M.A. / When a person is diagnosed with a chronic illness, the family as a whole is affected. The family members as caregivers to the patient become the clients. During the course of their care-giving, family members encounter various situations that require them to give ethical and value-ridden decisions that are related to the care and wellbeing of their patients. Many of the issues and dilemmas facing family members as caregivers place them in a double-bind situation. The decision to act or not to act is emotionally painful and guilt-provoking. These impacts on the family members warrant that they be assisted by a social worker, to adjust to a new situation as caregivers and also to preserve the normal family functioning system. The goal of this study is to investigate the emotional and social impact chronic illness has on the patient's family, with the purpose of formulating recommendations for the improvement of current family interventions as part of chronically ill patients rehabilitation programme. The study was conducted at Emseni Chronic Care center, which is a hospital for the chronically ill patients in Hillbrow. There are about 240 patients of which more than 60% are dislocated from their families. Purposive sampling was used in this study and 26 patient's families were interviewed. The qualitative approach is adopted in this study. The qualitative approach has advantages that it is a highly effective means of obtaining the information required for further understanding and exploration of a topic, Cresswell (1994). A qualitative interview was used with one main question, to gather data for the study. The data was also analyzed qualitatively and conclusions are drawn from the results. The study presents the guidelines as recommendations to be considered when working with families of chronically ill patients. The researcher is of the opinion that if practiced properly, the guidelines can be a valuable asset as a tool for social workers working with the family members as part of rehabilitation programme for the chronically ill patients. / Dr. W. Roestenburg

Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.

Thesis (Master of Science (Hons.) Social Ecology) -- University of Western Sydney, Hawkesbury, 1994. / "A dissertation submitted in fulfilment of the requirements for the degree of Master of Science (Honours) in Social Ecology in the University of Western Sydney - Hawkesbury" Bibliography : leaves 288-300.

This qualitative study focuses on the experiences of adults with Charcot-Marie-Tooth disease (CMT), a neuromuscular condition, and explores what living with this disease encompasses. The study is structured around two fundamental research questions that amount to people's experiences regarding how (in which areas) the disease affects them, and how they continuously deal with it. In order to address the research questions, data gathered from participants was qualitatively analysed, using grounded theory methodology. The study culminated in the formulation of a substantive grounded theory as to how affected people manage the disease's manifestations in order to optimise their continuous adaptation and well-being. A tripartite of concerns comprised the core concern, whereas the basic social psychological process of engaging with CMT emerged as the core strategy used by affected people to deal with the concerns. The core's three sub processes constituted three mostly sequential stages that CMT-affected people pass through in their adaptation to the disease. The identified theory and existing stage models of adaptation to chronic illnesses and disabilities were juxtaposed and discussed. The three stages were compared to and integrated with the relevant literature. These actions revealed that there are a number of new formulations and processes contained in all three stages, and that the first and last stages (orientating and optimising) are themselves unique. It emerged that there is no theoretical end-point to the adaptation process, but that a relative saturation point amounted to a variant of an outcome, called qualified wellness. For most, the core strategy was successful in resolving the main concern. A few, however, still experienced fear and agony about inheritance and dependency issues. This study contributes, via the route of knowledge and insight empowerment, to the well-being of people with CMT, including those who are struggling but do not know that they have this disease. Broadening of insight may also benefit medical help professionals and streamline service delivery. / Psychology / D. Litt. et Phil. (Psychology)

This qualitative study focuses on the experiences of adults with Charcot-Marie-Tooth disease (CMT), a neuromuscular condition, and explores what living with this disease encompasses. The study is structured around two fundamental research questions that amount to people's experiences regarding how (in which areas) the disease affects them, and how they continuously deal with it. In order to address the research questions, data gathered from participants was qualitatively analysed, using grounded theory methodology. The study culminated in the formulation of a substantive grounded theory as to how affected people manage the disease's manifestations in order to optimise their continuous adaptation and well-being. A tripartite of concerns comprised the core concern, whereas the basic social psychological process of engaging with CMT emerged as the core strategy used by affected people to deal with the concerns. The core's three sub processes constituted three mostly sequential stages that CMT-affected people pass through in their adaptation to the disease. The identified theory and existing stage models of adaptation to chronic illnesses and disabilities were juxtaposed and discussed. The three stages were compared to and integrated with the relevant literature. These actions revealed that there are a number of new formulations and processes contained in all three stages, and that the first and last stages (orientating and optimising) are themselves unique. It emerged that there is no theoretical end-point to the adaptation process, but that a relative saturation point amounted to a variant of an outcome, called qualified wellness. For most, the core strategy was successful in resolving the main concern. A few, however, still experienced fear and agony about inheritance and dependency issues. This study contributes, via the route of knowledge and insight empowerment, to the well-being of people with CMT, including those who are struggling but do not know that they have this disease. Broadening of insight may also benefit medical help professionals and streamline service delivery. / Psychology / D. Litt. et Phil. (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI) / Stroke is the main cause of disability in the United States. Individuals with stroke commonly report sensory impairment affects their recovery. Motor recovery and sensory impairment are related and impact individuals’ ability to perform valued occupations. Despite the prevalence of sensation impairment after stroke, many occupational therapists fail to include sensation assessment and intervention in treatment planning. The exclusion of sensation in occupational therapy interventions during stroke rehabilitation may be due to the lack of literature supporting the association between sensation and occupational performance. The current study aimed to determine the relationship between touch sensation of the affected hand and occupational performance and satisfaction in individuals with chronic stroke. Using a cross-sectional study design, this study associated factors related to hand sensation and function in individuals with chronic stroke. Fifty individuals with chronic stroke participated in a one-time testing session in which assessments related to sensation, movement of the hand and engagement in daily activities were administered. Correlation analyses were utilized to determine relationships between touch sensation of the affected hand with individuals’ abilities to engage in valued daily activities, arm and hand disability, and manual abilities. The main finding of the study was that individuals with intact sensation reported greater ability to perform valued occupations and satisfaction with their performance, as compared with individuals with touch sensation impairment. For individuals with impaired touch sensation of the affected hand, impairment of touch sensation of the hand did not correlate with individuals’ performance or satisfaction with valued occupations, arm or hand movement, or manual abilities. Collectively, the results of this study reflect the complex interaction between touch sensation, occupational performance, motor functioning, and manual abilities of the affected hand for individuals’ who have experienced a stroke. This study informs therapists, rehabilitation scientists, and other healthcare professionals that client-centered, individualized approaches, including a wide array of clinical assessments and intervention, including assessment of occupational performance and sensation, remain important components in stroke rehabilitation.