Thesis (D. Phil)(Information Science)--University of Pretoria, 2004. / Includes English summary. Includes bibliographical references.

Thesis (Ph.D.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 255-267.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 188-204).

This research project examined the changing expectations and knowledge of Managers in the Department of Health who attended the Sexual Health Counselling Project offered by Rhodes University, East London, South Africa. These managers came from contexts in which the hierarchical medical model is firmly entrenched. The Sexual Health Counselling Project, drawing on theoretical principles from Narrative and other theories,presented a challenge to the standard management practices used by the managers. It also challenged how they dealt with clients. This research explored changes in expectations and knowledge prior to and during a two- week training course that the managers attended. A personal awareness and shift in knowledge occurred for many managers who examined their current practices. Some managers, who were firmly entrenched in the hierarchical model,found it difficult to change their ways of working.

This qualitative study explored the use of Reiki in improving the quality of life of people living with HIV (PLWH). A purposive sample of seven participants consented to the study. Reiki attunement, self healing and data collection were done over a six-month period. An idiographic approach was used. The participants were interviewed, then underwent Reiki attunement, performed self healing for 21-30 days and were interviewed again. Responses suggest that Reiki therapy had positive outcomes. Illnessspecific symptom relief, increased levels of energy, improved sleeping patterns, decreased anxiety and depression, spiritual awakening and a better ability to handle stressful situations were reported. Reiki therapy enabled the participants to reappraise living with HIV, deal with anger, depression and self-blame. These positive changes led to some of them seeking employment, leaving destructive personal relationships and reconnecting with family members. The researcher strongly recommends further research in this area. / Sociology / (M.A. (Social Behavioural Studies HIV/AIDS))

M.A. / The challenge of HIV/AIDS is a global issue, instead of decreasing the number of people infected with the disease the number is increasing. Fortunately we have men and women who are volunteers to fight the increase of this pandemic. These heroes are the voluntary caregivers who are the mainstay of people with AIDS. However the fact that the caregivers suffer from loneliness and social isolation related to stigma and discrimination cannot be ignored. Voluntary caregivers can benefit form the opportunity to express basic emotions concerning, financial, emotional and physical issues and open line of communication should be in place. Providing an avenue foe emotional expression may enhance both physical and mental health to voluntary AIDS Caregivers. The qualitative study undertaken to explore the experiences of AIDS patients and their families regarding the home based care as service delivery. An explorative and qualitative design was used to determine the experiences of the AIDS caregivers, and aids patients concerning the support that they receive. AIDS patients and the families were selected from the organisations that are funded by the Department of Social Development in the Free State, Bloemfontein area. Pilot study was conducted prior to the commencement of the study comprising of ten participants in each group. Participants were requested to give information during the interviews. Data was collected and analysed and it was in followed by the literature control. The findings did not differ significantly in emotional and social aspects. The researcher drew conclusion and recommendations. Limitations were discussed. / Dr. Oliphant Ms. A. Vermeulen / M.A.

Background Nutrition and food security are important for maintaining a strong immune system and good general heath of People Living with HIV/AIDS (PLHA). The main aim of this study was to survey the nutritional status, habitual diet, dietary knowledge and demographic characteristics of PLHA in Nepal. A second aim of this study was to explore the voices of PLHA and policy level people on the current and possible future nutrition intervention programmes for PLHA in Nepal. Methods Using mixed methods (quantitative and qualitative) research techniques, 601 (M: 314 and F: 287) HIV positive people from the Kathmandu valley and Terai highway regions of Nepal were recruited and completed the study. All participants completed an interviewer administered questionnaire. This questionnaire includes an assessment of habitual food intake using a newly developed and validated 45-item semi-quantitative food frequency questionnaire. The validity of the FFQ was previously assessed against the 24-h multiple pass dietary recall in a sub-sample of the study population. Socio-economic and demographic information, dietary/nutritional knowledge, height, weight, waist circumferences and skinfold thickness were also collected. Finally, reported food intake was converted into energy and selected nutrient intakes (fat, protein, carbohydrate, iron, vitamin A and vitamin C) by linking with a newly compiled nutrient database of 116 food items for Nepal. Nutritional knowledge and perceptions of the current Nepalese nutritional supplementation and possible alternative interventions were explored using qualitative techniques. Four focus group discussions (FDG) and 11 in-depth interviews were carried out with PLHA and key local stakeholders respectively. Results The newly designed semi-quantitative FFQ can retrospectively assess the group mean intake for energy, protein, fat, carbohydrate, iron, carotene and vitamin C as there was no significant difference for reported intakes (all p > 0.2), but mean fat intake was significantly lower when determined by the FFQ than the 24-h recall (p < 0.001). The average age of participants was 33.8±6.4 years (mean ±SD) and 29% were classified as underweight (BMI < 18.5kg/m2). The study population typically ate a plant-based diet and intake of animal products was low, the energy intake of men and women was 1960±195 and 1880±261 kcal/d mean (±SD) respectively. Fat, protein and carbohydrate contributed 12%, 10% and 79% to total energy intake respectively. Iron and vitamin A intakes also tended to be lower than recommended, whereas vitamin C intake was satisfactory. Most participants (82%) believed that PLHA need a special diet but less than half of those reported changing their diet after diagnosis. A major reason for this was restricted income: 46% of participants reported being unable to afford sufficient food for the whole year, and 57% of those reported borrowing food for more than four months a year. Participants from FGD and in-depth interviews were not satisfied with the daily food and nutrient intake by HIV positive people. The Nepalese government currently provides a nutritional supplement for PLHA mainly for those who are on anti-retroviral treatment (ART). However, this was not satisfactory with the majority of volunteers reporting suffering negative health effects, including diarrhoea and vomiting, after consuming the supplement. Similarly, poor quality packaging, storage, delivery and lack of nutritional expertise and education were frequently reported problems for the proper implementation of the existing supplement. The participants suggested a nutrition intervention, based on a locally produced supplement, combined with dietary education and were highly motivated to support the development, implementation and evaluation of a new intervention. Conclusion Food and nutrient intakes by PLHA in Nepal were not adequate and did not meet dietary recommendations. Overall, the quality of the current nutritional supplement is poor and not suitable for ensuring maintenance of PLHA health. A nutrition intervention trial based on locally produced fortified mixed grain flour was favoured by PLHA and key stake holders. However, further research is needed to improve the nutritional status of PLHA in Nepal. Therefore, the evidence identified by this study could be used to inform the design of a new intervention. However, further research is recommended to clarify the issues.

AIDS is one of the most destructive diseases humankind has ever faced and also brings with it profound social, economic and public health consequences, making it one of the most serious health and development challenges in the world today. Zimbabwe, situated in southeastern Africa, is not spared from the pandemic. It continues to be one of the Sub-SaharanAfrican countries mostly heavily impacted by the AIDS epidemic, with almost 1.2 million people infected and over 1.1 million orphans. It ranks, therefore, as fifth highest in the world in the impact HIV and AIDS has had on the country. The most effective response has been to introduce programmes to reduce the number of new infections. Recent research has demonstrated treatment as a preventative measure to be very effective. This approach involves targeting those who are infected so that they are not able to transmit the disease. The decision that has to be made by an infected person, however, is whether to look for traditional treatment, conventional treatment or a combination of the two. Herbal medicine use is becoming very common in many countries, especially in the developing world, where public health safety has become a concern. It has become common to use herbal medicine concomitantly with allopathic or conventional medicine. The present study focused on investigating perceptions leading to the choice of treatment with the traditional alternative medicines (TAM) as (a)/n alternative or compliment to the conventional or allopathic option. This is a qualitative study that explores and describes participant’s perceptions, beliefs, attitudes and feelings around the use of traditional medicine, within the context of the Integrative Behaviour Model (IBM). Data was collected from 20 people living with HIV and AIDS from urban and rural settings of different ethnicities (Shona and Shangani). The data analysis was informed by The Interpretive Phenomenological Analysis with the aid of NVivo (V.10), a computer-assisted Qualitative Data Analysis Software. As predicted by the IBM, both perceived individual and environmental factors were found to be key in influencing decision-making on the use of TAM by people living with HIV and AIDS. Although there were a number of incidents in which either individual or environmental factors were perceived as independently influencing the TAM-use decision-making process, there was a lot of mutual influence between the environment and the individual. Such mutual causation was abstracted as reciprocal determinism. The IMB model assumed a unidirectional causation in which the environment could affect the individual factors. While the present study identified and demonstrated these environmental effects on the individual, it also identified and presented a reverse causation in which the individual would also affect the environment with respect to motivation for TAM use. Individual factors were psychological properties that drove the individual to use TAM. Attitude, social influence and personal agency emerged as the three dimensions of individual factors. Attitudes helped in identification of orientations that located objects of thought on dimensions of judgment about the use of TAM. Social influence explained social pressure experienced and expected regarding the use of TAM. The study demonstrated the importance of both the descriptive and injunctive norm with participants indicating that they perceived important others to be using traditional medicine and that they felt perceived expectations from others to do the same and hence the motivation to comply. Personal agency pointed to the participants’ capacities to originate and direct actions for the purposes of TAM use. All these constructs were found to be very important as perceived determinants of the behavioral intentions of people living with HIV and AIDS to use traditional medicines. In experiential attitude, generally the respondents showed more perceived positive evaluations of pleasurable experiences in their use of traditional medicines. However, there were other outcome evaluations that seemed to be ambivalent and which appeared to cause a lot of tension. The comprehension of experiential attitude was found therefore found to be trichotomous rather than dichotomous as per the IBM. The effects of the instrumental attitude were revealed in the ratings of the extent to which the use of traditional medicine was perceived as useful or rewarding, with the study revealing high ratings of usefulness. It becomes clear, therefore, that for people living with HIV and AIDS social influence, perceived attitudes and personal agency are important decision-making factors in their use of traditional and alternative medicine. Efforts towards education, integration and behaviour change programmes should design messages targeting these behavioral determinants. Understanding of these perceived determinants is crucial to influencing policy as well as the adoption of health practices through education, marketing and other modes of health promotion.

M.Cur. / The researcher's occupation as medical services manager at a packaging company regularly brings her into contact with the occupational health nurses employed at the factories. She has become aware that the occupational health nurses often become involved in ethical dilemmas with regards to the handling of HIV -positive people at the workplace in that the interests of the HIV -positive conflict with the interests of the employer. The occupational health nurse finds him/herself acting as intermediary and advocate between the two parties, namely the employer and the HIV -positive person. In spite of the provision of legal norms and ethical standards to regulate the interests of the HN -positive person in the workplace, no guidelines exist as to how these norms and standards should be operasionalised during interaction between the HIV -positive person, the occupational health nurse and the employer. The occupational health nurse is therefore uncertain how to act professionally within laid-down ethical standards with the HIV -positive person at the workplace. The purpose of this study is to describe guidelines and criteria for the operasionalisation of ethical standards for the occupational health nurse regarding the HIV -positive person in the workplace. This objective is obtained through the following aims: • Researching and describing literature with specific reference to current legal and ethical frameworks within the occupational health context regarding interaction with the HNpositive person in the workplace in order to formulate these ethical standards; • Researching and describing problems and solutions for the following target groups regarding the ethical aspects regarding the HN -positive person in the workplace: Occupational health nurses The HN -positive person in the workplace. The design of the research is qualitative, explorative and descriptive. The research was carried out by studying the occupational health nurses and HN -positive people employed by the packaging company countrywide. The occupational health nurses who were involved were obtained from a purposive test sample. The HN -positive people were chosen by making use of a quota test sample. Data obtained from the occupational health nurses was gathered by means of a workshop, and the data from the HN -positive people was obtained through personal interviews. The results of the research identified certain problems and solutions which were experienced by both target groups. These problems and solutions are divided into four sub-categories to illustrate how individual, organisational, health and family-systems are influenced. In order to assist the occupational health nurses to ethically handle the HIV -positive person in the workplace, guidelines and criteria were drawn up for the operasionalisation of the ethical standards. Additional research themes were identified through the study, the goal being to further improve the ethical handling of the HIV-positive person in the workplace, and to give better support to the HIV positive person.

Thesis (Ph. D. (Clinical Psychology)) -- Univesity of Limpopo, 2019 / The aim of the study was to determine the experience of ambiguous loss and grief reactions in adolescents affected by parental diagnosis of HIV/AIDS, and the identification of potential resilience factors that moderate the grieving symptoms. A convenient sample of 159 adolescents ninety-five (95) from families with a parental diagnosis of HIV/AIDS and a control group of sixty-four (64) adolescents whose parent(s) were diagnosed with cancer, participated in the study. The age of the participants from both families fell in the following ranges: 11-14 (n=45), 14-17 (n=65), 17-18 (n=45), 18 and above (n=2). Eighty-nine (89) were females whereas seventy (70) were males. A triangulation method of data collection was used wherein a biographical questionnaire designed by the researcher, a TRIG questionnaire to assess the level of grief in the participants and resilience scales were used in the quantitative phase. The family resilience scales included Family attachment and changeability Index 8 (FACI-8), Family Crisis Orientated Personal Evaluation Scale (F-COPES), Family Hardiness Index (FHI), and Relative and Friend Support Index (RFS). The Pearson correlation was used to identify the significance of potential resilience factors present in the affected families. Regression analysis was used to determine the predictability of variables to show moderating effect of resilience factors on the impact of experience of an ailing member of the family. Interviews were held with the adolescents in the qualitative phase using semistructured interview schedule. The questions elicited qualitative responses on the participants’ feelings towards the illness of the parents, the role they are playing and feelings towards the role, experience of feelings of loss, disclosure and the family qualities perceived to be helping them adapt to the stress of having a sick parent. The results showed that the two groups experienced ambiguous loss in the form of boundary ambiguity marked by enforced role changes following indisposed parent due to ill-health. Both groups of adolescents experienced forms of grief during the ailment of the parent(s). HIV/AIDS affected group experienced delayed grief whilst the control group of cancer affected individuals experienced acute and prolonged grief. Parental disclosure following diagnosis was higher among cancer affected families (75%) than those affected by HIV/AIDS (55%). There was, however, no significant difference between disclosure of disease status and the experience of grief, p=0.0120. Potential resilience factors in both families were F-COPES, FHI, and FACI-8. These factors were also found to have a moderating effect on the experience of grief in the HIV/AIDS affected families, but showed the opposite effect on the experience of grief in the cancer affected families. This shows the uniqueness of the study in the way the HIV/AIDs and Cancer affected families responded differently to the moderation of the resilience factors. The difference in the impact is in line with the shift in the status of HIV/AIDS from being a terminal condition to being manageable and considered chronic in contrast to cancer. The shift was seen occurring also in this study where previously high grief was associated with HIV/AIDS as its diagnosis was regarded as a death sentence. There was high stigma associated with HIV/AIDS diagnosis until recently when it was found to be controllable and also positively impacting on the life expectancy in South Africa that increased from 53 to 64 years post utilization of ARV’s.