This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.

An overview of the existing body of knowledge on the most widely researched areas of childhood leukaemia was presented and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This conceptual shift encompassed an ecosystemic approach. This study was conducted within a holistic systemic epistemology. A qualitative approach employing a case study method to provide rich descriptions of the context in which two leukaemia sufferer's symptoms were embedded. / Psychology / M.A. (Psyhcoloy)

An overview of the existing body of knowledge on the most widely researched areas of childhood leukaemia was presented and it was argued that a conceptual shift is required to achieve a more comprehensive understanding of the problem. This conceptual shift encompassed an ecosystemic approach. This study was conducted within a holistic systemic epistemology. A qualitative approach employing a case study method to provide rich descriptions of the context in which two leukaemia sufferer's symptoms were embedded. / Psychology / M.A. (Psyhcoloy)

No description available.

Thesis (MA)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: It is well known that coronary bypass graft surgery influences the psycho-social adjustment of the patient, but little is known about the effect of bypass surgery on the family members of the patient. The primary aim of this study was to assess the effect of coronary bypass graft surgery on certain aspects of the marital relationship and family functioning of the patient. The secondary aim was to determine which coping strategies families used during the two months after the operation. An experimental pre-test and post-test research design was used. Data during the first measure was collected by means of Biographical, Enriching and Nurturing Relationship Issues, Communication and Happiness (ENRICH)- and Family Adaptability and Cohesion Evaluation Scale-II (FACES II)-questionnaires, which were completed by the patient, the spouse of the patient and the eldest child still living with the parents. ENRICH-, FACES 11-and Family Crisis Oriented Personal Evaluation Scales (F-COPES)-questionnaires were used during the second measure which was conducted two months after the operation. The results indicated that bypass surgery affected the patients' marital satisfaction and communication negatively and changed their attitudes toward the division of new roles in the marriage and family. Bypass surgery had a further negative influence on the emotional bonding of the patients and their spouses with other members of the family. The patients' adaptability regarding new challenges facing the family was also negatively affected. The patients in the experimental group who were still working also showed a greater decline than the retired patients with regards to some of the measured variables. The coping strategies most often used by the families were the seeking of spiritual support and the reframing of the problem. Correlation coefficients between changes in the marital and family variables of the patient and the coping strategies used indicated that if passive appraisal was used, the patients' marital satisfaction would decrease and if reframing of the problem was used, the patients' adaptability regarding new challenges facing the family would increase. / AFRIKAANSE OPSOMMING: Alhoewel kroonaarsiektes die psigo-sosiale aanpassing van die pasiënt beïnvloed, bestaan daar min inligting oor die invloed wat kroonaarhartomleidingchirurgie op die huweliksverhouding en gesinsfunksionering van die pasiënt het. Die doel van hierdie ondersoek is om te bepaal hoe kroonaarhartomleidingchirurgie sekere aspekte van die pasiënt se huweliks- en gesinslewe beïnvloed. Verder het die ondersoek ten doelom te bepaal watter coping-strategieë die gesin post-operatief gebruik. Daar is van 'n eksperimentele voor- en na-metingnavorsingsontwerp gebruik gemaak. Data is ingesamel met Biografiese, Enriching and Nurturing Relationship Issues, Communication and Happiness (ENRICH)- en Family Adaptability and Cohesion Evaluation Scale-II (FACES II)-vraelyste wat gedurende 'n voormetingsgeleentheid deur die pasiënt, huweliksmaat van die pasiënt en oudste kind wat nog in die huis bly, voltooi is. Die na-meting, wat bestaan het uit die voltooing van ENRICH-, FACES 11-en Family Crisis Oriented Personal Evaluation Scales (F-COPES)-vraelyste, het twee maande na die operasie plaasgevind. Die resultate toon dat kroonaarhartomleidingchirurgie die pasiënte se huwelikstevredenheid en -kommunikasie nadelige beïnvloed het en 'n veranderinge in hul houding oor die rolverdeling in die huwelik en gesin teweeg gebring het. Verder het die operasie 'n nadelige effek op die pasiënte en hul huweliksmaats se gevoel van emosionele binding met ander gesinslede gehad. Die pasiënte se vermoë om by nuwe eise en uitdagings wat aan die gesin gestel word aan te pas, is ook nadelig beïnvloed. Verder is bevind dat die werkende pasiënte 'n groter verandering as die afgetrede pasiënte ten opsigte van sekere van die gemete veranderlikes getoon het. Die coping-strategieë wat die meeste deur die gesinne gebruik is, is die soeke na geestelike ondersteuning en die herdefiniëring van die probleem. Die resultate het ook aangedui dat as passiewe waardering as coping-strategie gebruik word, die pasiënte se tevredenheid met hul huwelik sal afneem. Verder sal gesinne se vermoë om by nuwe eise en uitdagings wat aan die gesin gestel word aan te pas, toeneem indien herdefiniëring van die probleem as coping-strategie gebruik word.

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Dementia is a chronic illness characterised by the progressive deterioration of cognitive functions. Patients diagnosed with dementia are most often cared for by family members. Families caring for dementia patients are faced with tasks that are physically exhausting and psychologically distressing. Nevertheless, some families show resilience and are able to overcome the adversity of the illness. This study aimed to identify and explore the resilience factors these families utilised to rise above the hardships faced when caring for a demented family member. The study was based on McCubbin and McCubbin’s (1996) Family Resiliency Model of Family Stress, Adjustment and Adaptation and Walsh’s (2002, 2003) Family Resilience Framework. A mixed-methods approach was followed to collect data from a convenience sample drawn from the Cape Metropolitan area in the Western Cape, South Africa. The study sample comprised of families in which either a spouse (n = 44) was caring for a partner with dementia or adult children (n = 47) were caring for a parent with dementia. The family resilience factors of these subgroups were explored separately and were compared with each other. The quantitative data analysis was conducted using analyses of variance (ANOVA), Pearson’s product-moment correlation coefficients, and a best-subsets multiple regression analysis. Qualitative data were analysed using thematic content analysis. These analyses revealed that positive communication patterns, acceptance, optimism, family hardiness, family connectedness, and the effective management of symptoms facilitated family adaptation in both the spouse and child subgroups. Negative patterns of communication within the family was the only variable that was inversely related to family adaptation in both family subgroups. The level of adaptation in the different family subgroups did not differ significantly, but the subgroups did differ slightly in terms of their communication patterns, coping strategies and social support avenues utilised. In addition to expanding the current literature regarding family resilience, the body of information collected in this study could be used to help families caring for dementia patients to create a family environment that maximises adjustment and adaptation. The results could also be used in the development and evaluation of intervention programmes tailored to the needs of these family subgroups. / AFRIKAANSE OPSOMMING: Demensie is 'n chroniese siekte wat gekenmerk word deur die progressiewe agteruitgang van kognitiewe funksies. Pasiënte wat met demensie gediagnoseer word, word meestal deur familielede versorg. Gesinne wat sorg vir demensiepasiënte word gekonfronteer met take wat fisies uitputtend en sielkundig ontstellend is. Tog toon sommige families volharding en is hulle in staat is om die teëspoed van hierdie siekte te oorkom. Hierdie studie het gepoog om die veerkragtigheidsfaktore te identifiseer en verken wat deur families wat 'n familielid met demensie versorg, aangewend word om bo hulle omstandighede uit te styg. Die studie is gebaseer op McCubbin en McCubbin (1996) se Family Resiliency Model of Family Stress, Adjustment and Adaptation en Walsh (2002, 2003) se Family Resilience Framework. Beide kwalitatiewe en kwantitatiewe data-insamelingsmetodes is in hierdie studie gebruik. 'n Gerieflikheidsteekproef is uit die Kaapse Metropolitaanse gebied in die Wes-Kaap, Suid- Afrika gewerf en het bestaan uit gesinne waarvan eggenote (n = 44) vir hulle eggenoot met demensie sorg of volwasse kinders (n = 47) vir ’n ouer met demensie sorg. Die gesinsveerkragtigheidsfaktore van hierdie subgroepe is afsonderlik ondersoek en met mekaar vergelyk. Die kwantitatiewe data-analise is via variansieontleding (VARO), die berekening van Pearson se produkmoment-korrelasiekoëffisiënte, en beste-subset regressie-analises uitgevoer. Kwalitatiewe data is met behulp van tematiese inhoudanalise ontleed. Hierdie analises het getoon dat positiewe kommunikasiepatrone, aanvaarding van die situasie, optimisme, familie gehardheid, familie verbondenheid, en die doeltreffende bestuur van demensiesimptome familie aanpassing in beide die eggenoot- en kind-subgroepe gefasiliteer het. Negatiewe, opruiende kommunikasiepatrone binne die gesin was die enigste veranderlike wat in beide subgroepe 'n omgekeerde verwantskap met familie aanpassing gehad het. Die vlak van aanpassing in die verskillende familie subgroepe het nie beduidend verskil nie, maar die subgroepe het effens verskil in terme van hulle kommunikasiepatrone, streshanteringstrategieë, en bronne van sosiale ondersteuning. Die resultate van hierdie studie brei uit op die huidige literatuur oor gesinsveerkragtigheid en kan gebruik word om families wat vir demensiepasiënte sorg te help om 'n familie-omgewing te skep wat die gesin se aanpasbaarheid verbeter. Die resultate kan ook gebruik word in die ontwikkeling en evaluering van intervensieprogramme wat die behoeftes van hierdie subgroepe teiken.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work and Social Administration / Master / Master of Philosophy

This exploratory study was designed to discover the culture of living with a head injured spouse. Using the ethnographic approach, five spouses of head injured survivors were interviewed. Analysis of data yielded five domains of meaning: concerns as a result of role transition, social isolation, loss, future and coping. Two cultural themes emerged as "no one understands" and a "wish list." Implications for nursing practice include increasing awareness of health care professionals regarding perceptions and needs of spouses of head injured survivors.

This written thesis accompanies a sixteen-minute documentary video, Harbor, in which the filmmaker explores her relationship with her father who has suffered a stroke. Detailed accounts of the pre-production, production and post-production of the video allow the reader to understand the challenging and rewarding process of making an autobiographical documentary. Theoretical issues are also discussed, including the validity, criticisms, artistic nature and ethical concerns of autobiographical filmmaking. The filmmaker stresses the universality of her story, and how, despite the film's very personal nature, it is applicable for anyone who has dealt with the illness and/or disability of a parent.