HIV/AIDS is no longer seen as an individual problem as it also affects the family as a whole. The purpose of this study is to purpose of analysing the mental health of family affected by HIV/AIDS in Rwanda. It should be noted that there were not studies conducted on the mental health of the affected families in Rwanda. A qualitative approach using case study design was used to describe the mental health of affected family in Rwanda. HIV/AIDS-related stressors, emotional reactions of family members and coping strategies they adopt to deal with those stressors and emotional reactions were studied. The effects of those reactions and strategies on the infected family member as well as the entire family were analysed. A purposive sampling was used to select two families from Mwana Ukundwa Association for the study. The findings of the study showed multiple losses, care, and socio-economic demands as the main stressors for both cases. Emotional reactions to those stressors included shock, anger, sadness, hopelessness, depression, fear and shame. Participants reported using both emotional and problem-focused coping strategies. Compassion, caring and showing concern had positive effects on the infected and affected as well as family members, whereas emotional reactions such as anger, unhappiness, and discouragement had negative effects on the entire family. Positive effects of family reactions and strategies to cope were associated with coping strategies such as; having opportunity to talk: to someone, distraction, family relationships, spiritual support, treatment, and socio-economic support. Ineffective strategies included family communication dysfunction due to withdrawal behaviour, alcohol abuse and going to nightclubs. These strategies had negative effects on both infected and affected family members. The results suggest that health professionals such as nurses, doctors and other healthcare providers should use a holistic approach in caring for infected family members. They should not only provided family care, but also include the family in planning to care for the infected family member. This will empower them to play a more effective role in home care-based. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2004.

"The Relationship Between the Effect of Uncertainty and Perceived Support Role Performance in Spouses of PostMyocardial Infarction Clients."Little understanding of the relationship between the illness of a family member and family functioning is provided in recent studies.Studies have indicated that recovery from an illness crisis can be influenced by support from the family. The purpose of this study was to examine spouses of myocardial infarction patients for the relationship between perceived support role performance and the uncertainty regarding the illness of the patient. The population studied consisted of a convenience sample of 36 spouses of patients currently enrolled in Phase II of a cardiac rehabilitation program in a community hospital. Human subjects rights were protected. The hypothesis examined was that "uncertainty has a direct negative relationship to perception of support role performance. Study findings also did not indicate any relationships between the variables of age, gender, support role performance, and uncertainty. The results of the study could be used in planning support groups for spouses of myocardial infarction patients and to provide opportunities for the patient and spouse to form attitudes and acquire skills to master the changes in psychological, social, and physical status. The hospital course of individuals having experienced an acute coronary event is frequently characterized by emotional distress. Nurses can assist family members to identify emotional stresses and intervene to decrease emotional stress. Uncertainty is one factor that can play a role in the perception of illness-related events. / School of Nursing

Social support is likely to play an especially important role in coping with a cancer diagnosis as it presents a unique set of stressors to the individual. The purpose of this study was to examine biological sex differences in the perceived availability of three modes of social support (emotional, instrumental, and informational), source of support (friends vs. family), and social support seeking behavior in a population of cancer patients. The sample included 71 men and 71 women who had been diagnosed with cancer within two years of the start of the study. No significant sex differences were found in social support seeking; however, results revealed that women perceived greater availability of emotional support as well as greater support from friends on all modes of social support than did men. Implications of these findings and future directions for research are discussed. / Department of Counseling Psychology and Guidance Services

Illness that requires hospitalisation is a potential cause of anxiety for the entire family. Furthermore, increases in technology and specialisation of hospital services have resulted in increasing numbers of patients being transferred to centralised tertiary hospitals. There is limited international and national literature that explores the phenomenon of having one's spouse hospitalised in non-local tertiary centres. Therefore, this study was conducted with the aim of exploring the experiences of those whose spouses were hospitalised in non-local tertiary settings. Understanding of the experiences of 14 people affected by such hospitalisations was underpinned by a Heideggerian phenomenological perspective. Three major themes emerged from this study. Those who have their spouse hospitalised in non-local tertiary settings spend time waiting; a time best described as being-in-suspense. Despite being-in-suspense the research participants adjusted to their understanding of the situation; a period of time interpreted as fitting being out-of-town into being-in-the-world. The final theme that emerged from this study is that there were times when the research participants perceived that they were alone, unable to support or be supported by their spouses: being with and without others. Overall the findings of this research indicate that those whose spouses were hospitalised in a non-local tertiary centre lived day by day, with little or no social support, awaiting outcomes over which they had limited control. The worst potential outcome for these individuals would be that of the spouse's death in the non-local centre. When the outcomes of the non-local hospitalisation could be predicted, the events of living day by day were manageable. It also emerged from conducting this study that in living day by day, the supporting spouse dealt with the circumstances by being focussed on the temporality of the present and a vision of a positive future. However, their spouses were not always able to conceive the future in such a positive way. Nurses and other health professionals must remain cognisant of the fact that while they are familiar with the everydayness of non-local hospitalisations, [abstract incomplete].

The purpose of this study was to examine the relationship between life stressors, resources, and psychological symptomatology of 20 family caregivers of Alzheimer's patients. Stressors were categorized as stressors specific to the caregiving role and general life stressors. Resources were also categorized as resources specific to the caregiving role and general life resources. Multiple regression determined which stressors, resources, and demographic variables predicted psychological symptomatology. Specific stressors that were significant predictors included: caregiving events, caregiving event chronicity, and mean burden scores. Significant general stressors included: size of caregivers' household, non-caregiving events and non-caregiving event chronicity. Significant resources included: other caregivers, the duties other caregivers provided, and caregiver's educational level. No Other Demographic Variables were found to be significant predictors.

M.A. (Psychology) / It is generally accepted that Acquired Immunodeficiency Syndrome is the most serious pandemic ever to threaten South Africa. Within the context of South Africa being an African country, this pandemic is dramatically increasing and establishing a pattern which will not only effect the health services in the future, but will also have a devastating effect on the economy of the country. The greatest impact of the Acquired Immunodeficiency Syndrome is not only on the individual and his health condition, but also on the context within which the individual functions. Within this context, the family is affected and a reciprocal effect takes place, where the manner in which the family of the affected individual deals with his condition, may have a detrimental effect on his illness. To date limited research has been conducted to describe this condition and its impact on the family. This study was undertaken in order to deal with the problem. Two experimental groups were recruited, the reason being that these two experimental groups would largely cover the diversity of the field in which this condition occurs. The first experimental group consisted out of white homosexual males who were diagnosed as having AIDS and the second group consisted out of a group of black heterosexual males who were also diagnosed as having AIDS. Ten psychosocial variables were isolated in order to investigate the impact the Acquired Immunodeficiency Syndrome has on family interaction. These were: depression, alienation, conflict within the family, cohesion within the family, meaningful interaction within the family, social interaction within the family, moral/religious emphasis within the family, impact of the disease on physical ability, the need for sleep and rest, and total sickness impact on the individual. An analysis of the data indicated that both white homosexual male subjects and black heterosexual male subjects displayed significantly more depression, less social interaction, a greater need for sleep and rest, and a decline in physical ability. Furthermore, the analysis also indicated a very serious impact on the individual's ability to function. Of exceptional importance was the fact that white homosexual subjects displayed significantly more alienation and increased conflict within their families than the black heterosexual subjects, while the black heterosexual subjects in turn experienced less significant interaction within their families

This study utilized ethnographic methodology to describe the communicative interactional patterns in families with a member who has breast cancer. Three breast cancer patients whose families were between the adolescent and launching of children developmental lifestage (McGoldrick & Carter, 1982) were chosen for the study. Data were collected from a series of three interview sessions over a period of four weeks with a two week time lapse between each of the interview sessions. Interview sessions were conducted in the families' homes by the researcher. All interviews were video and audio tape recorded for the purpose of preserving data for transcribing and coding. Research questions examined individual perception of meaning in regard to the disease, the structure and organization of the family in relation to the illness, and the effects of family communicative interaction on the course and management of the disease. Findings indicated that family members' responses to the diagnosis of "breast cancer were influenced by multi-generational "beliefs. All three families formulated a collective belief which supported the mother's belief about the disease. Each of the three families were mother-centered, and each mother seemed to use a metacommunicative approach to mediating family transactions. Each of the three fathers were reported as having been isolated and withdrawn within the family at various times. However, each father appeared to play a protective role in deflecting tension and stress away from the mother. All three couples appeared to have constructed an egalitarian relationship with an implicit agreement as to who was more skilled to hold the power within a particular context. In all three families, the generational boundaries were clearly defined. Conflict and affect were most generally expressed in an indirect manner through wit and sarcasm. However, because each of these three families were structured to allow for personal autonomous functioning of each individual member, patients were supported in seeking a modality outside of the family system to express more ambivalent feelings.

The purpose of this study was to examine the effect of an intervention program for Alzheimer's patients on coping efficacy of their family caregivers. Using a pre-post repeated measures design, 16 family caregivers were interviewed before and after a medical, nursing, and social service intervention. Self-report measures, adjusted for caregiver satisfaction and caregiver mastery, were used to determine if there was a change in: resources, burden, and coping efficacy with caregiver specific and general life events. Results showed a marginal effect [F = 2.6, df(4,10), p<.10] for the omnibus MANCOVA. Most of this change was due to an increase in resources. Covariates of caregiver satisfaction and mastery were correlated with average burden. Results suggest that interventions such as this will be helpful for family caregivers of Alzheimer's patients.

Caring for a family member or loved one with dementia places a heavy burden on those providing the care. Caregivers often develop chronic depression because of having to deal with this burden. A great deal of literature has been published discussing coping effectiveness, effects of social support, and other internal and external means of support for the caregiver. However, little has been written about the changes, if any, in depression that the caregiver experiences after the termination of care, either through institutionalization or death of the person with dementia. This study examined whether there is a change in depression of spousal caregivers after institutionalization of the dementia care recipient as well as any changes in depression that may have occurred as a result of the death of the dementia care recipient. Two theoretical models, the wear and tear model and the adaptation model were discussed in terms of caregiver depression after institutionalization of the dementia care recipient. Two other theoretical models, the relief model and the stress model, were discussed in terms of caregiver depression after the death of the dementia care recipient. Datasets from the National Institute on Aging sponsored Health and Retirement Study were analyzed. Results indicate that both male and female spousal caregivers report an increase in depression after the institutionalization or death of the dementia care recipient, but that as time passes, males report a decrease in depression while females continue to report an increase in depression.

Individuals are living longer now than they have in the past. As a result, there is an increased incidence in illnesses that are more prevalent in later life. One group of illnesses that is more prevalent is age related dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are two common types of dementia found in the older adult population. Recent research suggests that these two types of dementia may both have a vascular component that is instrumental in their development. Not only may this vascular component be present in both these illnesses, but also it may be related to a more severe cognitive decline in the aging process. Results indicate that both cardiovascular disease and general and spousal social support in middle age are all three independent significant predictors of mild cognitive impairment and other non-normative cognitive impairment in later life. However, results do not indicate that social support moderates the relationship between cardiovascular disease and cognition.