Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The growing burden of mental illnesses in low- and middle-income countries, such as Uganda, necessitates effective interventions to promote mental and social well-being among their populations. Mood disorders contribute more substantially to the global burden of mental illnesses than do other forms of mental disorders. The substantial global burden of mental illnesses is projected to grow more rapidly in low- and middle-income countries than in high-income countries in the future. Because experiences of and responses to mood disorders are invariably patterned by social and cultural contexts, as argued in the growing field of cross-cultural psychiatry, health care systems, especially in low- and middle-income countries, need to design and deliver culturally relevant interventions that effectively deal with this problem. However, there is generally a paucity of suitable evidence to guide the planning and delivery of such interventions in countries like Uganda. As a response to the apparent knowledge and research gaps regarding experiences of mood disorders and care in Western Uganda, I conducted a qualitative study involving outpatients and their care providers, that is, outpatients’ families, psychiatric health workers, religious healers and traditional healers. Using purposive and snow ball sampling techniques, I selected participants, that is, outpatients as well as psychiatric health workers, outpatients’ families, religious healers and traditional healers involved in the care of the outpatients from the Mbarara Regional Referral Hospital (MRRH) and the “Greater Mbarara” region, respectively. The aim of this study is to explore explanatory models that outpatients and care providers in Western Uganda use in responding to mood disorders. I analysed the data collected in the fieldwork using ATLAS.ti 6.2, a computer-software programme designed to support qualitative data analysis. Results from the study indicate that outpatients and their care providers hold complex, diverse and contradictory explanatory models regarding mood disorders and care, which are shaped by their unique social and cultural contexts. Additionally, poor relationships and communication between patients and their care providers, especially between outpatients and psychiatric health workers, are strongly evident; structural barriers significantly hinder the provision and utilisation of care; care is generally inadequate, although it is conceptualised broadly to include biomedical, popular and folk treatments; and outpatients generally exhibit inconsequential (weak) agency in managing distress, which is primarily caused by mood disorders and care-seeking challenges. The results of the current study suggest several implications regarding mental health practice, training, policy and research. / AFRIKAANSE OPSOMMING: Weens die toenemende geestesiektelas in lae- en middelinkomstelande soos Uganda word intervensies vereis om die geestelike en maatskaplike welsyn van die bevolkings van daardie lande te bevorder. Gemoedsteurings maak ’n groter deel van die wêreldwye geestesiektelas uit as ander vorme van geestesongesteldheid. Die beduidende wêreldwye geestesiektelas sal in die toekoms na verwagting vinniger in lae- en middelinkomstelande as in hoë-inkomstelande toeneem. Aangesien ervarings van én reaksies op gemoedsteurings meestal deur maatskaplike en kulturele kontekste beïnvloed word, soos die groeiende dissipline van transkulturele psigiatrie beweer, moet gesondheidsorgstelsels, veral dié in lae- en middelinkomstelande, kultureel tersaaklike intervensies ontwerp en voorsien wat hierdie probleem doeltreffend hanteer. Tog is daar oor die algemeen ’n skaarste aan geskikte bewyse om die beplanning en voorsiening van sulke intervensies in lande soos Uganda te rig. In antwoord op die klaarblyklike kennis- en navorsingsleemtes met betrekking tot ervarings van gemoedsteurings en sorg in Wes-Uganda het ek ’n kwalitatiewe studie onder buitepasiënte en hul versorgers – met ander woorde hul familie, psigiatriese gesondheidswerkers, geloofsgenesers en tradisionele genesers – onderneem. Die steekproef het bestaan uit pasiënte en hul familielede, psigiatriese gesondheidswerkers sowel as geloofs- en tradisionele genesers wat gemoeid is met die versorging van buitepasiënte by die streeksverwysingshospitaal Mbarara (MRRH) én in die Mbarara-distrik onderskeidelik. Die doel met die studie was om te verken watter verklarende modelle pasiënte en versorgers in Wes-Uganda gebruik om op gemoedsteurings te reageer. Die data wat met die veldwerk ingesamel is, is ontleed met behulp van die rekenaarsagteware ATLAS.ti 6.2, wat ontwerp is om kwalitatiewe dataontleding te ondersteun. Die resultate van die studie toon dat buitepasiënte en hul versorgers oor komplekse, uiteenlopende en teenstellende verklarende modelle met betrekking tot gemoedsteurings en sorg beskik, wat deur hul unieke maatskaplike en kulturele kontekste gevorm word. My navorsing dui daarop dat swak verhoudings en kommunikasie tussen pasiënte en hul versorgers, veral tussen buitepasiënte en psigiatriese gesondheidswerkers, aan die orde van die dag is; dat strukturele versperrings die voorsiening en benutting van sorg beduidend verhinder; dat sorg oor die algemeen onvoldoende is, hoewel dit volgens die algemene begrip biomediese, populêre én volksbehandelings insluit, en dat buitepasiënte meestal ontoereikende (swak) vermoëns toon om nood wat uit gemoedsteurings en uitdagings in die soeke na sorg spruit, te hanteer. Die studie sit uiteindelik ook verskeie belangrike implikasies vir geestesgesondheidspraktyke, -opleiding, -beleid en -navorsing uiteen.

Assignment (MA)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Adherence to medical regimes and the difficulties associated with patient adherence are well documented. Furthermore, non-adherence with prescribed medication is ubiquitous. Regarding HIV, strict adherence to combination highly active antiretroviral therapy regimes is a prerequisite for immunological reconstitution. Certain factors have been identified as predicting non-adherence. However, the role of personality variables on adherence has been neglected, specifically with regards to personality pathology. Moreover, there is a high rate of comorbidity between HIV and Axis II disorders, including BPD. Despite controversy, the DSM-IV-TR identifies nine fundamental criteria required for the diagnosis of BPD to be made. These criteria are considered separately in an attempt to elucidate their potential role on non-adherence. Clinically, it is likely that the criteria interact to create a gestalt effect, further complicating adherence. / AFRIKAANSE OPSOMMING: Patient voldoening ter mediese aanbevele en die probleme geassosier daarmee is goed gedokumenteer. En verder is dit allerdags dat patlente nie met hul voorgeskrewe medikasie voldoen nie. In verband met MIV, streng voldoening tot HAART is a voorvereiste vir immunologiese hersamestelling. Sekere faktore is geidentifiseer wat voldoening en die teenoorgestelde daarvan voorspel. Alhoewel, die rei van persoonlikheid veranderlikes op voldoening is nie in ag geneem nie, spesifiek in verband met persoonlikheid patologie. Bowenal, is daar n hoe frekwensie van komorbiditeit tussen MIV en As II steurings, insluitend BPO. Ten spyte van kontroversie, die OSM-IV-TR identifiseer nege fundementele kriteria, waarvan vyf teenwoordig moet wees vir n diagnose van BPO. Hierdie kriteria word individueel bespreek in n poging om hulle impak op patiente voldoening te illustreer. Klinies is dit heel moontlik dat daar interaksie is tussen die kriteria wat n gestalt effek sal skep, wat voldoening weer verder sal kompliseer.

Thesis (MA)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: HIV/AIDS places much stress on those living with the disease. An understanding of the processes of stress and coping and how these relate to people living with HIV/AIDS (PLWHA) can inform the nature of services we offer to PLWHAs. Social support has been shown to playa mediatory role in the stress response and is also considered to be a problem-focused coping strategy. This paper presents an overview of the literature on stress, coping and social support with the aim of assisting healthcare workers to understand how these issues relate to HIV/AIDS and to show how healthcare workers, and, specifically psychologists can use their unique competencies and skills to enhance the quality of life of PLWHAs. / AFRIKAANSE OPSOMMING: MIVNIGS plaas baie druk op mense wat met die siekte moet saamleef. Insig rakende die prosesse van spanning en hantering daarvan en hoe dit verband hou met mense wat met MIVNIGS moet saamleef, het die potensiaal om die aard van die dienste wat aan die spesifieke populasie gelewer word, in te lig. Sosiale ondersteuning blyk 'n bemiddelende rol te speel in spanningsresponse en word ook beskou as 'n probleemgefokusde hanteringsmeganisme. Die betrokke werkstuk bied 'n oorsig van die literatuur rakende spanning, hantering en sosiale ondersteuning. Dit is gefokus daarop om bystand te verleen aan gesondheidsorg werkers om hulle insig te gee hoe hierdie kwessies met MIVNIGS verband hou. Dit poog ook om aan te toon hoe gesondheidsorgwerkers en spesifiek sielkundiges, hul unieke bevoegdhede en vaardighede kan benut om die wat met MIVNIGS moet saamleef, se kwaliteit van lewe te verryk.

Thesis (MA)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: Statistics indicate that not only HIV-infection and AIDS but all sexual and reproductive health problems are increasing globally. In order to address these issues the socio-cultural context in which sexual behaviour is expressed must be understood. Given that sexual health risks are compounded by socio-political and socio-economic issues, researchers must direct their focus to high-risk, low socio-economic communities. Adolescents have been identified as a prime target for sexual awareness and preventative programmes and research has stressed the importance of gaining an understanding of adolescent sexuality, in order to address the sexual health risks that threaten adolescents. In addition, there is a paucity of research on especially the role of the male adolescent in the study of sexual and reproductive health. In the current study, constructions of male adolescent sexuality in traditionally coloured and rural communities were explored. The nature of the research was exploratory and the aims were to determine the range and frequency of sexual behaviour that male adolescents in a specific community engage in and secondly, explore male adolescents' constructions of their sexuality and sexual behaviour in intimate heterosexual sexual relationships. Multiple methods of data collection were utilised. Self-report questionnaires were completed by 179 male adolescents between the age of 15 and 21, at two schools in the rural areas surrounding Stellenbosch. The data from the questionnaire was quantitatively analysed. Seven in-depth interviews were conducted with male adolescents between the age of 16 and 18. The data from the interviews was analysed qualitatively. An analysis of the data indicated that male adolescents' ability to take control over safe sex practices are undermined by attempts to defend and conceal their sexual behaviour and sexuality. Male adolescents from traditionally coloured and rural areas distance and externalise their sexual behaviour and sexuality. Sexual behaviour is explained and understood as being directed by external factors and by fear of negative evaluation by peers and parents. Such a construction of sexuality continues to prevent male adolescents from understanding and constructing their sexuality as self-owned and self-directed. In turn this construction continues to result in behaviour that runs counter to safe sex guidelines. / AFRIKAANSE OPSOMMING: Statistieke toon dat alle seksueel-oordraagbare siektes en reproduktiewe gesondheidsprobleme, insluitend HIV-infeksie en VIGS, op globale vlak toeneem. Ten einde hierdie probleme aan te spreek is dit noodsaaklik om die sosio-kulturele konteks van seksualiteit en seksuele gedrag in ag te neem. Gegewe dat sosio-politiese en sosioekonomiese omstandighede 'n impak het op seksuele gesondheidsrisikos, word navorsers genoodsaak om hul fokus te rig op hoë-risiko, lae sosio-ekonomiese gemeenskappe. Adolessente word geïdentifiseer as primêre teikengroep vir bewustheids- en voorkomingsprogramme aangaande seksualiteit. Navorsing toon die belangrikheid aan van insig in adolessente seksualiteit, ten einde seksuele gesondheidsrisiko's in dié teikengroep aan te spreek. Verder is daar ook 'n leemte in navorsing betreffende die rol van die manlike adolessent in seksuele en reproduktiewe gesondheid. Hierdie studie het die konstruksies van manlike adolessente seksualiteit in tradisioneel "kleurling", landelike gemeenskappe ondersoek. Die navorsing is eksploratief van aard, met primêre doelwit 'n bepaling van die omvang en frekwensie van seksuele gedrag waarin manlike adolessente in 'n spesifieke gemeenskap deelneem. 'n Sekondêre doelwit is om manlike adolessente se konstruksies van hul seksualiteit en seksuele gedrag in intieme heteroseksuele verhoudings te ondersoek. Data-insameling het 'n kombinasie van metodes behels. Vraelyste is deur 179 manlike adolessente tussen die ouderdom van 15 en 21, komende uit twee skole in die Stellenboschdistrik, ingevul. Die data is kwantitatief geanaliseer. Verder is sewe in-diepte onderhoude met manlike adolessente tussen die ouderdom van 16 en 18 gevoer. Data uit hierdie onderhoude is kwalitatief geanaliseer. Die analise van die data het aangedui dat manlike adolessente se vermoë om beheer te neem oor veilige seksuele praktyk, ondermyn word deur pogings om hul seksualiteit en seksuele gedrag te verskans. Manlike adolessente vanuit tradisioneel "kleurling", landelike gemeenskappe distansiëer hulself van en eksternaliseer hul seksuele gedrag en seksualiteit. Seksuele gedrag word betekenis gegee en verstaan as gedrag wat deur eksterne faktore en die vrees vir negatiewe evaluering deur ouers en die portuurgroep, beheer word. Hierdie konstruksie van seksualiteit verhoed dat manlike adolessente hul seksualiteit in 'n konteks van selfbeheer en selfbesit kan betekenis gee. Sulke konstruksies dra daartoe by om veilige seksuele gedragsriglyne te ondermyn.

Thesis (MA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: This study is aimed at exploring mental health services for low-income women in the West Coast I Winelands Region of South Africa. In order to understand the extent to which such services are empowering, the accessibility and theoretical underpinnings of these services are investigated. It was found that although services appear to be available, they are often not very accessible. They also often lack a specific gender focus. In certain instances, services need to increase their accessibility in order to accommodate the restrictive environments of women in this region. As such, it is believed that services require greater integration in their approach to intervention concerning both gender and the origins of mental health problems. Results of this study also highlight areas on which future research could focus. These areas include language of service provision, how organizations understand available theories surrounding service provision, and the service needs of women in this region themselves. / AFRIKAANSE OPSOMMING: Hierdie studie is gemik op die ondersoek van geestesgesondheidsdienste vir vroue van lae-inkomste groepe in die Weskus I wynverbouingstreek van Suid Afrika. Die toeganklikheid en teoretiese onderstuttngs van hierdie dienste word ondersoek in In poging om die graad waarin delke dienste bemagtigend is, te verstaan. Bevindinge toon dat dienste, albeit beskikbaar voorkom, dikwels nie baie toeganklik is nie. Dienste toon ook meestal 'n gebrekkige fokus ten opsigte van 'n spesifieke geslag. In sekere gevalle behoort die toeganklikheid van dienste verbeter te word in 'n poging om die beperkende omstandighede van vroue in hierdie streek tegemoet te kom. As sulks benodig dienste 'n hoër mate van integrasie in hul benadering tot intervensie, beide wat geslag en die oorsprong van geestesgesondheidsprobleme betref. Bevindinge lig ook areas uit waarop toekomstige navorsing kan fokus. Hierdie areas sluit die volgende in: die taal van diensvoorsiening, hoe organisasies beskikbare teorieë ten opsigte van diensvoorsiening verstaan, en die behoefts van die vroue in hierdie streek self ten opsigte van dienste.

Thesis (MA)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: Family Resilience is a relatively new construct describing how families recover after experiencing stress and adversity. Defined within the salutogenic paradigm, resilience implies the ability to bounce back after being "stretched" or challenged, as well as being able to rise above adversity and to survive stress. Using a cross-sectional, survey research design the present study aimed to further explore and explicate those resiliency factors which enable families to maintain established patterns of functioning when threatened by risk factors. It also aimed to examine those recovery factors which foster the families ability to bounce back from crisis and disruption. Teachers who had accepted the voluntary severance package from the South African Department of Education between 1996 and 1998 were approached to take part in this study on behalf of their family. Thirty participants completed a biographical questionnaire as well as the Family Index of Regenerativity and Adaptation (FIRA-G) which measures the major components of the Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & Thompson, 1991). Results confirmed the relationship between family stressors, family strains and family distress, implying that if stressors and strains are not managed, they pile up, deplete resources and lead to family tension and stress (Lavee, McCubbin & Patterson, 1985; Lavee et al. 1987; McCubbin & Patterson, 1983). Results also highlighted the protective nature of good financial management, suggesting that there are measurable factors which act as crisis-meeting resources, diminish the negative impact and degree of the stressor and ultimately foster resilience and facilitate recovery. Finally, social support was highlighted as a resilience variable. Family schema (encompassing concepts of reframing and spiritual support) remains one of the crucial factors which contributes towards, firstly, the resistance of decay in the face of stressors, and secondly, which facilitates the recovery trajectory. It is maintained that this could be one of the most crucial factors for ongoing investigation in resiliency research. / AFRIKAANSE OPSOMMING: Gesinsveerkragtigheid ("resilience") is 'n relatiewe nuwe konstruk wat verwys na gesinne se vermoë om te herstel nadat hulle spanning en terugslae ervaar het. Dit word beskryf vanuit die salutogenese paradigma en word gedefinieer as gesinne se vermoë om terug te bons nadat hulle teenspoed ervaar het. 'n Dwarsnit navorsingsontwerp is gebruik om die twee aspekte van gesinsveerkragtigheid, naamlik weerstand en herstel, te ondersoek en te beskryf. Weerstandsfaktore verwys na dié faktore wat gesinne in staat stelom gevestigde patrone van funksionering, tydens bedreiging deur risiko-faktore, te handhaaf, terwyl herstel-faktore verwys na dié faktore wat gesinne se vermoë om terug te bons na 'n krisis, bevorder. Onderwysers wat tussen 1996 en 1998 die vrywillige uittredingspakket van die Departement van Onderwys aanvaar het, is genader om namens hul gesinne deel te neem aan hierdie ondersoek. Dertig deelnemers het 'n biografiese vraelys sowel as die "Family Index of Regenerativity and Adaptation" (FIRA-G) voltooi. Die FIRA-G vraelyste meet die hoofkomponente van die "Resiliency Model of Family Stress, Adjustment and Adaptation" (McCubbin & Thompson, 1991 ). Resultate het die verband tussen gesinstressors, gesinspanning en gesinsnood bevestig, met die implikasie dat indien 'n opeenhoping van stressors en spanning nie hanteer word nie, gesinshulpbronne uitgeput word en dat dit tot gesinspanning en stres kan lei. Die beskermende aard van goeie finansiële bestuur is bevestig. Sosiale ondersteuning is geïdentifiseer as 'n belangrike faktor in gesinsweerstand. Gesinskemas, wat herformulering en geestelike ondersteuning insluit, blyk 'n deurslaggewende gesinsveerkragtige faktor te wees en behoort in die toekoms verder ondersoek te word.

Thesis (MA) -- University of Stellenbosch, 2000. / ENGLISH ABSTRACT: The aim of this study was to determine whether any relationship existed between identified circumstantial factors about the living conditions of black families and specific conflict tactics employed by them in an informal settlement in the Helderberg basin. The research hypothesis is founded on crime statistics for the past five years for the Helderberg basin that have shown a generally higher crime incidence/reporting rate for informal and low cost-housing compared to more affluent areas in the basin (CIAC, 2000). The purpose of exploring the existence of such a relationship was to highlight particular circumstantial factors, assisting decision makers at local government to intervene more effectively in terms of funds and resources to ensure safer community. A semi-structured questionnaire, developed by the author, was used to determine the presence of circumstantial factors in this community; the Conflict Tactic Scales, (CTS), developed by Straus (1979), served as the measure to assess the predominant conflict tactics employed by families in Nomzamo, an informal settlement in the Helderberg basin. Fifty families (2 members per family) participated in the study with one condition that one of the members should be a child between the ages of 12 and 17. The only significant relationship that was obtained was between the circumstantial factorlevel of education, and the conflict tactic-physical assault between spouses, which highlights the fact that continued education raises ones' awareness and empowers one to speak out against violence in the home. Possible reasons were offered, given that no other significant trends could be determined in the study and recommendations for future research in this field are made. / AFRIKAANSE OPSOMMING: Die doel van die studie was om vas the stelof daar enigsins 'n verband bestaan tussen bepaalde omgewingsfaktore verwant aan die lewensomstandighede van swart gesinne in 'n informele nedersetting in the Helderberg-kom en spesifieke konflik strategieë deur hulle gebruik. Die navorsing hipotese spruit voort uit misdaad statistiek oor die afgelope vyf jaar vir die Helderberg-kom, wat oor die algemeen 'n hoë misdaadaanmeldingsyfer vertoon vir informele en lae-koste behuising areas in vergeleke met meer gegoede areas in die kom (CIAC, 2000). Die bepaling of daar wel 'n verband bestaan, het ten doelom besluitmakers binne plaaslike owerhede te assisteer om fondse tot hul beskikking, meer effektief aan te wend om misdaad verder te bekamp en die gemeenskap te beveilig. Die bepaling van die teenwoordigheid van omgewingsfaktore binne die gemeenskap, is gedoen deur middel van 'n semi-gestruktureerde vraelys wat deur die skrywer ontwikkel is; om vas te stel welke konflik strategieë meerendeels deur gesinne gebruik word in dié informele nedersetting, is gebruik gemaak van die Conflict Tactic Scales (CTS) soos ontwikkel deur Straus (1979). Vyftig gesinne (twee lede per gesin) het deelgeneem aan die studie met die voorwaarde dat een van die lede van die gesin 'n adolessent tussen 12 en 17 moes wees. Die enigste beduidenswaardige verband wat verkry is, was tussen die omgewingsfaktor - opvoedingspeil, en die konflik strategie - fisiese aanranding tussen eggenote. Dit dui daarop dat met toenemende onderrig, verhoog 'n mens se gewaarwordig en word 'n mens bemagtig om 'n standpunt in te neem teen geweld in die huis. Sekere redes word aangevoer gegee die feit dat geen ander beduidende verbande voortgespruit het uit die studie nie en voorstelle vir verder navorsing in dié veld word gegee.

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: This paper provides an overview and critical evaluation of current (1990-2001) research into Human Immune-deficiency Virus (HIV) and Acquired Immuno-deficiency Syndrome (AIDS), with particular reference to factors affecting quality of life (QOL) among those living with the disease. A brief look at the importance of optimal QOL when faced with a life crisis such as HIV/AIDS, leads to a discussion of factors influencing QOL in HIV/AIDS. These factors include coping styles, mental adjustment, social support, stigmatization, socio-economic and socia-cultural factors, gender, depression as well as disease progression. The overview is informed by prominent research trends and a critical look at the current understanding of factors impacting on the QOL of people living with HIV/AIDS. Recommendations are made on issues that need further clarification, while future research orientations are also suggested. In the absence of satisfactory treatment strategies or a cure for HIV/AIDS, as well as the evidence of a potentiall0 to 12 year life expectancy, there is a pressing need for a better understanding of factors that influence QOL. There is strong support for the notion that QOL directly impacts on disease progression and therefore also on the quality and quantity of survival time. It follows that a better understanding of the nature and determinants of QOL for HIV patients will yield valuable intervention guidelines within a biopsychosocial framework. / AFRIKAANSE OPSOMMING: Hierdie artikel bied 'n oorsig en kritiese evaluering van onlangse (1990-2001) navorsing in die veld van Menslike Immuniteitsgebrek Virus (MIV) en Verworwe Immuniteitsgebrek Sindroom (VIGS), met besondere verwysing na faktore wat bydra tot die lewenskwaliteit van geïnfekteerde indiwidue. Die belangrikheid van optimale lewenskwaliteit teen die agtergrond van 'n lewenskrisis soos 'n MIV-diagnose, word kortliks bepsreek. Daarop volg In bespreking van faktore wat In invloed het op lewenskwaliteit in HIV/AIDS. Hierdie faktore sluit in hanteringstyl, psigiese aanpasbaarheid, sosiale ondersteuning, stigmatisering, sosio-ekonomies en sosio-kulturele faktore, geslag, depressie asook siekteverloop. Die oorsig word gerugsteun deur prominente navorsingstendense asook 'n kritiese blik op huidige perspektiewe op faktore wat 'n impak het op die lewenskwaliteit van mense wat leef met MIVjVIGS. Aanbevelings word gemaak aangaande aspekte waaroor verdere helderheid verkry moet word, asook oor toekomstige navorsingsvraagstukke. Gegewe die afwesigheid van voldoende behandelingstrategieë of selfs 'n geneesmiddel vir MIV, tesame met die bewys van 'n 10 tot 12 jaar potensiële lewensverwagting, bestaan daar 'n dringende noodsaaklikheid vir grondiger insig in faktore wat lewenskwaliteit beïnvloed. Daar is sterk steun vir die uitgangspunt dat lewenskwaliteit 'n direkte impak het op siekteverloop en derhalwe ook op die duur en kwaliteit van oorlewingstyd. Verbeterde kennis oor die aard en determinante van lewenskwaliteit in MIV-pasiënte sal dus waardevolle inligting kan verskaf in terme van toepaslike riglyne vir intervensies binne 'n biopsigososiale raamwerk.

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: The primary goal of this cross-cultural study was to determine how low-income female farm workers in the Western Cape of South Africa, describe their own coping mechanisms. Eight participants were asked to respond to an open-ended question on how they cope with life's difficulties. The current study formed part of a larger project entitled: "Forgotten women on farms". The psychological distress and resilience of female farm workers of colour in the Western Cape: exploring the possibilities for mental health support (Kruger, 1998). The coping interviews were analyzed by means of grounded theory. Analysis revealed that 28 coping mechanisms were identified by the participants themselves. A distinction was made between problem-focused coping mechanisms and emotion-focused coping mechanisms. Out of the 28 identified mechanisms, 8 were categorized as problem-focused coping mechanisms, while 20 were categorized as emotion-focused coping mechanisms, suggesting that the participants predominantly employ emotion-focused coping mechanisms. It was also found that the emotion-focused coping mechanisms employed by the participants often involved an avoidance of emotion. The findings were discussed by: (i) Critically discussing the way in which emotion-focused coping is traditionally defined within the coping literature. (ii) Comparing this to the conceptualization of the role of emotion by authors of trauma literature. Possible reasons for the prevalent use of emotion-focused coping mechanisms in this particular population were provided. The implications of these findings for assessment of coping strategies and for mental health care in this population were discussed. / AFRIKAANSE OPSOMMING: Ole hoofdoeisteiling van hierdie kruis-kulturele studie was om vas te stel hoe laeinkomste vroueplaaswerkers in die Wes-Kaap van Suid-Afrika hulle eie streshanteringsmeganismes beskryf. Agt deelnemers is gevra om op "n oop vraag oor hoe hulle lewensmoeilikhede hanteer, te reageer. Hierdie studie vorm deel van "n groter projek getiteld "Forgotten women on farms". The psychological distress and resilience of female farm workers of colour in the Western Cape: exploring the possibilities for mental health support (Kruger, 1998). Hierdie onderhoude oor streshantering is ontleed m.b.v. "grounded theory". Analise het getoon dat 28 hanteringsmeganismes deur die deelnemers self ge"ldentifiseer is. Onderskeid is gemaak tussen probleem-gerigte hanteringsmeganismes en emosioneel-gerigte hanteringsmeganismes. Uit die 28 gerdentifiseerde meganismes, is 8 gekategoriseer as probleem-gerigte hanteringsmeganismes, terwyl 20 gekategoriseer is as emosioneel-gerigte hanteringsmeganismes, duidend daarop dat deelnemers grootliks van emosioneel-gerigte hanteringsmeganismes gebruik maak. Daar is ook gevind dat die emosioneel-gerigte hanteringmeganismes dikwels "n vermyding van emosie behels het. Hierdie bevindinge is bespreek deur: (i) Die manier waarop emosioneel-gerigte hanteringsmeganismes tradisioneel in die literatuur gedefinieer word krities te bespreek. (ii) "n Vergelyking te tref met die wyse waarop die rol van emosie deur die outeurs van trauma literatuur gekonseptualiseer word. Moontlike redes vir die groter gebruik van emosioneel-gerigte hanteringsmeganismes in hierdie spesifieke populasie is voorsien. Die implikasies van hierdie bevindinge vir die meting van hanteringsmeganismes en vir geestesgesondheidsdienste binne hierdie populasie is bespreek.

Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: Visual-motor integration is an important neuro-psychological aspect of school readiness. Developmental deficits in this area can have a detrimental influence on a child's ability to master reading, writing and arithmetic skills at school entrance level. Visual-motor integration problems should therefore be detected as early as possible to be able to implement intervention strategies which will promote visual-motor development. The study is socially relevant as it corresponds with the South African school policy which changed to a more integrative, inclusive approach after 1994. The American standardised Beery Developmental Test for Visual-Motor Integration (VMI) is widely used as a screening technique for visual-motor abilities by psychologists, occupational therapists, educators and remedial teachers in South Africa. In order to determine the predictive validity of the American VMI for a group of South African subjects, the results of children on the VMI: 1989-norms and VMI: 1997-norms were compared to their results in the Copying Test of the Junior South African Individual Scales (JSAIS). Performance on these three tests were also compared with certain biographical variables as well as teacher ratings of specific academic skills. A representative sample of 238 pre-school children from the Stellenbosch region were selected. According to the obtained results, a significant relationship was found between the results of the VMI: 1989 and VMI: 1997. The results of both the VMI: 1989 and VMI: 1997 correlated significantly with the results of the Copying Test. Performance in the tests correlated with chronological age, socio-economic status, as well as teacher ratings of specific academic skills. The discrepancy between the test performance of the three ethnic groups, suggests that the rate of the perceptual motor development described by the VMI developmental norms may be culture-specific. Considering the overall results of this study, the interchangeability of the Copying Test and the VMI, especially the VMI: 1997, in clinical use is acceptable in the South African context. The Developmental Test of Visual-Motor Integration thus offers significant predictive validity, as well as a valid indication, of the visual-motor integration development in the sample ofpre-schoolers used. / AFRIKAANSE OPSOMMING: Visueel-motoriese integrasie IS 'n essensiële neuro-sielkundige aspek van skoolgereedheid. Ontwikkelingsagterstande in hierdie area kan 'n kind se lees-, taal- en rekenkundige vermoëns nadelig beïnvloed. Probleme ten opsigte van visueel-motoriese integrasie behoort dus so vroeg as moontlik opgespoor te word sodat remediërende strategieë geïmplementeer kan word wat visueel-motoriese integrasie bevorder. Die navorsing is sosiaal relevant deurdat dit aansluit by die skoolbeleid wat sedert 1994 na 'n meer geïntegreerde, inklusiewe benadering met die akkomodasie van diversiteit, verander het. Sielkundiges, arbeidsterapeute, opvoedkundiges en remediërende onderwysers in Suid- Afrika benut die Amerikaans gestandaardiseerde Beery-Ontwikkelingstoets vir Visueel- Motoriese Integrasie (VMI) op gereelde grondslag vir die evaluering van visueelmotoriese vaardighede. Ten einde die voorspellingsgeldigheid te bepaal van die Amerikaanse VMI vir 'n groep Suid-Afrikaanse toetslinge, is hul prestasies op die VMI: 1989-norms, sowel as die VMI: 1997-norms, met hul prestasies in die Natekentoets van die Junior Suid-Afrikaanse Individuele Skale (JSAIS) vergelyk. Prestasie in die toetse is ook met sekere biografiese veranderlikes, sowel as onderwyser-beoordelings van spesifieke akademiese vaardighede, vergelyk. 'n Verteenwoordigende steekproef van 238 voorskoolse kinders vanuit die Stellenbosch-omgewing is gekies. Uit die resultate blyk daar 'n beduidende korrelasie tussen die VMI: 1989-resultate en die VMI: 1997-resultate te wees. Die resultate van beide die VMI: 1989 en VMI: 1997 het beduidend met dié van die Natekentoets gekorreleer. Prestasie in die toetse het met kronologiese ouderdom, sosio-ekonomiese status, asook onderwyser-beoordelings van spesifieke akademiese vaardighede, gekorreleer. Die VMI-prestasies van die drie etniese groepe het beduidend verskil en die gevolgtrekking kan gemaak word dat die VMI nie as 'n kultuurvrye toets beskou kan word nie. Die gevolgtrekking op grond van die resultate van die huidige studie blyk dat die VMI, en veral die VMI: 1997, beduidende voorspellingsgeldigheid by die voorskoolse ondersoekgroep gelewer het en a / ISISHW ANKATHELO: Ukumanya ngokuhamba okubonakalayo kuyinto ebalulekileyo yokulungela ukungena esikolweni. lintsilelo zenkqubela phambili kulo mba zinganefuthe elibonakalayo lobugcisa bokufunda emntwaneni, ukubhala nobuchule bezibalo kumgangatho wokungena esikolweni. lingxaki zokumanya ngokuhamba okubonakalayo kufuneka ziqatshelwe kuselithuba khon'ukuze kwenziwe amalinge okungenela aya kuthi onyuse inkqubela phambili yokuhamba okubonakalayo. I-Beery Development Test yokumanya ngokuhamba okubonakalayo (VMI) isetyenziswa ngokubanzi njengobugcisa bomkhusane wokuhamba okubonakalayo, ziinzululwazi zengqondo, iingcali zokunyanga, abefundisi-ntsapho, kwakunye neetitshala ezilungisayo eMzantsi Afrika, kodwa kusekho impikiswano yokuba olu vavanyo, lubekwe emgangathweni yiMelika, likhupha iziphumo ezizizo na kwilizwe leentlanga ezahlukeneyo njengoMzantsi Afrika. Ukuze kufunyanwe ukuba 1-VMI ikhupha iziphumo ezizizo na kumalungu aseMzantsi Afrika, iziphumo zabantwana kwi-VMI: 1989 nakwi- VMI: 1997 zathelekiswa neziphumo zabo kwi South African Copying Test. Kuye kwakhethwa isampulu yabantwana abangama-238 abalungele ukungena esikolweni kwingingqi yaseStellenbosch. Kuye kwafunyanwa unxulumano olubalulekileyo phakathi kweziphumo zeVMI: 1989 neze- VMI: 1997. Zozibini iziphumo ze-VMI: 1989 neze- VMI: 1997 ziye zanxulumana ngokubalulekileyo neziphumo ze-Copying Test. Indlela ekwenziwe ngayo iye yanxulumana nokulandelelana ngamaxesha obudala ngokunjalo novavanyo lukatitshala lobugcisa obuthile kwezemfundo. Umahluko wovavanyo phakathi kwendlela ekuqhutywe ngayo ziintlanga ezintathu, ucebisa ukuba isantya senkqubela phambili sendlela yokubona echazwe sisithethe senkqubela se-VMI sinokwayama kwimpucuko. Nakubeni kunjalo, xa sicinga ngeziphumo zonke zesi sifundo, 1-VMI inike uphawu lenkqubela phambili yokumanya ngokuhamba okubonakalayo kwisampulu yabantwana abasetyenzisiweyo abalungele ukungena esikolweni.