Eating disorders remain a phenomenon that escapes full comprehension, resulting in frustration for those who suffer from the disorders, their families, and their therapists. It is becoming increasingly necessary to describe the mechanism by which eating disorders develop, in order to effectively treat and prevent these disorders. The aim of this study was to illuminate factors that contributed to the development of eating disorders within the individual contexts of the lives of the participants, as well as how those factors interacted in context to culminate in the development of an eating disorder. This qualitative study was conducted from an interpretive perspective. The findings show how individual contextual factors interact to produce a marked fear of gaining weight, which is driven by fear of negative evaluation, and that the eating disorder behaviour serves specific functions that are related to coping with stress within the lives of the participants. / Psychology / M. Sc. (Psychology with specialisation in Research Consultation)

This study is an exploratory investigation aimed at understanding the intrapsychic themes of children affected by HIV/AIDS, using the medium of the Sceno test. The Sceno test is a play assessment technique. The aim of this research was to ascertain if the Sceno test would be a useful procedure to increase our understanding of children's intrapsychic experience of illness, impending death, and/or the death of their parents. Four children, between the ages of 7 - 11, who are affected by HIV/AIDS and are living in a children's home, were assessed three times. Two children not affected by HIV/AIDS but who had lost their parents were also included in the study. The assessment sessions were videotaped and then the action and dialogue transcribed. A hermeneutic phenomenological methodology was used within a narrative framework to interpret the 'text' of the children's play. Several important themes arose in analysis. Children were concerned with routines, particularly within the family. This is believed to be demonstration of a need for security and structure. The role of the Mother as caring and nurturing occurred often in the childrens' play. This demonstrates attachment or wish for attachment to this figure. Other important themes were those of organising the environment and having control over the context of the play, and the theme of the doctor and illness. The Sceno was found to be a valuable means of eliciting the intrapsychic themes of these children. Limitations and implications of the study are considered. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

Text in English / International studies have demonstrated that Implantable Cardioverter Defibrillators (ICDs) can have a significant impact on the Quality of Life (QOL) of patients. This is often due to factors that cause considerable psychological distress and has not been investigated in South Africa before. This research study thus investigated factors that influence QOL in patients with ICDs who are followed up in the Cardiac Clinic at Groote Schuur Hospital. The objectives were to describe demographic, clinical, ICD and patient support characteristics; to determine the prevalence of anxiety and depression; to assess QOL and to establish factors that influence depression, anxiety and QOL. The method involved a quantitative approach and a descriptive, cross-sectional and correlational design. All eligible patients with ICDs from the Cardiac Clinic were invited to participate. Participants completed a Demographic and Clinical Questionnaire, the Hospital Anxiety and Depression Scale (HADS) and the SF-36v2 Health Survey. A descriptive analysis of frequencies and summary statistics were done, followed by a regression, comparison and correlational analyses. A total of 70 patients (57 years mean, 65% male) participated in the study. The HADS mean score for anxiety was 6.50, SD 4.52 and for depression 4.96, SD 3.36. The SF-36v2 QOL Physical Component Summary (PCS) mean score was 43.83, SD 9.43 and the Mental Component Summary (MCS) was 47.81, SD 10.71. Factors associated with depression, anxiety and poor QOL included having more than 5 ICD shocks (appropriate or inappropriate). Patients who felt that the ICD influenced their lifestyle positively, was 10.46 times more like to have mental well-being. This study showed that patients with ICDs managed in the state sector, is a vulnerable population. They often live far from hospital, have a high unemployment rate and a poor income. The HADS revealed that 21.4% of the patients had depressive symptoms and 28.6% fulfilled criteria for anxiety. The SF-36v2 revealed that the QOL of patients with ICDs was significantly lower than the norm, with regard to their physical and mental well-being. The study highlights the need for psychological and social support of patients living with ICDs. Keywords: quality of life; implantable cardioverter defibrillator; sudden cardiac death; arrhythmia; anxiety; depression; HADS; SF36v2. / Psychology / M.A. (Psychology)

Este estudo qualitativo problematizou os processos de subjetivação das pessoas vivendo com HIV e Aids (PVHA) na contemporaneidade, buscando questionar as concepções naturalizadas e universais sobre o fenômeno do HIV/Aids, ressaltando suas nuances históricas e políticas. O objetivo geral foi de investigar a experiência de se viver com HIV/Aids, analisar as questões da descoberta da soropositividade, investigar a vida afetivo-sexual dessas PVHA após a descoberta do HIV e problematizar sobre o significado que atribuem à adesão e ao uso da medicação. Utilizou-se de um referencial teórico pós-estruturalista, baseado no pensamento de Michel Foucault. Seis entrevistas semiestruturadas foram realizadas com PVHA que são atendidas em um SAE (Serviço de Atendimento Especializado em DST e Aids) de Recife-PE. Os sujeitos foram selecionados através de uma amostra acidental e intencional. Problematizou-se a existência de um método em Foucault, não sendo possível falar em método a partir deste pensador, mas em metodologias. Seu objeto de estudo foi sempre o sujeito, assim, seu caminho foi problematizá-lo, considerando sua contingência histórica, tensionada pelos jogos de verdade e pela dimensão ética da relação consigo e com o outro. Trabalhou-se com o conceito de experiência, como central a esta pesquisa, tomando-o como parte dos processos de subjetivações. O estudo sobre a experiência de viver com HIV/Aids mostrou que os sujeitos da Aids vivenciam, ainda muito de perto, a perspectiva de doença e morte, apesar do tempo passado e dos avanços conseguidos. Quanto às experiências afetivo-sexuais, evidenciou-se mediada pela questão da contaminação e prevenção do HIV, sendo possível apontar como a Aids como um discurso, funcionando dentro de dispositivos de vigilância e controle da sexualidade, interferindo diretamente nessas práticas sexuais. É sob a insígnia da prevenção que uma lógica sanitarista media os engajamentos numa relação amorosa e/ou sexual, onde predominam a preocupação consigo e com o outro, através das técnicas de si e de uma ética do cuidado. Finalmente, a experiência com uso da medicação e com a adesão ao tratamento, tomados como discursos enredados com o dispositivo de controle sobre a vida. Assim, sujeitos seguem prescrições médicas que lhes guiam num cuidado com sua saúde e com a da população, onde esses discursos parecem estabelecer pilares para uma sociedade orientada pelo biopoder e por biopolíticas onde o corpo transforma-se num campo de batalhas. A Aids parece circular como um dos discursos que servem ao dispositivo da biopolítica na sua vigilância sobre a preservação da vida. / This qualitative study problematized processes of subjectivation on people living with HIV/AIDS in the contemporaneity; it aimed to question the naturalized and universalised conceptions on the phenomena of HIV/AIDS, highlighting their historical and political nuances. Therefore, general objective was to investigate the experience of living with HIV/AIDS. It was also to analyse discovery of the HIV status, to investigate the affective-sexual lives of those people post HIV and problematize the meaning given by them to adherence to the treatment and use of medication. A post-structuralism theoretical approach was used, based on Michel Foucaults thought. We conducted 6 semi-structured interviews with HIV/AIDS people attending a SAE (special care service for STDs and AIDS) in Recife-PE, where subjects were accidental and deliberately chosen. The study on experience revealed HIV/Aids people facing a perspective of illness or death, regardless all time elapsed and advances acquired. As for the affective-sexual experiences, we were able to see they were mediated by matters of contamination and how AIDS as a Discourse was used by dispositif of surveillance and control for the sexuality, directly interfering on sexual practices. It is under the insignia of prevention that a sanitation order intervene engagements on love or sexual relationships, where predominates a concern of oneself or towards the others through some Techniques of the self and Ethics of Care. Finally, the issue of medication and adherence seem to work as a dispositif controlling life where medical prescriptions guided them with their health care and the population caring; those discourses seem to set foundations for a biopolitics oriented society whereas the body is transformed into a field of battles.

Made available in DSpace on 2017-06-01T18:29:27Z (GMT). No. of bitstreams: 1 ricardo_delgado_marques_lima.pdf: 1508002 bytes, checksum: cce65ea22a2c4422bf2647297d6d1f91 (MD5) Previous issue date: 2015-05-18 / This qualitative study problematized processes of subjectivation on people living with HIV/AIDS in the contemporaneity; it aimed to question the naturalized and universalised conceptions on the phenomena of HIV/AIDS, highlighting their historical and political nuances. Therefore, general objective was to investigate the experience of living with HIV/AIDS. It was also to analyse discovery of the HIV status, to investigate the affective-sexual lives of those people post HIV and problematize the meaning given by them to adherence to the treatment and use of medication. A post-structuralism theoretical approach was used, based on Michel Foucault´s thought. We conducted 6 semi-structured interviews with HIV/AIDS people attending a SAE (special care service for STD´s and AIDS) in Recife-PE, where subjects were accidental and deliberately chosen. The study on experience revealed HIV/Aids people facing a perspective of illness or death, regardless all time elapsed and advances acquired. As for the affective-sexual experiences, we were able to see they were mediated by matters of contamination and how AIDS as a Discourse was used by dispositif of surveillance and control for the sexuality, directly interfering on sexual practices. It is under the insignia of prevention that a sanitation order intervene engagements on love or sexual relationships, where predominates a concern of oneself or towards the others through some Techniques of the self and Ethics of Care. Finally, the issue of medication and adherence seem to work as a dispositif controlling life where medical prescriptions guided them with their health care and the population caring; those discourses seem to set foundations for a biopolitics oriented society whereas the body is transformed into a field of battles. / Este estudo qualitativo problematizou os processos de subjetivação das pessoas vivendo com HIV e Aids (PVHA) na contemporaneidade, buscando questionar as concepções naturalizadas e universais sobre o fenômeno do HIV/Aids, ressaltando suas nuances históricas e políticas. O objetivo geral foi de investigar a experiência de se viver com HIV/Aids, analisar as questões da descoberta da soropositividade, investigar a vida afetivo-sexual dessas PVHA após a descoberta do HIV e problematizar sobre o significado que atribuem à adesão e ao uso da medicação. Utilizou-se de um referencial teórico pós-estruturalista, baseado no pensamento de Michel Foucault. Seis entrevistas semiestruturadas foram realizadas com PVHA que são atendidas em um SAE (Serviço de Atendimento Especializado em DST e Aids) de Recife-PE. Os sujeitos foram selecionados através de uma amostra acidental e intencional. Problematizou-se a existência de um método em Foucault, não sendo possível falar em método a partir deste pensador, mas em metodologias. Seu objeto de estudo foi sempre o sujeito, assim, seu caminho foi problematizá-lo, considerando sua contingência histórica, tensionada pelos jogos de verdade e pela dimensão ética da relação consigo e com o outro. Trabalhou-se com o conceito de experiência, como central a esta pesquisa, tomando-o como parte dos processos de subjetivações. O estudo sobre a experiência de viver com HIV/Aids mostrou que os sujeitos da Aids vivenciam, ainda muito de perto, a perspectiva de doença e morte, apesar do tempo passado e dos avanços conseguidos. Quanto às experiências afetivo-sexuais, evidenciou-se mediada pela questão da contaminação e prevenção do HIV, sendo possível apontar como a Aids como um discurso, funcionando dentro de dispositivos de vigilância e controle da sexualidade, interferindo diretamente nessas práticas sexuais. É sob a insígnia da prevenção que uma lógica sanitarista media os engajamentos numa relação amorosa e/ou sexual, onde predominam a preocupação consigo e com o outro, através das técnicas de si e de uma ética do cuidado. Finalmente, a experiência com uso da medicação e com a adesão ao tratamento, tomados como discursos enredados com o dispositivo de controle sobre a vida. Assim, sujeitos seguem prescrições médicas que lhes guiam num cuidado com sua saúde e com a da população, onde esses discursos parecem estabelecer pilares para uma sociedade orientada pelo biopoder e por biopolíticas onde o corpo transforma-se num campo de batalhas. A Aids parece circular como um dos discursos que servem ao dispositivo da biopolítica na sua vigilância sobre a preservação da vida.

This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response. Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption in well-being. For the participants in this study, learning to live with the illness was an ongoing, continually shifting process of adjustment, where the participants moved from a familiar sense of well-being to an alternative sense of well-being. In this process the participants used a variety of strengths and resources ranging from those that supported them in reconstructing identity, regaining control, and rebuilding relationships to those that assisted them in reestablishing a healthy lifestyle and restoring meaning and purpose. Striving toward well-being while acknowledging the inconceivable notion of losing one's cognitive abilities was the central strength that the participants brought to this process. It captured the paradox the participants faced in living with early-stage dementia, which was to relegate the illness to the background of their lives while managing its symptoms in the foreground.