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The purpose of this study was to test Lazarus and Folkman's (1984) theoretical framework of stress and coping as it applied to daughters who have parents living in care facilities. Specifically, the effects of personal and environmental influences, cognitive appraisals, and coping on positive affect and depression were examined in two subsamples of daughters: daughters with parents with dementia (n=100) and daughters with parents with other health difficulties (n=89). The data were collected from a volunteer sample of 189 daughters (M age 51.3) in the Greater Vancouver region. Daughters completed three parts of a questionnaire over a six-week period. Specific variables of interest included prior communal behaviors, support satisfaction, care satisfaction, appraisals (perceived control and perceived stress), coping strategies (relationship-focused, problem-focused, emotionfocused), positive affect, and depression. Negative affectivity (NA) was examined as a confounding variable. Path analysis using LISREL VIII (Joreskog & Sorbom, 1993) was undertaken to examine the hypothesized relationships between antecedent, mediating, and outcome variables that are central to Lazarus and Folkman's (1984) theoretical framework. Initial results revealed a poor fitting model for both the dementia and other health groups. However, a revised model, taking into account theoretical and empirical support for a direct relationship between support satisfaction and emotion-focused coping, provided an acceptable fit for both groups. The overall pattern of relationships for the variables in the model offer some support for the hypothesized model and for Lazarus and Folkman's theoretical assumptions. For both groups, greater control over the stressful aspect of facility care was related to more problem-focused coping, which in turn was related to more positive affect. For the other health group, greater appraised stress was related to more emotion-focused coping, which was in turn was related to greater depression. Among daughters with parents with dementia, low levels of care satisfaction and high communal behaviors were associated with greater perceived control. The hypothesized mediational role of appraisals and coping was not supported. The results point to the importance of understanding caregiving in the context of chronic stress and the unique contribution of personality, health type, and positive aspects of caregiving to a daughter's stress process.

The need for a family therapeutic counselling programme in the management of HIV/AIDS was established by the researcher in 2001 (den Hollander 2001). The focus of this study was to develop the training programme model in family therapeutic counselling for church leaders and lay counsellors. This was accomplished using a variety of samples and research instruments, by firstly exploring the issues and problems facing people and families living with HIV/AIDS and then how best churches could respond as faith-based community organizations. At a theoretical level, this study sought to compare the paradigms of contextual and narrative family therapy with the theory and practice of social work and practical narrative theology, in order to integrate these paradigms into an incorporated response to the HIV/AIDS pandemic. The main research methodology was the Intervention Research Model as adapted from De Vos (2001). This model consists of six phases, consisting of problem analysis and project planning, information gathering and synthesis, design, early development and pilot testing, evaluation and advanced development, and dissemination of the training model. During the analysis phase an extensive literature research, as well as several field studies, both quantitative and qualitative were conducted. During the development phase, three pilot studies were designed and performed, in attempt to accommodate the context specific problems of different families and communities. The results of these two phases indicated a need for pastoral training in family therapeutic counselling, specifically in the areas of mental health, trauma and bereavement and child participation. Importantly, the need to intervene meaningfully to alleviate structural problems such as poverty and food insecurity were clearly indicated, with the study recommendation being for active networking across all stakeholders so that therapeutic counselling may work in tandem with these community based efforts. Recommendations in respect of offering such training are to provide a comprehensive structure of training, supervision and counselling practice. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

There is no abstract available for this thesis. / Department of Communication Studies

The existing scholarly literature that addresses the transgenerational transmission of family processes fails to answer many questions concerning adults' current relationships with partners and peers. The purpose of the present study was to investigate how adults' perceptions of their family of origin climates affect their own satisfaction with emotionally significant interpersonal relationships and their fear of intimacy in these relationships. Participants were recruited from a mid-western college. A total of 281 participants were tested.The main research question was: What is the nature of the relationship between adults' perceptions of their family of origin climate and their current relationship satisfaction/fear of intimacy. It was hypothesized that adults' perceptions of cohesion, expressiveness, independence, achievement orientation, intellectual-cultural orientation, active-recreational orientation, moral religious emphasis, and organization within their families of origin would be positively related to their satisfaction with their current friendship and partner relationships and negatively related to their fear of intimacy. It was conversely hypothesized that adult's perceptions of conflict and control within their families of origin would be negatively related to their current relationship satisfaction with friends and partners and positively related to their fear of intimacy.Family of origin climate was assessed by the Family Environment Scale which measures 10 aspects of family of origin climate. These are: cohesion, expressiveness, conflict, independent, achievement orientation, intellectual-cultural orientation, activerecreational orientation, moral-religious emphasis, organization, and control. Relationshipsatisfaction was measured in two types of relationships: partner relationship satisfaction with the Relationship Assessment Scale and peer relationship satisfaction with the Inventory of Parent and Peer Attachment, Peer Scale. The Fear of Intimacy Scale was utilized to assess participants' anxiety or fear that influences intimacy in a close relationship or at the prospect of a close relationship. Participants also completed a demographic questionnaire.Results of a canonical correlation analysis indicated that perceptions of family of origin climate did not influence current relationship satisfaction or fear of intimacy in adults. Adults' perceptions of their family of origin climates did not influence their current relationship satisfaction and fear of intimacy. Limitations of the current study and recommendations for future research are discussed. / Department of Counseling Psychology and Guidance Services

The focus of this qualitative phenomenological research study was the lived experience of married couples between the ages of 60 and 70, one of whom has type 2 diabetes. The author sought to discover additional meanings concerning the experience of diabetic education, adherence to medications plans, modifications in lifestyle, and the role of the non-diabetic spouse in the experience. Participants were six married couples between the ages of 60 and 70. Three wives and three husbands had been diagnosed with type 2 diabetes. Two one hour interviews were conducted with each couple, both spouses present. Each couple was asked the question "Tell me what it is like living with diabetes." Interviews were audio taped and transcribed by the researcher. Informant volunteers were identified using the snowball method of sampling. The author identified the two domains of experience with the health care system and experience with the spouse..Themes of the first domain were identified as relationship with health care provider and education of patient and spouse at time of diagnosis. Themes in the second domain were spousal support, perceived compliance, and perceived risk of complications. Implications for adult education and advanced nursing practice include the importance of including the non-diabetic spouse in the education and treatment plan at time of diagnosis and offering a clear explanation of the relationship between adherence and long term complications of the disease. Suggestions for further research include investigation of the self reporting of behavior modification and outcomes of adherence, the effectiveness of provider interventions in monitoring behavioral changes, and to study women with diabetes married to men without diabetes. / Department of Educational Studies

The purpose of this study was to explore the marital adjustment of older adult couples with breast cancer, prostate cancer, and couples who have experienced neither. Participants were 64 couples in which at least one of the spouses was over 55 years of age, including 19 breast cancer couples, 20 prostate cancer couples, 25 couples who had experienced neither of these cancers. Most participants were young-old, Protestant, Caucasians from a high socioeconomic class. The breast cancer and prostate cancer participants had completed treatment an average of 39.5 months prior to participation. The methodology was a mail survey. Participants completed a demographic questionnaire, the Marital Satisfaction Questionnaire for Older Adults (MSQFOP) (Haynes et al., 1992), Primary Communication Inventory (PCI) (Navran, 1967), Miller Social Intimacy Scale (MSIS) (Miller & Lefcourt, 1982), and the Index of Sexual Satisfaction (ISS) (Hudson et al., 1981).There were no differences in the amount of discordance between the couples groups' level of marital satisfaction, communication, intimacy, and sexual satisfaction. In addition, there were no differences in the level of marital satisfaction, communication, intimacy, and sexual satisfaction between the participant groups. There was a significantly greater correlation between the prostate cancer couples' scores on the ISS than the correlation between the breast cancer couples' scores and the scores of the couples who had not experienced breast cancer or prostate cancer.The level of marital satisfaction, communication, intimacy, and sexual satisfaction reported was similar to that of the normative samples. There was no difference between the marital adjustment of the cancer couples and older couples who had experienced neither type of cancer. These results are good news for breast and prostate cancer survivors, and professionals. Older adults may be better able to incorporate the experience of cancer into their lives or are better prepared for chronic illness through anticipatory socialization. The high degree of agreement between the prostate cancer spouses on the ISS may be related to the sexual dysfunction that frequently accompanies treatment for this cancer. Future research should be qualitative and longitudinal and continue to explore the psychosocial implications of prostate cancer. / Center for Gerontology

This research was designed to do four things: first to discover what problems face caregivers who bring up handicapped children in their own homes; second, what community resources are available or which should be available to assist the mentally retarded and his family to cope with the problem; third, social policy measures available through the Transkei government, e.g. single care grant and disability grant and under what conditions are they available and whether other resources/services are available, and fourth, to find out from caregivers themselves how well the social services, although limited which are intended to help them and their children work in practice, more specifically in rural areas especially when community and public sector measures are highly circumscribed. The lack of resources for mentally retarded children and their families in Transkei and particularly the Sterkspruit district raised some questions in the researcher's mind on how to rear a mentally retarded child in this area. Data was gathered from a sample of all mentally retarded children who are single care grant recipients. The subjects were the mothers of these children or the present custodian about the time of the study. Information was also gathered from the social workers in the district mainly from their case files in the office. The sample was sufficient for the study to be meaningful and well represented and to eliminate guesses and assumptions about the lives of mentally handicapped children and their families. Findings reveal that caring for a mentally retarded child is a demanding task with varying levels of stress. Families of the retarded, in general, tend to have more problems in individual and marital adjustment, child-rearing practices, and sibling relationship. They are significantly affected - socially, economically and emotionally - by mental retardation. Support systems both formal and informal, were a great single source of help for these families for them to cope with these children. Recommendations for better quality of life for both the handicapped child and his family are given in the last chapter, and they are most suitable for undertaking by the Welfare and Education Departments. It is not the purpose of this study to give advice to parents on how to bring up their handicapped children. Often using the mothers' own words, the researcher only presents the picture given by the parents themselves of how they actually learn to live with a handicapped child

HIV/AIDS has affected families in a profound and tragic way. Children whose parents have succumbed due to HIV/AIDS related infections have to be cared for by their relatives. This study focused on the experiences of primary caregivers of adolescents who are living with HIV in a semi-rural area of Eastern Cape Province, Grahamstown. There is a dearth of literature that is addressing the well-being, experiences and challenges of primary caregivers of adolescents living with HIV. Adolescence is a complex life stage during which adolescents usually present challenging behaviours and are grappling with moral issues. Caregiving to these youngsters who are burdened with HIV infection places additional demands on caregivers, especially so when they are experiencing poverty and poor social and welfare support. A qualitative study was most appropriate to explore and describe the experiences of adolescents infected with HIV. The population of this study was the primary caregivers of adolescents caring for adolescents with HIV in the area of Grahamstown, who are between 11 to 19 years old. A purposive sample of nine primary caregivers of adolescents living with HIV was selected. Data was collected by conducting individual interviews, using a semi-structured interview schedule. Data was analysed thematically according to prescribed theoretical guidelines. Data was verified by means of guidelines for the truth value, applicability, consistency, and neutrality of the study. The findings of the study indicated that primary caregivers experience that caring for adolescents who are living with HIV places a huge burden due to adolescents' negative behaviour, HIV stigma and discrimination, poor support from their families, being confronted with adolescents' emotional issues that they are not capacitated to deal with, and no adequate community resources to assist them. The challenges primary caregivers experience lead to negative effects on their health status. The findings of the study could be useful for informing intervention programmes that are targeting this group and policy development, and implementation of programmes benefiting both infected adolescents and their primary caregivers.

Human Immune Deficiency Virus (HIV), which results in Acquired Immune Deficiency Syndrome (AIDS), has many manifestations. Literature reveals that some of these manifestations may compromise the infected individual’s sense of well-being and negatively impact on health related quality of life. As the number of people living with HIV/AIDS disease grows, so does the need for their care. In the early days of the AIDS epidemic, care was primarily handled by special agencies, hospitals and clinics. These agencies have been inundated with the demands of people living with HIV/AIDS, while their resources are shrinking. As it stands now, the total assistance given to people living with HIV/AIDS is provided by relatives and this responsibility of caregiving will more increasingly rest with families. This situation is particularly salient for the rural community in South Africa, which has been disproportionately affected by the AIDS epidemic. AIDS has a tremendous impact on the entire family system, particularly on the individual who has primary responsibility for caregiving. The caregiver must cope with many circumstances that are frustrating and often beyond their control. Caring for a Person Living with HIV/AIDS (PLWHA) appears to be a major stressor in the lives of caregivers, and can be very demanding, impacting on carers financially, physically, emotionally and socially. Given the lack of research on HIV/AIDS family caregiving from a salutogenic approach, this study aimed to explore and describe the sense of coherence and coping of family caregivers of HIV/AIDS patients in the Kwazakhele area in Port Elizabeth. The sample consisted of 50 participants aged between 21 and 65 years, recruited via the Kwazakhele Masizakhe Project. An exploratory-descriptive design was employed. Data was obtained by a biographical questionnaire, the Coping Resources Inventory (CRI) and the Sense of Coherence (SOC-29) Questionnaire. A non-probability convenience sample of adult male and female family caregivers were sampled. Descriptive statistics and correlation coefficients were utilized to describe and explore the coping and sense of coherence of the family caregivers and the correlation between these constructs, respectively. The data obtained from the biographical questionnaire was analysed by using descriptive statistics and frequency counts. Key findings include the following: Results from the coping resources measure indicated that this sample perceived themselves as having an average level of coping resources. The sample tended to rely more readily on spiritual resources and less on cognitive resources. Results from the SOC-29 revealed fairly high mean scores. There is no positive relationship between the SOC-29 and the CRI for the current sample. No significant relationship existed between the SOC and the subscales of the CRI. Suggestions are made for future research, the limitations and value of research were outlined.