Thesis (Ph.D.(Psychology))--University of the Witwatersrand, Faculty of Humanities, 2013. / The research entailed a comprehensive study of vicarious trauma in short-term insurance claims workers, compared to trauma counsellors and a control group of holiday booking consultants. A well-known, comprehensive model of compassion fatigue/secondary traumatic stress, developed for therapists formed the basis of the study. The research attempted to determine whether this model can be applied more widely to include administrative populations exposed to traumatised clients on a regular basis. To this end, the model was deconstructed into its eleven constituent parts and each element was investigated in addition to other variables of interest to the study. This was done to determine the importance and applicability of each model element and other selected variables to the administrative context. A mixed methods approach was utilised, which combined quantitative and qualitative data. The results yielded by the study were collectively utilised to construct an etic and an emic voice from the research. At the same time, effects from vicarious trauma were considered from an overarching bio-psychosocial stance, systematically gauging effects on various levels of functioning. Scores from quantitative measures on secondary traumatic stress, negative cognitive schemas, empathy, social support and compassion satisfaction were statistically analysed, which revealed significant differences between the worker groups. Widely accepted relationships between the study variables were tested and found to hold true within and across groups. Regression analysis determined the roles of empathy, social support and compassion satisfaction in vicarious trauma, as measured by secondary traumatic stress and negative cognitive schemas. In addition, constructivist selfdevelopment theory was employed to interpret the negative cognitive effects from vicarious traumatisation. Qualitative data were utilised to further elucidate the role and nature of vicarious trauma in each of the worker groups. The themes of exposure to client suffering, detachment, level of empathic engagement, personal trauma history and difficult life demands were unearthed from the qualitative data, which illuminated the importance and role of each of these elements to claims workers. Other areas of interest, being utilisation of sick-leave as a means to cope, work-related illness, attitudes towards professional counselling, feelings evoked by traumatised clients, and the language utilised by workers in response to client traumata were investigated. Further effects on participants as well iv as effects that reach beyond the person were identified and examined. Effects on the social and work contexts were also elucidated. Finally, interesting themes that emerged spontaneously from the data were considered. The consideration of the various model elements and other areas of interest systematically revealed that administrative workers dealing with traumatised clients are also affected by the process of vicarious trauma. Furthermore, the model was found to be largely suitable to the context of claims workers. However, the model was expanded to augment its usability within the more general administrative domain. Finally, the overarching aim was to enrich, contextualise and elaborate on the experiences of claims workers within their unique work context, to facilitate insight and a deeper understanding of vicarious trauma in more administrative populations that have largely been overlooked in research.

Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population. The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants. Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes. Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS.

Despite recognition that reductions in fossil-fuel usage are necessary to reduce environmental harm, energy consumption continues to rise globally. There is a growing need to understand how to effectively influence individuals to reduce their energy consumption, particularly of fossil-fuels. Pro-environmental behaviour is the subset of consumer behaviour that is oriented towards reducing environmental impact compared to other options. It is widely agreed that due to a multiplicity of influencers, pro-environmental behaviour is best analysed using an integrated approach that allows the inclusion of different disciplinary perspectives, and seeks to identify the most important influences in the system under study. This dissertation sought to address the broader challenge of how to better design programs and policies that result in behaviour that is more sustainable. The objective of this dissertation was to assess the importance and effects of program structure and advice-giving on the pro-environmental behaviour of participating in a home energy evaluation program that encouraged homeowners to implement energy efficiency retrofits. Program structure was defined as the combination of the price of the evaluation, the financial reward structure, the level of government support, and the focus on influencing eight specific decisions within a specified timeframe. Advice-giving occurred during the initial evaluation with a home energy advisor and with the delivery of the report that contained a set of recommendations. A convergent mixed methods research design was employed to assess the relative importance of the two factors on participation and advice-following, where advice-following was considered as the matching of decisions to recommendations. The quantitative dataset was made up of files that detailed the 13,429 initial and the 6,123 follow-up evaluations conducted by advisors of the Residential Energy Efficiency Project (REEP) in the Region of Waterloo between 1999 and 2011. The qualitative data were gathered through 12 interviews with home energy advisors, eight of whom had worked for REEP and had conducted more than half of the home energy evaluations contained in the quantitative dataset. A natural quasi-experimental intervention that measured self-selection in response to varying program structure was employed to examine for variations in participation, material characteristics of houses, recommendations, and advice-following. To extend our understanding of the process of participation and decision making patterns, other analyses focused on relationships between the number of recommendations, the time between initial and follow-up evaluations, the number and types of decisions made, and the prioritization of decisions. The interviews assessed for differences in styles of advice-giving, and for their impact through comparison with the quantitative data that detailed the recommendations and decisions taken by the homeowners. The results of the effects of both factors were interpreted jointly and compared to previous studies about REEP or the EnerGuide for Houses and program as it was delivered nationally. This dissertation confirmed that an integrated approach to examining pro-environmental behaviour is supported as a useful framework for analysis. The findings support a process-based definition of pro-environmental behaviour as a useful model and form of integration. A convergent mixed methods research design is supported as a valuable and rigorous approach to examine the impact of various influences simultaneously. The delineation of multiple stages in the decision making process greatly enhanced the quality of analyses and findings. The two main factors of program structure and advice-giving affected advice-following. One factor influenced the other, as the program structure affected the receptiveness of homeowners as perceived by advisors, which affected advice-giving. The findings support the importance of both behaviourist and social learning approaches in influencing pro-environmental behaviour, and that their importance varies depending on the stage of the decision process. The findings show that behaviourist interventions, such as the program structure, were associated with variations in participation, and that different subsets of the population of houses from the Region of Waterloo were attracted to the different program structures. Indeed, in each program structure, the decision to return was influenced by different decisions. A critical finding of this study was that these programs were not sufficient to alter the path dependence of energy consumption or of energy systems as the program participants usually did not implement the most effective retrofits, and if they did, the retrofits did not achieve adequate depth of reductions to energy consumption in a timely manner. According to the home energy advisors, many homeowners had pre-conceived ideas upon entering the program of replacing their heating systems and windows. The interpretation of the qualitative and quantitative data showed that these intentions were often not altered, particularly in the case of windows, the decision that advisors believed to be the least effective of energy decisions.

Introduction : Au sein de la population vieillissante, les chutes à domicile représentent une problématique importante (1 personne âgée/3 chute au moins 1 fois/année). Pour détecter automatiquement les chutes en respectant la vie privée, une technologie novatrice a été développée : la vidéosurveillance intelligente. Objectif : Explorer la perception et la réceptivité des personnes âgées concernant l’introduction de cette nouvelle technologie, à domicile. Méthodologie : Trente personnes âgées ont participé à une entrevue structurée (devis mixte). Une analyse de contenu (données qualitatives) et des analyses descriptives (données quantitatives) ont été effectuées puis combinées. Résultats : 93,4% des participants sont favorables (ou partiellement) à la vidéosurveillance intelligente et 43,3% l’utiliserait pour le sentiment de sécurité et la confidentialité procurés. Conclusion : Le contexte de vie des personnes âgées influence leur perception et réceptivité envers la vidéosurveillance intelligente. Il s’agit maintenant d’évaluer cette technologie dans divers milieux de vie. / Backgroung: Among the elderly, at-home falls are a significant problem (on average, 1 elder/3 falls at least 1/year). In order to automatically detect falls while maintaining privacy, an innovative technology was developed: an intelligent videomonitoring system. Objective: To explore the perception and receptivity of the elderly regarding the introduction of this new technology at home. Methodology: Using a mixed methods design, 30 elderly underwent a structured interview. A content analysis (qualitative data) and descriptive analyses (quantitative data) were executed and then combined. Findings: 93.4% of the participants were favorable (or partially) to the intelligent videomonitoring system and 43.3% would use it for the sense of security and the privacy provided. Conclusion: The living situation of the elderly influences their perception and receptivity regarding an intelligent videomonitoring system. The next step will be to evaluate this new technology in various living environments.

Despite recognition that reductions in fossil-fuel usage are necessary to reduce environmental harm, energy consumption continues to rise globally. There is a growing need to understand how to effectively influence individuals to reduce their energy consumption, particularly of fossil-fuels. Pro-environmental behaviour is the subset of consumer behaviour that is oriented towards reducing environmental impact compared to other options. It is widely agreed that due to a multiplicity of influencers, pro-environmental behaviour is best analysed using an integrated approach that allows the inclusion of different disciplinary perspectives, and seeks to identify the most important influences in the system under study. This dissertation sought to address the broader challenge of how to better design programs and policies that result in behaviour that is more sustainable. The objective of this dissertation was to assess the importance and effects of program structure and advice-giving on the pro-environmental behaviour of participating in a home energy evaluation program that encouraged homeowners to implement energy efficiency retrofits. Program structure was defined as the combination of the price of the evaluation, the financial reward structure, the level of government support, and the focus on influencing eight specific decisions within a specified timeframe. Advice-giving occurred during the initial evaluation with a home energy advisor and with the delivery of the report that contained a set of recommendations. A convergent mixed methods research design was employed to assess the relative importance of the two factors on participation and advice-following, where advice-following was considered as the matching of decisions to recommendations. The quantitative dataset was made up of files that detailed the 13,429 initial and the 6,123 follow-up evaluations conducted by advisors of the Residential Energy Efficiency Project (REEP) in the Region of Waterloo between 1999 and 2011. The qualitative data were gathered through 12 interviews with home energy advisors, eight of whom had worked for REEP and had conducted more than half of the home energy evaluations contained in the quantitative dataset. A natural quasi-experimental intervention that measured self-selection in response to varying program structure was employed to examine for variations in participation, material characteristics of houses, recommendations, and advice-following. To extend our understanding of the process of participation and decision making patterns, other analyses focused on relationships between the number of recommendations, the time between initial and follow-up evaluations, the number and types of decisions made, and the prioritization of decisions. The interviews assessed for differences in styles of advice-giving, and for their impact through comparison with the quantitative data that detailed the recommendations and decisions taken by the homeowners. The results of the effects of both factors were interpreted jointly and compared to previous studies about REEP or the EnerGuide for Houses and program as it was delivered nationally. This dissertation confirmed that an integrated approach to examining pro-environmental behaviour is supported as a useful framework for analysis. The findings support a process-based definition of pro-environmental behaviour as a useful model and form of integration. A convergent mixed methods research design is supported as a valuable and rigorous approach to examine the impact of various influences simultaneously. The delineation of multiple stages in the decision making process greatly enhanced the quality of analyses and findings. The two main factors of program structure and advice-giving affected advice-following. One factor influenced the other, as the program structure affected the receptiveness of homeowners as perceived by advisors, which affected advice-giving. The findings support the importance of both behaviourist and social learning approaches in influencing pro-environmental behaviour, and that their importance varies depending on the stage of the decision process. The findings show that behaviourist interventions, such as the program structure, were associated with variations in participation, and that different subsets of the population of houses from the Region of Waterloo were attracted to the different program structures. Indeed, in each program structure, the decision to return was influenced by different decisions. A critical finding of this study was that these programs were not sufficient to alter the path dependence of energy consumption or of energy systems as the program participants usually did not implement the most effective retrofits, and if they did, the retrofits did not achieve adequate depth of reductions to energy consumption in a timely manner. According to the home energy advisors, many homeowners had pre-conceived ideas upon entering the program of replacing their heating systems and windows. The interpretation of the qualitative and quantitative data showed that these intentions were often not altered, particularly in the case of windows, the decision that advisors believed to be the least effective of energy decisions.

The proliferation of the internet and associated online activities exposes users to numerous information security (InfoSec) threats. Such online activities attract a variety of online users who include novice computer users with no basic InfoSec awareness knowledge. Information systems that collect and use sensitive and confidential personal information of users need to provide reliable protection mechanisms to safeguard this information. Given the constant user involvement in these systems and the notion of users being the weakest link in the InfoSec chain, technical solutions alone are insufficient. The usability of online InfoSec systems can play an integral role in making sure that users use the applications effectively, thereby improving the overall security of the applications. The development of online InfoSec systems calls for addressing the InfoSec problem as a social problem, and such development must seek to find a balance between technical and social aspects. The research addressed the problem of usable security in online InfoSec applications by using an approach that enabled the consideration of both InfoSec and usability in viewing the system as a socio-technical system with technical and social sub-systems. Therefore, the research proposed a socio-technical framework that promotes the development of usable security for online information systems using online banking as a case study. Using a convergent mixed methods research (MMR) design, the research collected data from online banking users through a survey and obtained the views of online banking developers through unstructured interviews. The findings from the two research methods contributed to the selection of 12 usable security design principles proposed in the sociotechnical information security (STInfoSec) framework. The research contributed to online InfoSec systems theory by developing a validated STInfoSec framework that went through an evaluation process by seven field experts. Although intended for online banking, the framework can be applied to other similar online InfoSec applications, with minimum adaptation. The STInfoSec framework provides checklist items that allow for easy application during the development process. The checklist items can also be used to evaluate existing online banking websites to identify possible usable security problems. / Computer Science / D. Phil. (Computer Science)

Background Due to technological and medical advances, increasing numbers of pregnant and post natal women require higher levels of care, including maternity high dependency care (MHDC). Up to 5% of women in the UK will receive MHDC, although there are varying opinions as to the defining features and definition of this care. Furthermore, limited evidence suggests that the size and type of obstetric unit (OU) influences the way MHDC is provided. There is robust evidence indicating that healthcare professionals must be able to recognise when higher levels of care are required and escalate care appropriately. However, there is limited evidence examining the factors that influence a midwife to decide whether MHDC is provided or a woman’s care is escalated away from the OU to a specialist unit. Research Aims 1. To obtain a professional consensus regarding the defining features of and definition for MHDC in OUs remote from tertiary referral units. 2. To examine the factors that influence a midwife to provide MHDC or request the escalation of care (EoC) away from the OU. Methods An exploratory sequential mixed methods design was used: Delphi survey: A three-round modified Delphi survey of 193 obstetricians, anaesthetists, and midwives across seven OUs (annual birth rates 1500-4500) remote from a tertiary referral centre in Southern England. Round 1 (qualitative) involved completion of a self-report questionnaire. Rounds 2/3 (quantitative); respondents rated their level of agreement or disagreement against five point Likert items for a series of statements. First round data were analysed using qualitative description. The level of consensus for the combined percentage of strongly agree / agree statements was set at 80% for the second and third rounds Focus Groups: Focus groups with midwives across three OUs in Southern England (annual birth rates 1700, 4000 and 5000). Three scenarios in the form of video vignettes were used as triggers for the focus groups. Scenario 1; severe pre-eclampsia, physiologically unstable 2; major postpartum haemorrhage requiring invasive monitoring 3; recent admission with chest pain receiving facial oxygen and continuous ECG monitoring. Two focus groups were conducted in each of the OUs with band 6 / 7 midwives. Data were analysed using a qualitative framework approach. Findings Delphi survey: Response rates for the first, second and third rounds were 44% (n=85), 87% (n=74/85) and 90.5% (n= 67/74) respectively. Four themes were identified (conditions, vigilance, interventions, and service delivery). The respondents achieved consensus regarding the defining features of MHDC with the exceptions of post-operative care and post natal epidural anaesthesia. A definition for MHDC was agreed, although it reflected local variations in service delivery. MHDC was equated with level 2 care (ICS, 2009) although respondents from the three smallest OUs agreed it also comprised level 1 care. The smaller OUs were less likely to provide MHDC and had a more liberal policy of transferring women to intensive care. Midwives in the smaller OUs were more likely to escalate care to ICU than doctors. Focus Groups: Factors influencing midwives’ EoC decisions included local service delivery, patient specific / professional factors, and guidelines to a lesser extent. ‘Fixed’ factors the midwives had limited or no opportunity to change included the proximity of the labour ward to the ICU and the availability of specialist equipment. Midwives in the smallest OU did not have access to the facilities / equipment for MHDC provision and could not provide it. Midwives in the larger OUs provided MHDC but identified varying levels of competence and used ‘workarounds’ to facilitate care. A woman’s clinical complexity and potential for physiological deterioration were influential as to whether MHDC was assessed as appropriate. Midwifery staffing levels, skill mix and workload (variable factors) could also be influential. Differences of opinion were noted between midwives working in the same OUs and varying reliance was placed on clinical guidelines. Conclusion Whilst a consensus on the defining features of, and definition for MHDC has been obtained, the research corroborates previous evidence that local variations exist in MHDC provision. Given midwives from the larger OUs had variable opinions as to whether MHDC could be provided, there may be inequitable MHDC provision at a local level. Organisationally robust systems are required to promote safe, equitable MHDC care including MHDC education and training for midwives and precise EoC guidelines (so workarounds are minimised). The latter must take into consideration local service delivery and the ‘variable’ factors that influence midwives’ EoC decisions.

The world is dominated by digital media that have become central to many children’s lives. Children born in the last 30 years have become known as ‘digital natives’, as digital technology has always been part of their experiential field. The use of such media in play therapy could offer innovative ways of enhancing dialogue with those children in whose field they are included, as they have been to date unexplored in play therapy interventions, possibly resulting in missed therapeutic opportunities. This mixed methods research took the form of an email questionnaire sent out to play therapists in South Africa to ascertain whether digital technology is being used in therapy and, if so, which digital media are being used and how. Additionally, a focus group interview was conducted using the same questionnaire to ensure data triangulation. The data gathered were analysed qualitatively, and an understanding was gained regarding the current use of digital media in play therapy. / Social Work / M. Diac. (Play Therapy)

The purpose of the study is to explore the current policy and practice of the national and institutional QA system in public HEIs in Ethiopia in order to determine how the quality of teaching and learning might have been enhanced through the QA system. Two organisational theories – contingency and neo-institutional theory – provide a theoretical lens to explain how internal and external organisational environments affect the implementation of QA in the HEIs. The mixed-methods research approach was used in the study, including document analysis, semi-structured interviews and questionnaires. Three public universities were chosen as data source. At macro level, the HERQA was also included to examine the effect of the institutional environments on internal quality assurance practices. The findings revealed that there is little evidence of self-initiated quality enhancement activities in the public HEIs. They do not have adequate structures, systems, and written policies to assure quality. The quality assurance efforts were implemented without a clear sense of direction and purposes and therefore lacked effective coordination. The self-evaluations were symbolically took place at the higher levels of the universities and that the results of the evaluations were rarely used in a structured way in improvement of teaching-learning, faculty decision-making and planning processes. It is far from clear that whether the internal quality assurance contributed to the teaching and learning or transformed the student learning experience. It can be concluded that the HERQA’s quality assurance policy and practices seems to be de-coupled from internal initiatives to improve quality in the higher education institutions. It is recommended that HEIs should develop QA policy, mobilise resources for institutional quality improvement, establish full-fledged QA structures at all levels, and furnish the structures with necessary human resources. The HEIs should initiate and undertake effective self-assessment of their activities, own it and work towards achieving their own stated objectives. It is important that the HERQA should develop accreditation procedures, particularly at programme level, for the public HEIs. The HERQA should consider playing more active roles in communicating with HEIs regularly about QA; pay more attention to a follow-up of the audits, the punctual development and delivery of the SEDs. The HERQA should be more independent, have more autonomy and sufficient resources to become a viable professional agency informing the HE sector on the quality of its performance. / Educational Leadership and Management / D. Ed. (Education Management)

The demands on health and social care organisations require professions to work more collaboratively. During pre-registration training, health care and social work students learn within practice settings, supported by practice mentors. These settings are rich learning environments to experience interprofessional working (IPW) and for students to learn together through interprofessional practice learning (IPPL). There is, however, evidence that students' experiences of both are varied or limited. The value placed on IPW, and IPPL, is therefore of interest. This thesis will investigate practice mentors' attitudes to IPW and IPPL, and explore their perspectives of the enablers and barriers to these occurring in practice settings. A mixed-methods case study approach was used to measure the attitudes of practice mentors from health and social work, and to identify enablers and barriers to IPW, and IPPL for students. Online surveys and semi-structured face to face interviews were carried out with a range of professions within one Scottish health board and associated local authority. Results showed that attitudes to IPW, and IPPL for students were generally positive. Attitudes were not significantly affected by governing body, gender, area of work, years of experience, or prior experience of IPE. IPW was perceived to be enabled by shared processes and policies, IPPL for staff, effective communication, established teams, and shared processes and policies. Proximity to other professions and shared spaces encouraged informal communication and positive interprofessional relationships. Regular structured IPPL opportunities for students were limited. However, where opportunities did occur, this was linked to areas where practice mentors perceived that there was a strong interprofessional team identity. Although attitudes to IPW, and IPPL for students are positive, further work is needed to identify systems for improving IPW, to strengthen professions' identity as interprofessional teams, and to increase IPPL opportunities for students.