Masters of Public Health - see Magister Public Health / With a prevalence of 14.3% among the 15-49 years age group, HIV/AIDS still constitutes a significant challenge in Zambia. In order to respond to the impact of HIV/AIDS within the workplace, government ministries have developed HIV-focused workplace policies and programmes that provide HIV/AIDS services. However, despite their availability, the number of employees accessing the services, especially those targetting HIV positive workers remains low. The fear (either perceived or real) of disclosing an HIV positive status is one likely reason for the low uptake of services. HIV-positive status disclosure is an important public health goal as it can create opportunities for an individual to access information and social and medical support, and this will affect career and workload related decisions. This exploratory, qualitative study aims to identify and describe the HIV-disclosure experiences of 12 openly HIV-positive Zambian public sector workers living in Lusaka and working in four Zambian Ministries. Both male and female public sector workers were interviewed. The participants’ experiences of disclosing their HIV positive status in the workplace were explored in depth in this study. With the aim of providing those responsible for overseeing and managing the Zambian public sector HIV workplace initiatives with some practical recommendations regarding the disclosure support needed by HIV-positive public sector workers. The study found that whilst participants had an initial fear of disclosing their HIVpositive status in the workplace, their HIV disclosure actually proved to be very beneficial. Not only did it allow their health-related needs (such as accessing medication and visiting a doctor) to be met, but their disclosure also encouraged others to also disclose their status. The recommendations are are aimed at creating a supportive working environment for people living with HIV within the Zambian public service, and offering suggestions to their managers on how best to support the process of disclosure amongst their staff.

Depuis les années 90, le Canada utilise des manuels américains traduits et adaptés pour la formation initiale en VIH/sida. Pourtant, à la lumière des écrits, nous savons qu’il existe un écart entre la formation en sciences infirmières et les compétences requises pour prodiguer des soins aux personnes vivant avec le VIH (PVVIH). Consciente de ces lacunes de la formation en VIH/sida et qui, à ce jour, n’ont pas été explorées dans le matériel pédagogique, cette étude met en relief les représentations du VIH, de la PVVIH et des soins et explore les effets de ces représentations tout en proposant des pistes de recommandations. Un devis de recherche qualitatif, de type descriptif, convenait aux objectifs de cette étude. Étant donné la nature de la problématique et des objectifs, une analyse qualitative de contenu était appropriée et privilégiée pour orienter ce projet. La collecte des données s’est déroulée en automne 2015, par l’analyse de 18 manuels scolaires de médecine-chirurgie, utilisés dans la formation initiale. En résumé, les résultats de cette étude ont mis en lumière les représentations du VIH, des PVVIH et des soins qui sont transmises par les manuels scolaires et ont permis d’exposer le type de connaissances, d’attitudes potentielles et éventuelles et de soins qu’engendrent ces sources textuelles. Par l’entremise de ce projet de recherche, il a été possible de proposer des pistes de solutions afin de pallier aux lacunes des manuels scolaires et améliorer le contenu de ces textes en accordant une attention particulière aux connaissances, attitudes et soins que ce contenu peut produire.

The purpose of this qualitative research study was to describe female adult children's experiences when they return to the parental home to live, and to develop theory to explain the processes and consequences involved in the return to the parental home. Primary data sources included 1 1/2 hour audiotaped, semi-structured interviews with 15 female adult children who had returned to the parental home to live. Other sources of data included individual and conjoint interviews with parents and daughters from a subset of four families, and field notes about the interviews. Grounded theory methodology (Strauss & Corbin, 1990, 1998) was used. Transcribed interviews were systematically analyzed to develop a theoretical model, in which the core social and psychological process was labelled "regrouping." In response to life events and personal choices, women return to the parental home to regroup--to recuperate, reenergize, contemplate and pursue lifeplans. Their intention is to enhance personal well-being and to secure a better quality life in the future. Regrouping is embedded in the life context of female adult children's specific life-events and choices, living environments, family and social relationships, and sociocultural scripts -- all conditions that can hinder or facilitate the process. Regrouping is a cyclical rather than a linear process. Female adult children who had returned to the parental home did not experience a simple, uncomplicated linear forward movement towards attaining valued personal goals. Rather, they experienced an oscillating pattern of “faltering” and "advancing" in their efforts to realize valued goals. This experience has implications for the development of a fluctuating sense of self or self-image, the fulfilment of personal goals, the quality of the experience as positive or negative, and for family relations. The contribution of the theoretical model to the literature is the discovery that returning home in adulthood may be a strategy for managing change and transition in one's life and for attaining certain lifespan development tasks (e.g., individuating from parents, establishing a career, and attaining financial security). Implications for counselling practice, and the self-help needs of adults who have returned home to live are noted. Suggestions for facilitating returning adult children's personal development (i.e., clarifying personal goals, weighing the pros and cons of returning and remaining at the parental home, maintaining self-esteem, seeking social support) and facilitating family relations . (i.e, having realistic expectations of parents, being sensitive to mothers, negotiating privacy and boundaries, managing cross-cultural dynamics) are discussed. It is suggested that future research extend the application of the theory to men, as well as more diverse ethnic groups. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Magister Scientiae (Physiotherapy) - MSc(Physio) / A spinal cord injury causes a major impact on the life of individuals who experience it. From the impact of the accident or disease causing spinal cord damage, one is left immobile, insensitive to touch and dysfunction of the urinal and anal organs, which in turn leaves bowel, bladder and sexual functions in jeopardy. These impairments and activity limitations restrict or exclude the individual from participation in everyday social interaction. There is also a perceived stigma from society, depending on the response from the surrounding physical and social environment. The aim of the current study was to explore the most valued constructs of quality of life among persons with spinal cord injury in in a Tanzania rural area. The study objectives were to deduce the participants’ own understanding of quality of life and exploration of its constructs in all domains of life namely physical, social, economic and environmental with consideration to the barriers and facilitators. A qualitative study design is employed in which a sample of 15 persons with spinal cord injury living in three selected districts of the rural Kilimanjaro region, were purposefully selected. Environmental observations and semi structured interviews were conducted in the home of each participant. Transcriptions were done verbatim before translation from Kiswahili (national language) to English by the researcher then back translated by two professional translators (Appendix M, page 145). The whole translated sample was compiled, proof read by the researcher several times; and major pre-determined themes were assembled by content analysis, parallel to a generation of sub themes to form the results part of this study. The findings of the current study showed that the most valued facilitators of Quality of life are support from family and friends, having faith in God, socioeconomic connections, income generating activities and an accessible home and environment.Barriers to quality of life were inaccessible environments, unreliable social support, and lack of empowerment, negative psychological traits such as anger, fear and worries that resulted from negative community actions, beliefs and attitudes (social environment). Such findings generate a package of intrinsic issues of concern from persons with spinal cord injury which adds to the body of knowledge pertaining to quality of life and spinal cord injury. The results from the current study indicate that persons with SCI in the selected rural area are partially satisfied with their current life due to various psychosocial, economic and environmental barriers. This dissatisfaction could be used as one of the major indications of poorly perceived quality of life. The researcher recommends that a comprehensive rehabilitation program should assess and take account of subjective needs from the client’s perspective to achieve better quality of life. Due to a known fact that the infrastructure of the rural area is complex, with a number of physical barriers, which further affects participation of persons with spinal cord injury in their communities, resolute social and political actions are necessary to rectify such environments to make it accessible for all.

Bakgrund: Varje timme får en kvinna i Sverige en bröstcancerdiagnos, det är den vanligaste förekommande cancersjukdomen hos kvinnor. Vid diagnostiserad bröstcancer finns det olika behandlingsmetoder, ofta kombineras flera metoder för att få bästa resultat. Vilken eller vilka behandlingar som ordineras är beroende av vilken typ av bröstcancer kvinnan har och i vilket stadium cancern är i då den upptäcks. Syfte: Syftet var att beskriva kvinnors upplevelse av att leva med bröstcancer. Metod: En kvalitativ litteraturöversikt med induktiv ansats har genomförts. De 21 kvalitativa studierna som låg till grund för resultatet analyserades enligt Fribergs femstegsanalys. Resultat: Vid analys av studierna framstod kategorierna “kvinnornas känslor kring bröstcancer” och “stödets betydelse för kvinnor med bröstcancer”. Slutsats: Sammanfattningsvis bidrar arbetet till en utökad förståelse och medvetenhet om kvinnor som drabbas av bröstcancer och belyser kvinnors subjektiva känslor, upplevelser och uppfattningar av att leva med bröstcancer. Det är viktigt att sjukvårdspersonal stöttar kvinnorna under bröstcancerförloppet, genom att bemöta kvinnorna med öppenhet, lyhördhet och förmedla tydlig information. / Background: Every hour a woman in Sweden gets a cancer diagnosis, which is the most common cancer diagnosis among women. When you get diagnosed with breast cancer there are different methods for treatment, and they are often combined with multiple methods for the best result. Which treatments that are used depends on what type and stage the breast cancer is in when it’s discovered. Aim: The aim was to describe women's experience of living with breast cancer. Method: A qualitative literature review with an inductive approach was done and 21 articles has been compiled in the result and analyzed according to Fribergs five step analysis. Results: When analyzing the studies, the categories “women’s feelings about breast cancer” and “the importance of support for women with breast cancer” emerged. Conclusion: The conclusion highlights an expanded understanding and awareness of women suffering from breast cancer and women's subjective feelings, experiences and perceptions of living with breast cancer. It is important that healthcare professionals support women during the breast cancer progress, by treating women with openness, responsiveness and conveying clear information.

Bakgrund: Ulcerös kolit är en kronisk sjukdom som orsakar inflammation i tjockoch ändtarm och karakteriseras av att gå i skov. Botemedel finns ännu inte och symtom är något många upplever trots medicinsk behandling. Syfte: Att belysa hur det är att leva med ulcerös kolit. Metod: Tidigare vetenskaplig forskning har samlats in via vårdvetenskapliga databaser och en induktiv ansats har använts. Artiklar granskades och tio stycken valdes ut. Innehållsanalys utfördes genom att meningsbärande enheter kodades med hjälp av kategorier. Resultat: Fyra teman bildades: Oro och rädsla på grund av ovisshet, Oförmåga att delta i fritids- och arbetsaktiviteter, Påverkan på livskvalité och livsstil samt Påfrestningar och utmaningar för barn med ulcerös kolit. Resultatet visade att både vuxna och barn kunde känna sig både psykiskt och fysiskt nedsatta och led av bland annat oro och rädsla. Konklusion: Det behövs mer kommunikation, information och stöd från vården för att minska oron bland patienter med ulcerös kolit. / Background: Ulcerative colitis is a chronic disease that causes inflammation of the colon and rectum and is characterized by relapses. There is no cure yet and symptoms are something many people experience despite medical treatment. Aim: To shed light on what it is like to live with ulcerative colitis. Method: Previous scientific research has been collected via caring science databases and an inductive approach has been used. Articles were reviewed and ten were selected. Content analysis was performed by coding meaningful units using categories. Results: Four themes were formed: Anxiety and fear due to uncertainty, Inability to participate in leisure and work activities, Impact on quality of life and lifestyle and Stress and challenges for children with ulcerative colitis. The results showed that both adults and children could feel both mentally and physically impaired and suffered from, among other things, anxiety and fear. Conclusion: More communication, information and support from healthcare is needed to reduce the anxiety among patients with ulcerative colitis.

The purpose of the study was to explore perceptions of PLWHA towards using traditional medicines (TM) together with antiretroviral therapy (ART). The study was conducted in two ART health facilities in the Manzini Region in Swaziland. Audiotaped individual interviews were conducted to collect data. The study population was PLWHA using TM and ART and were aged 18-49 years. Voice recording was used to capture data during the in-depth interviews until saturation was reached. One grand tour question was asked and follow-up probing questions were asked dependent on participant responses and study objectives. Findings of the study revealed that PLWHA are still searching for a cure, and the preexistence of TM prior to ART is influencing them to combine TM and ART. Several reasons for combining the two treatment modalities were, to boost the immune system, enhancing appetite, to treat opportunistic infections and ART side effects. There was stigma associated with long-life ART and discrimination for using TM experienced by PLWHA. It could benefit the country to repeat the similar research at National level, to include all the four regions, in both rural and urban settings. / Health Studies

Background: Mb Crohn is a chronic inflammatory bowel disease without any clear pathophysiology and varies in disease activity from case to case. The symptoms come in relapses, between the relapses the patient is asymptomatic. Aim: To examine how it is to live with Mb Crohn. Method: A general structured literature study. Ten articles were reviewed with a content analysis, categorized, created themes and was discussed. Results: Three main themes were identified: Social consequences of living with Mb Crohn, mental and physical consequences of living with Mb Crohn and information can affect management of the disease and one subtheme: Relationships with the surroundings. The result showed that lack of information created concern for the future. Many felt misunderstood by the caregivers and the society. Mb crohn effects the everyday life as it is invisible for others at the same time. Conclusion: The literature study showed that people with Mb Crohn get most of life affected and there were both positive and negative experiences. The majority had felt concern, fear and anxiety linked to the disease. Experience of being treated bad and being misunderstood was found. These experiences and emotions gave life a changed character after the disease. Further research is required with focus on how the nurses can support patients with Mb Crohn to deal with their life situation. / Bakgrund: Mb Crohn är en kronisk inflammatorisk tarmsjukdom som saknar en klar patofysiologi och varierar i sjukdomsaktivitet från fall till fall. Symtomen kommer i skov, mellan skoven är patienten symtomfri. Syfte: Att undersöka hur det är att leva med Mb Crohn. Metod: Allmän strukturerad litteraturstudie. Tio artiklar granskades med hjälp av en innehållsanalys, kategoriserades, teman skapades samt diskuterades. Resultat: Tre huvudteman identifierades: Sociala konsekvenser av att leva med Mb Crohn, psykiska och fysiska konsekvenser av att leva med Mb Crohn och information påverkar hanteringen av sjukdomen samt ett undertema: Relationer till omgivningen. Resultatet visade att avsaknaden av information kring sjukdomen gav upphov till oro inför framtiden, många kände sig missförstådda av både vården och omgivningen. Mb Crohn påverkade vardagen samtidigt som den var osynlig för andra. Konklusion: Litteraturstudien visade att personer med Mb Crohn får större delar av livet påverkade av sjukdomen, samtidigt framkom både negativa och positiva erfarenheter. Majoriteten hade upplevt oro, rädsla och ångest kopplat till sjukdomen. Erfarenheter av att bli illa behandlade eller missförstådda fanns. Dessa känslor och upplevelser gav livet en förändrad karaktär efter insjuknandet. Ytterligare forskning bör ske med fokus på hur sjuksköterskor kan stötta patienter med Mb Crohn att hantera sin livssituation.

In order to determine what mental health problems South African children living with HIV experience, interviews were conducted with HIV-positive children and their caregivers at a paediatric HIV clinic in Tshwane. The interviews with the children included assessments that focused on the children's self-esteem (Self-Description Questionnaire), experiences of anxiety (RCMAS), and the coping strategies that they employed in daily living (Kidcope). The interviews with caregivers included a questionnaire about demographic details, the Parental Stress Index (PSI), and the Coping with Children's Negative Emotions Scale (CCNES). Caregivers also completed the Child Behaviour Checklist (CBCL), which assesses a range of psychological problems in children. These results were compared to a sample of HIV-negative children and their caregivers from the same community. Although many children living with HIV-infection displayed clinical levels of somatic and depressive symptoms, these did not differ at statistically significant rates from the HIVnegative comparison group. Furthermore, children living with HIV were not found to experience clinically significant levels of anxiety as assessed by the RCMAS. Children living with HIV were found to employ more adaptive coping strategies than maladaptive coping strategies and significantly fewer maladaptive coping strategies than HIV-uninfected children use. Children living with HIV were also found to have significantly higher positive self-evaluations than HIVuninfected children. The results of the caregiver assessments indicated that caregivers of children living with HIV experience more distress in their relationship with their child and tend to engage less with negative emotional displays of their children than do caregivers of HIV-uninfected children. / Dissertation (MA)--University of Pretoria, 2016. / Psychology / MA / Unrestricted

No abstract available. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted