Thesis (MSD (EAP))--University of Pretoria, 2003.

Distriktssköterskan ska bedriva hälsofrämjande arbete både på individ, grupp- och samhällsnivå. Hälsosamtalet kan vara en del av distriktssköterskans arbetsuppgift för att nå fram till patienten med hälsoinformation. Syftet med vår studie är att undersöka patientens erfarenheter av hälsosamtalet. Vi har använt oss av kvalitativ metod genom att intervjua sex patienter, som deltagit i planerade hälsosamtal på vårdcentral. Intervjuerna spelades in på band och texten skrevs ut ordagrant av författarna. Data bearbetades enligt kvalitativ innehållsanalys och genom det framkom då tre kategorier. Att få stöd till livsstilsförändringar, Att bli motiverad till att ta eget ansvar för sin hälsa, Att ha behov av ytterligare stöd och fyra underkategorier. Resultatet visar, att genom hälsosamtalet får patienterna en ökad insikt om att de behöver ändra levnadsvanor för att motverka ohälsa. Distriktssköterskans kompetens och stöd gör, att motivationen till att vilja förändra livsstil underlättas för patienterna. Förändringen är lättare att genomföra om distriktssköterskan ger patienterna en möjlighet att återkomma för uppföljning. Distriktssköterskan får möjlighet att förmedla kunskaper om levnadsvanor på ett pedagogiskt sätt genom hälsosamtalet. Vidare måste distriktssköterskan vara medveten om att utgå från patientens perspektiv vid ett hälsosamtal, för att lyckas motivera till en förändring av levnadsvanor. / Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska

There are two dominant approaches to counselling for sexual risk reduction In South Africa. The TASO model which is based on client centred principles, informs much of vCT counsellors' training. More recently, the (ARRM) AIDS Risk Reduction Model which includes a cognitive behavioural component to counselling for sexual risk reduction has been introduced. A sample of vCT counsellors who have been trained using the ARRM were interviewed to develop an understanding of their experiences of using this approach. These participants provide a vCT service to clients in the midlands of the province of KwaZulu-Natal. A central finding was that although counsellors experienced the cognitive behavioural approach as having good potential for effecting sexual behaviour change, numerous barriers were identified to applying the approach within the South African context. Counsellors were also critical of the TASO model as a model for counsell ing for sexual risk reduction. Elements of the cognitive behavioural approach they experienced as useful included its potential for changing cognitions (misconceptions and myths in communities), the collaborative nature of the approach, negotiating strategies for risk reduction, use of a problem solving approach, follow-up and monitoring of behaviour. Barriers identified included contextual constraints such as poverty, gender power differentials and cultural practices. Also identified as a barrier was the dominance of the biomedical approach within the health care system. Despite identifying barriers to the application of this approach, counsellors remained optimistic that cognitive behavioural approaches could be adapted to the life context of their clients and that this could be facilitated through further training and mentoring. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

Voluntary counselling and testing, the cornerstone of HIV/AIDS prevention efforts worldwide, is at the centre of a policy debate rega rding its effectiveness. Informed by social constructionism and drawing on various tools from ethnomethodology and conversation analysis, a sample of twenty-seven vid eotaped simulated counselling interactions in South Africa was analysed. The aim was to assess how the interactional tasks of the voluntary counselling and testing sess ion were worked through by clients and counsellors, and how this was done against the publ ic health and counselling frameworks that inform voluntary counselling and testing pract ice. The goal of the analysis was not to examine practitioners’ competencies, but to exam ine their unfolding actions in the situation and to consider the interactional functio ns these actions might serve. The results show that of the three interactional ta sks of voluntary counselling and testing, information-giving lays the foundation upon which the advice and support goals are realised. It is constructed as critical to client a nd counsellor identities and is a powerful tool through which hope is dispensed. Both the info rmation-giving and support tasks of voluntary counselling and testing combine to manage client distress into more concrete and manageable terms that encourage client coping. Counsellors draw on a range of advice-giving strategies – those that place the onu s of responsibility on the client to those that view the counsellor as the moral guide able to direct client change – in order to encourage clients to reflect on their risk behaviou r. In general, voluntary counselling and testing is framed as a moral activity, and this is most evident in the advice-giving segments. The public health and counselling framewo rks that inform voluntary counselling and testing create a dilemma for counse llors. In practice, counsellors orient towards a directive and health-advising role rather than a non-directive, client-centred counselling role. The implication of this research is that voluntary counselling and testing needs to be defined and framed more clearly – i.e. as a public health intervention with preferred outcomes that draws on a set of client-centred skills. Reconceptualisations of voluntary counselling and testing need to acknowledge the mor al framework under which it operates. Clear implementation guidelines (and training) on what voluntary counselling and testing is and that define its goals more clearly will be useful in assisting counsellors to implement the policies that govern their practice. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

This master thesis reports on potentially useful applications for “The social layer concept”, consisting of a combination of telephone-based health advice-giving and dynamic marking of shared web pages, with the aim to contribute to the online health counselling domain. An experimental user study was performed to test a web marking tool prototype. The experimental tool was shown to be useful in helping clients focus on relevant health information and dynamic web marking does provide a useful and complementary service to telephone-based advice-giving. It was considered most useful for complex health advice-giving issues.

As a Rogerian mental health therapist, a personal journey was taken that establishes my practice ethics as an applied theatre practitioner. What was undertaken was the unpacking of a practice ethics gained through my training as an actor and therapist. This thesis examines the role of codes or standards of practice in humanistic counselling, applied theatre and a synthesized practice between both. Standards of practice shape these practices through the specific ideologies relevant within the institutional cultures in which the practice is applied. This is especially problematic when the institutional setting understands care delivery as practice shaped by problem identification, interventions and expected outcome goals. Further, the ideology that underpins the standard, becomes self-reinforcing and tends to exert influence over what type of practice is culturally relevant or considered best practice within the institutional setting. This is of concern for practitioners who practice from a different or multiple ideological base from the institutional setting in which they work. A shaping goal of the research was to test-out, through critical evaluation, if the American Counseling Association's (ACA's) standards of practice was relevant and applicable to a synthesized practice between humanistic counselling practice and applied theatre practice. The results posed by the critical evaluation suggest that the ACAs standard is not applicable because it promotes empirical, or rather, evidenced-based models of practice over humanist ones. Because of its limited scope of application, the ACAs model is not applicable to synthesized or dual practices that bridge particular fields. Through lines of valuing within bridged fields, usually represent multiple ideological drivers. It was found that as a standard of practice the British Association of Counsellors and Psychotherapists (BACP) standard is a better fit. It is compatible with social construction. Within the research Carl Rogers' humanistic, client-centered and non-directive therapy is contrasted with Joseph Chaikin's brand of experimental theatre exemplified in his The Presence of the Actor. Chaikin's book is used as a tool to reconstruct examples of what I came to understand as ethical practice while attending drama school in the UK. The understandings gleaned by the juxtaposition impacts how I understand the ACAs utility as a practitioner.

Background HIV infection continues to be a challenge in South Africa with new infections reported at alarming rates. Health Care Workers (HCWs) who are nurses consequently have frequent contact with HIV positive and TB co-infected patients. During this contact their counselling behaviour is influenced by their knowledge, beliefs and attitudes about HIV and AIDS, STIs and TB (HAST) and may influence provision as well as the quality of HAST counselling behaviour. Aim The aim of the study was to assess eThekwini Municipality Health Care Workers’ knowledge, beliefs and attitudes regarding counselling behaviour for HAST and to make recommendations based on the findings of this study. Methods A descriptive cross sectional study design was used in which data about HAST counselling behaviour were collected using self administered questionnaires. The study population was all the nurses working at eThekwini Municipality Health clinics that were on duty at the time of the study and excluded those nurses who were absent or on leave during the period of data collection. Informed consent was signed by each respondent. Data were captured using SPSS version 14 and univariate, bivariate and multivariate analysis was undertaken. The level of significance was P<0, 05. Results The HCWs were well informed regarding counselling behaviour for HAST. HCWs with university education scored higher than those with college level of education but there were no statistically significant differences between the HCWs with the university education and those with college education. However some HCWs’ attitudes and beliefs about poverty were negative and may not be helpful in improving a patient’s health. Results showed that some HCWs’ negative attitudes about HAST counselling resulted from fear of HIV and or TB infection. Age and the level of education showed statistically significant association with beliefs. Older, better educated HCWs with a university education scored higher for knowledge for HAST counselling behaviour. There was no statistical significant difference found between HCWs who see less than 100 patients per day and those who see more than 100 patients per day. Conclusion The findings of the study show that HCWs were well informed regarding counselling behaviour for HAST, even though some HCWs have negative attitudes which are not supportive which need to be addressed. Recommendations It is recommended that HCWs receive continuous training in order to address the negative attitudes about counselling behaviour for HAST. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2012

South Africa has one of the highest prevalence of HIV infections in the world. Sexual transmission is the primary mode of transmission across the country’s population. Misinformation about AIDS, negative attitudes to HIV testing and AIDS’ stigmatizing beliefs represent potential barriers to seeking HIV testing. Youth between 15-24 years have the greatest risk of HIV infection but only 37% of students at the University of KwaZulu-Natal (UKZN) had undertaken HIV counselling and testing (HCT) according to the HEAIDS (2008) report. Prevention of HIV and behaviour change includes knowledge about, and adequacy of, HIV counselling and testing (HCT) resources on campuses. The aim of this study was to investigate students’ perceptions about HCT at UKZN and make recommendations regarding improvements. An observational, analytical, cross-sectional study of UKZN undergraduate students on the five campuses was conducted. Participants completed anonymous self-administered questionnaires. Of 965 surveyed students, 663 (71%) had tested for HIV among whom 545 (58%) were females and 501(52%) were 20-25 years. Fear of positive results, perceived low risk of acquiring the infection and having confidence in his/her partner influenced student HIV testing behaviour (p<0.001). A significant difference was also found in positive attitudes towards HCT on campus between people who had tested (median score 20) and people who had not tested (median score 18) (p < 0.05). Since one third of students at UKZN had not tested for HIV, HCT at UKZN needs to be advertised more effectively so as to increase HIV testing by students on campuses. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

It is a common practice for therapists-in-training and experienced therapists to ensure their self-care and ethical competency requirements through seeking and maintaining therapeutic counselling when dealing with significant personal concerns (Moulden & Firestone, 2010; Everall & Paulson, 2004; Spelliscy, 2009; Pope, Sonne, & Green, 2006; Amundson, 2009; Tjetviet & Gottlib, 2010). However, therapists-in-training and experienced therapists have reported challenges and barriers that arise when making the decision to seek and maintain therapy. Some of these challenges and barriers of seeking and maintaining therapy noted in the current research literature, includes concerns of public and self stigmas, a fear of emotion, fear of treatment, confidentiality concerns, difficulties with the choice, accessibility, and acceptability of therapists’ credentials or educational programs, and the actual financial costs associated with obtaining therapy (Dearing, Maddux, & Tangney, 2005; Komiya, Good, & Sherrod, 2000; Holzman, Searight, & Hughes, 1996; Ey, Henning, & Shaw, 2000; Siebert & Siebert, 2007; Barnett & Hillard, 2011; Gilroy, Carroll, & Murra, 2002; Siebert, 2005). Similarly, current research literature regarding the challenges and barriers that Asian individuals face when deciding to seek or maintain therapeutic counselling, have also reported a list of institutional and sociocultural barriers to seeking services (Shea & Yeh, 2008; Sue & Sue, 2003; Braun, Tanji, & Heck, 2001; Park & Kim, 2008; Tsang, Tam, Chan, & Cheung, 2003; Chen & Mak, 2008; Akutse & Chu, 2006; Zane & Yeh, 2002). Acculturation is the process of adapting to behaviours, values, knowledge, and identity of the dominant society (Kim & Abreu, 2001). It has been found, that different levels of acculturation will affect an individual’s level of tolerance towards social, professional, and cultural stigmas, as well as their level of confidence in seeking therapy (Zhang & Dixon, 2003). Leong & Lau, 2001, stated that an individual’s level of acculturation has a major influence on the attitudes towards seeking therapy. It is these themes in the current research literature on the challenges and barriers to seeking and maintaining therapy that resonated with my own personal experience navigating through the mental health system for therapeutic support as a first generation Asian individual, therapist-in-training. Being an acculturated first generation Asian and therapist-in-training, through careful consideration, I use analytic autoethnography as my methodology to explore, reflect, and share my experiences and journey navigating through my self-care journey before and after my father’s death. With the use of analytic autoethnography, I bring together parallels between my personal experience with what themes are noted in current research literature on the challenges and barriers to seeking and maintaining therapy.

This research investigated an issue that has implications for early breastfeeding cessation and impaired mother-child bonding. It focused on child abuse survivors' perceptions and reactions surrounding breastfeeding and bonding, the necessity of trust before disclosing abuse, and the transition to self-efficacy. It also provided recommendations for health professionals' practice.