the understanding of this impact of illness, I examined perceived levels of social connectedness in persons with chronic diseases (CD), functional somatic syndromes (FSS) and medically unexplained symptoms (MUS). A major focus of this study was to investigate the association of social connectedness with depression, anxiety, and general health in patients with ongoing symptoms of illness. Data collection was obtained through the use of four online surveys collectively known as VOICE (Verification of Coping, Illness and Experience). For the purposes of this study, five measures were used: the Social Connectedness Scale, Short Form Health Survey (SF-36), Patient Health Questionnaire depression scale (PHQ-8), Hopkins Symptoms Checklist (HSCL) and the Social Impact Scale. Participants were recruited through announcements via online message boards and support groups, as well as through the distribution of brochures in local medical practices. A total of 148 participants (80% female) completed all four surveys. Results indicated that the chronic illness groups did not significantly differ in social connectedness, although there was some indication that the FSS group felt more social isolation. Regression analyses indicated that, while accounting for socio-cultural and health factors, social connectedness was the strongest predictor of depression (β = - .43, p < .001), anxiety (β = -.48, p < .001) and general health (β = .34, p < .001) in chronically ill persons. The independent and robust relationship of social connectedness with psychological and physical health in individuals with chronic illness suggests that this is an important factor deserving of future research with important clinical applications.

How should the impact of HIV and AIDS on rural livelihoods be factored into efforts to monitor and stabilise household food security? With both HIV and AIDS and food security at the top of the global development agenda, this is a question posed by many scholars, practitioners, donor agencies and government departments. However, while there is an excess of discourse outlining the theoretical bases for how HIV and AIDS can, and is, radically transforming household food acquisition; there is a lack of empirical evidence from the South African context that demonstrates if, and how, HIV and AIDS changes household-level strategies of food acquisition and intake. This thesis explores the association of household-level mortality, chronic illness and additional child-dependent fostering with household experience of food security and food acquisition strategies, in three rural villages in the Eastern Cape and KwaZulu-Natal Provinces of South Africa. Qualitative and quantitative methods of data-collection were applied to 307 households in the three sites. For twelve months, both HIV and AIDS-afflicted and non-afflicted households were repeatedly visited at 3-month intervals, in order to be assessed for levels of food security, dietary intake and method of food procurement (purchased, cultivated, wild or donated). Overall, HIV and AIDS-afflicted households showed a significantly higher experience of food insecurity, probably attributable to shortages in food quantity. Dietary composition and overall diversity, however, was not significantly different. Although households with chronic illness and recent mortality showed a heightened investment in cultivation sources, the success of these strategies were to a great extent mediated by household income, and the level of medical treatment received by those who were chronically ill. Chronic illness was also associated with more donations, but these required considerable investments in social capital networks. Finally, use of wild leafy vegetables was not associated with household HIV and AIDS status, despite the financial, nutritional and labour-saving properties of these foods. Overall, the study suggests that there was little evidence of long-term planning and strategy in household food security responses. There was no evidence for shifts to labour-saving crops or foods and, in some instances, child labour was being used to ameliorate prime-adult labour deficits. Moreover, given that the vast majority (89.2%) of food groups were sourced through purchase, it is questionable whether investing in diverse food acquisition strategies would be advisable. Unless supported by medical treatment and steady earned household income, policies to promote intensified household agricultural subsistence production in the wake of HIV and AIDS are unlikely to provide households with anything more than short-term safety-nets, rather than long-term, sustainable food security solutions.