Magister Scientiae (Occupational Therapy) - MSc(OT) / The growing phenomenon of drug abuse has alerted the attention of health professionals, addiction counsellors, school educators, the media and community members. Susceptible sub groups of the population such as adolescents have been seriously affected as addiction destroys their identities, health, daily performance, family structure and ultimately results in social disintegration. Consequently, rehabilitation facilities have been established and addicts are entering the treatment system via referrals from school principals, the judiciary court or desperate parents and family members. Despite this, after having spent a reasonable amount of time and money in rehabilitation centres, relapse rates are significantly high and addicts are returning to treatment. The question was then raised as to whether recurrent relapses were as a result of their occupational needs not being met in treatment. To understand whether the occupational needs of these recovering adolescents are met, a true client-centred approach was employed. A descriptive approach was used within a qualitative research paradigm. The participants that were selected from four drug rehabilitation facilities in the Cape Town Metropolis, included 8 recovering drug addicted adolescents, 2 rehabilitation workers employed at two different facilities, and a sum of 26 parents of recovering addicts. Purposeful sampling was used for the adolescents and rehabilitation workers while convenient sampling was used for the parents. To access the perspectives and perceptions of the participants the researcher used individual semi-structured interviews for the recovering adolescents and drug rehabilitation workers, and focus groups for the parents. The data was analysed thematically using Lincoln & Guba’s (1985) method of qualitative data analysis. All data was managed manually. The objectives of the study explored perceptions of drug addicted adolescents with regard to relapse, to describe the barriers with regard to drug rehabilitation and their occupational needs, to reveal facilitators with reference to the recovery process, and to present suitable strategies which may improve drug treatment practice. Three themes were constructed based on the findings of the study. The themes were: 1) easy to get in, difficult to get out, 2) breakdown on life caused by drug addiction, and 3) moving forward towards recovery. Since adolescence is known as a transitional period characterised by identity development, adolescents are naturally influenced by their social and physical environment, particularly their peer groups at school and in the community. Consequently, adolescents enter treatment with numerous physical, psychological, social, intrapersonal, and legal needs. The constant pursuit of drugs and its lifestyle leads to dysfunction and imbalance in the individual’s daily performances with relapse remaining a common element in the recovery process. The lack of knowledge from participants pertaining to the concept of relapse was perceived as a barrier to recovery. The physical and social environment such as the general availability and accessibility of drugs in adolescent’s community, the unfavourable influence that peers and family relationships play, organisational challenges such as staff handling principles regarding their developmental stage and ineffective communication within the rehabilitation centre, and personal barriers including manipulative and behavioural difficulties, emerged as contra-indicative to the recovery process. Many of the recovering drug addicted adolescents were unable to cope with the array of needs and triggers, and found themselves relapsing and returning to the rehabilitation facility. Among the many facilitators as perceived by the participants, the actual programme at the rehabilitation centre was significant in promoting progress. If it included education groups, where clients are taught about substance abuse, relapse and how to restructure their lifestyle of recovery, it was deemed as beneficial. Another facilitator highlighted by the participants was the involvement of family by incorporating parent support sessions, and an interesting factor suc Recommendations for the study included that adolescents who abuse substances need to be treated very differently to adults or children, and that maintaining communication or a connection with them via aftercare for example, will enable them to sustain their sobriety outside of the rehabilitation facility. Since addiction affects the individual’s identity, roles, and habits on an occupational performance level it is paramount that treatment should be addressed from an occupation-based perspective in collaboration with existing evidence-based addiction models. Occupational therapists are uniquely equipped to deal with these components. h as including spirituality as a resource was raised as valuable in their recovery process.

Magister Curationis - MCur / Clinical learning experiences form an integral part of the 2nd and 3rd year learner nurses' training, because it is in the clinical placement that nurses should acquire the knowledge, skills and values that are necessary for professional practice competency. Nurses who are working night shift routinely feel deserted and left out of the information sphere. In most cases, these nurses find themselves in situations of staff shortages, diminished resources and reduced managerial direction. This situation is leading to demotivation. Maslow’s theory in relation to the hierarchy of human needs is regarded as the basic motivators of human activity. Maslow’s theoretical framework of the hierarchy of basic human needs was employed to compare the motivational needs of 2nd and 3rd year learner nurses who were working either night or day shift at the time of data collection. The purpose of the study was to compare the motivational needs of 2nd and 3rd year learner nurses who were working day and / or night shift. The researcher followed a quantitative, descriptive and comparative survey design with a sample of the population. A sample of 2nd year (n = 103) and 3rd year learner nurses (n = 103) was drawn from each group and a 100 fully completed questionnaires were submitted by each group. The researcher gathered the data with the assistance of a self-administered questionnaire that comprised primarily of closed-ended questions and a 5-point Likert scale was employed to capture their responses. The researcher used a structured questionnaire to explore the perceptions of the 2nd and 3rd year learner nurses about their needs to acquire motivation in the workplace in the context of Maslow’s hierarchy of needs. The researcher used descriptive and inferential statistics to analyse the data. Data was plotted and expressed by means of frequency tables. Descriptive statistical analysis and associations between various variables were completed by using parametric tests. The findings of the study were related to Maslow’s hierarchy of needs; i.e. the physiological, safety, social, self-esteem and self-actualisation needs to motivate the 2nd and 3rd year learner nurses during day and night shift. The findings include significant differences between the needs of 2nd and 3rd year respondents in relation to working day and night shift at the health service institutions in the Western Cape Province. In Item 27, the perceived needs of the 2nd and 3rd year respondents to be placed in their units of preference during night shift varied between never to sometimes. The 2nd year respondents (n = 74, 74.0%) and (n = 74, 76.8%) of 3rd year respondents on night shift experienced their need to be placed in a unit of preference to be considered. From the descriptive statistics (Tables 4.15 – 4.220), it was evident that the 2nd year respondents did neither have the highest nor lowest mean values across the study; the observation for the 3rd year respondents was similar. The mean values of night shift respondents mostly scored lower than the day shift mean values. The inferential statistics indicated significant differences between 2nd and 3rd year day shift respondents and between 2nd and 3rd year night shift respondents with night shift depicting more significant differences than day shift. That confirmed that both 2nd and 3rd year learner nurses’ motivational needs of night shift respondents were more pronounced than the needs of day shift respondents. Emerging from this research, recommendations were formulated for clinical educators, nurse educators, unit managers and professional nurses in accordance with Maslow's hierarchy of needs with the purpose of meeting the motivational needs of the 2nd and 3rd year learner nurses at the health service institutions in the Western Cape Province. Validity and reliability principles were applied during the entire research process. The reliability and validity of the research instrument was determined by applying Cronbach's alpha test. The Cronbach alpha coefficients were 0.93 and 0.93 for the day and night shift respondents respectively. Those values were above 70% and close to 100%, which indicated that the questionnaire had been a reliable research instrument. All coefficients of the pilot study were above 70% which indicated that the instrument was consistent and reliable. The reliability of the questions were tested for content and face validity. The researcher observed ethical considerations during the entire research process. Ethical considerations of beneficence, avoiding undue intrusion, the right to privacy, confidentiality, fair treatment, respect for the respondents, the right to freedom and the right to withdraw from the study at any stage, informed consent and protecting respondents from any harm were adhered to. The respondents provided written consent that acknowledged those ethical principles.

This dissertation reports on an analysis conducted to establish the electronic research needs experienced by postgraduate students at higher education institutions within an increasing electronic research environment. Innovation and improvements in technology have caused research students to approach the library with a whole range of needs and expectations undreamed of in the nonelectronic library. A quantitative research instrument was mainly used to gather data, together with the results from a user survey. This study is therefore regarded as a quantitative study. From both the literature survey and research for this study it became clear that postgraduate students in South Africa and throughout the world experience similar e-research needs with regard to primary data sharing, transfer of data and computation, e-access, e-communication, e-training and e-publishing. By taking the specific needs of postgraduate students into account, the library will be able to create an electronic research environment distinguished by ease of use and access - the principal and most valued research partner in a postgraduate students’ pursuit of academic distinction and success. / Dissertation (M.Ed (Computer-integrated Education))--University of Pretoria, 2007. / Curriculum Studies / unrestricted

Employment of PWD (People with Disabilities) has been taken into serious cognizance by the Government, and various legislations have been passed to ensure that employers mainstream disability in the workplace. It is also known that in South Africa, employed PWD are still underrepresented in the employment sector. The Departments have not yet met the 2% target by the Government (OSDP:2000&Dube 2005). It is a fact that most PWD are able to work if given opportunities and reasonable accommodations by the employers. There is however, lack of sufficient scientifically determined information on the needs and barriers as experienced by employees with physical disability, resulting in the inability of employer to accommodate those needs in order to ensure maximum productivity amongst people with disabilities in the workplace. Hence, the study attempts to answer the research question of what are the barriers and needs as experienced by employees with physical disabilities in the workplace? The objectives of the study is to explore the working experiences of PWD in the workplace, further to identify the barriers and the needs as experienced by them and to make recommendations to the employer on how to eliminate these barriers, thus addressing the needs of PWD in the workplace. A qualitative research approach was followed in this study to give in-depth description of the experiences, perceptions, and needs of employees with physical disabilities in the workplace. The researcher utilized applied research method which aims at solving problems in order to assist decision-making at line levels, managerial levels and policy levels. A collective case study research design was followed to gather data directly from respondents in their natural environment for the purpose of studying interactions, attitudes and characteristics. The aim is to understand and interpret the meaning that they give in relation to their workplace. A non-probability sampling method was used to select 12 respondents who have a physical disability and are employed within the Government sector for the period of 1 year or more. The data was collected through the semi-structured interviews with an interview schedule. The interview was used to gain a detailed picture of the respondents’ experiences, beliefs, regarding the barriers and needs they are experiencing in the workplace. The research results revealed job dissatisfaction and emotional experiences of hopelessness, anger and frustration by the PWD within the workplace. The results of such experiences are attributed to physical and social barriers identified, as well as lack of management support and lack of implementation of existing legislations and policies on managing disability in the workplace. Physical barriers are associated with the physical infrastructure and the working environment, whilst social barriers are associated with the attitude of the employers, supervisors and co-workers towards the PWD (Chima 2002&Barlow 2003). The needs that were identified were the need for recognition, need for reasonable accommodation, the need for advocacy and empowerment. In essence PWD need to be treated like any other employee within the workplace. They need to be included especially on issues concerning them and their work. Employers need to start making efforts to address the barriers affecting PWD and try to also meet their needs in the workplace. This can be done in consultation with the PWD to create and ensure a conducive working environment. / Dissertation (MSD (Employee Assistance Programme))--University of Pretoria, 2008. / Social Work and Criminology / unrestricted

Please read the abstract (Summary) in the section 00front of this document / Thesis (D Phil (Information Science))--University of Pretoria, 2007. / Information Science / unrestricted

The study was mainly to investigate the need for an Employee Assistance Programme at Reamogetswe Secure Care Centre, North West Province. EAP is a worksite programme aimed at assisting troubled employees to improve their work productivity and enhance their social functioning. The investigation was comprised of a literature study about EAP in order to gain an understanding of it. A questionnaire was designed and handed out to employees of the Secure Care Centre to complete. Empirical findings were gathered based on the information from the questionnaires, which were completed and returned by the respondents. The findings in the study suggested that there is a need for implementing an EAP at the Centre to assist with problems affecting employees. The findings suggested that 93.8% of the respondents agree that the Centre should take responsibility for employee’s welfare. The majority of the respondents further indicated that they prefer to have an EAP practitioner always at the Centre. The study also revealed that if employees experience problems be it personal or work related or a combination of both, they need to assist to enhance their social functioning. / Dissertation (MSD (EAP))--University of Pretoria, 2006. / Social Work and Criminology / unrestricted

Objective: Evaluation of surgical quality ensures consistency of care and facilitates improvements in the quality of care delivered. Methods: An overview of surgical quality measurement is presented. A system for monitoring thoracic morbidity and mortality (TM&M) at the Ottawa Hospital is introduced and evaluated. Results of a needs assessment survey on the involvement in thoracic surgical research and quality improvement initiatives are presented. Results: Structure, process, and outcomes reflect different viewpoints on how to evaluate surgical quality. The feasibility of the TM&M system is evaluated using descriptive and univariate statistics, while its inter-rater reliability is assessed amongst the Canadian Association of Thoracic Surgeons. Conclusions: Outcomes have been fundamental in the evaluation of surgical quality. TM&M classification system advocates for a practice of continuous quality improvement and provides standardized and reliable feedback on surgical outcomes. Results of the needs assessment have built a strong foundation of knowledge on prospective ways to enhance the monitoring of surgical quality.

The importance of psychological needs for optimal mental and physical well-being has been well documented within the literature. However, there remains little consensus on the definition of basic psychological needs, on which needs are most important or fundamental, and on how to best assess basic needs in individuals. The purpose of this dissertation was to develop and validate a comprehensive measure of fundamental psychological needs and to examine its predictive utility for both mental and physical health. To fulfil these objectives, measure construction and validation studies were conducted in 2 separate undergraduate student samples (N = 226; N = 283). Participants completed online self-report measures of emotional and psychological symptoms, negative life events, personality characteristics, and psychological needs. Factor Analyses of the Psychological Needs Questionnaire (PNQ) revealed that needs can be classified in a three-level multi-factorial confirmatory model and that self-worth and relationship types of psychological needs can be further divided into several, second-level factors. Results also indicated that the PNQ is reliable and possesses good construct validity as well as predictive utility for numerous psychological and physical problems. In addition, psychological needs moderated the relationship between depressive personality characteristics and mood. Future studies should examine the proposed needs-based model in a longitudinal fashion, both in community and clinical samples. In addition to functioning as a global introduction and providing an overview of the relevant literature, Chapter 1 proposes a new model of psychological needs. Chapter 2 describes in further detail the importance of each need identified by the new model, with a particular emphasis on the consequences associated with having each need unfulfilled. Chapter 3, 4, and 5 represent three academic journal articles resulting from the data collected in the current project. Finally, chapter 6 provides a global discussion of the entire dissertation.

Care ethics is primarily about responding to needs. Yet, surprisingly, attempts to apply the ethics of care in the domain of law have paid almost no attention to the concept of legal needs. This study fills that gap by systematically defining legal needs. It does this by revising current understandings of legal need through a unified conceptual framework for the philosophy of needs and a comparative analysis of legal action, and its major alternatives in dispute resolution and prevention. The conception of legal need that results is both more sensitive to preventative functions of the law and opens the door to a much wider range of policy options beyond legal aid. Legal needs are found to be a special case of institutional needs, i.e. needs that cannot be satisfied without an institution. I argue that the existence of institutional needs means institutions, rather than any particular actor within them, can be caregivers, but not all conceptions of the ethics of care are compatible with this kind of need. Joan Tronto’s conception of care is found to be the most accommodating and is used as a framework for a series of policy recommendations to move us towards a caring legal system.

This thesis is comprised of three chapters that empirically examine two important areas in health economics: access to health care and health outcomes. The first chapter explores the impact of health care utilization on unmet health care needs (UHC) using four biennial confidential master files (2001-2010) of the Canadian Community Health Survey and applying an instrumental variables (IV) approach to deal with the endogeneity of health care utilization. The presence of drug insurance and the number of physicians in each health region are used to identify the causal effect. I find a clear and robustly negative relationship between health care use and unmet health care needs; individuals who are more likely to report unmet health care needs are those who use the health care system less frequently. One more visit to a family doctor, specialist or a medical doctor on average, decreases the probability of having unmet health care needs by 7.1, 4.6 and 2.8 percentage points, respectively. Further analysis by sub groups reveals that the impact of health care utilization on UHC is larger for females in comparison to males, rural residents in comparison to urban dwellers and those with low household income rather than high. The second chapter of this thesis examines whether the presence of the unmet health-care (UHC) needs has an adverse effect on health outcomes using the National Population Health Survey, a nationally representative longitudinal data set spanning 18 years. I pay close attention to the potential endogeneity of this problem. Five direct and indirect measures of health-related outcomes are examined. I find clear and robust evidence that the presence of UHC either two-years previously or anytime in the past, affects negatively the current health of the individual – controlling for a host of other influences. For instance, reporting UHC in the previous cycle reduces the probability of being in excellent or very good health and in good mental health, respectively by 8.1 and 1.2 percentage points; it reduces the HUI3 score by 2.9 percentage points and increases the expected number of medications used by 11%. Further analysis by looking at the effect of UHC when it was due to accessibility reasons, reveal that the effect of UHC because of accessibility reasons on health outcomes is larger than the one of the overall UHC, but the difference is small in general. Finally, the third chapter of this thesis examines the link between social networks and access to health care utilization, focusing particularly on the probability of having a regular family doctor. Unlike previous work that uses cross sectional data, I use panel data from the National Population Health survey to control for unobserved heterogeneity. Access to a regular family doctor is modeled using the dynamic random effects probit model, which makes it possible to explore the dynamics of access to a regular family doctor– for instance, the role played by past access status to a family doctor in predicting current access. In particular, I use the dynamic random effects probit model that controls for both unobserved heterogeneity and for initial conditions effects. I find robust evidence of a highly statistically significant relationship between social capital and the probability of having a regular family doctor. Although the marginal effects are modest, the results from all model specifications show that there is clear evidence that individuals with high levels of tangible, affection, emotional, social interaction, who live with spouse only or with spouse and children are more likely to have a regular family doctor, whereas those living alone are less likely to have a regular family doctor. The results also reveal that past access to a family doctor is an important determinant for both current and future access. The predicted probability of having a regular family doctor is about 18 percentage points (or 20%) higher for individuals who had a family doctor in the previous period, relative to those who did not. In addition, I find that unobserved heterogeneity accounts for about 25% of the variation in accessing a regular family doctor and is significantly correlated with the access to a family doctor over my long panel.