This study involved designing an instrument to estimate self care knowledge levels of post myocardial infarction patients. The instrument subscales were diet, smoking, exercise, signs and symptoms of cardiac distress, medications, stress and high blood pressure. Twenty-six subjects were tested following hospital discharge and again two weeks later. Test-retest reliability was performed to establish stability of the instrument. The preset criterion level of.70 for the total scale was not met. The medication subscale did meet the.70 criterion level. Reliability estimates were conducted to establish internal consistency of the instrument. The preset criterion level of.70 was not met for the total scale; however, the stress subscale did meet the.70 criterion level on the retest. Concurrent validity was estimated by comparing subscale knowledge scores with self report behavior. Point biserial coefficients did not meet the preset.70 criterion levels. These results suggest that reliability and validity estimates in the post myocardial infarction patient population were not statistically significant. (Abstract shortened with permission of author.)

Health Studies / (D. Litt. et Phil. (Health Studies))

The study seeks to identify factors affecting compliance to TB treatment and determine those that make some patients complete TB treatment in Andara district, Kavango region in Namibia. The self-efficacy model by Shortridge-Baggett and Van der Bijl (1996) was the conceptual framework which guided this study. A quantitative, cross-sectional, descriptive and comparative study design was used. Data was collected using a structured questionnaire administered by a registered nurse. A total of 49 respondents were interviewed: (23 compliant and 26 non-compliant). Informed consent was obtained from each respondent prior to data collection. SPSS and MS Excel were used to analyse data and describe differences between the two groups. Respondents (N=26) gave „feeling better‟ 7 (27%), „distance‟ 8 (31%), „lack of family support‟ 4 (15%), no food 2 (8%), side effects 2 (8%), other reasons 2 (8%) and medicines not working 1 (4%), as their reasons for not completing treatment. However, long waiting times at the clinic, non availability of food and lack of knowledge of TB or treatment are the significant factors contributing to non-compliance. / Health Studies / M.A. (Public Health)

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The traumatic nature of spinal cord injury (SCI) imposes major and permanent life changes that necessitate physical, social and vocational adjustments for the individual, as well as placing strain on the family. The importance of psychological aspects of adjustment and rehabilitation has progressively become recognised as an integral part of facilitating a higher quality of life for individuals and their families living with SCI. While it has been established that psychological disturbance is not an inevitable long-term consequence of SCI, researchers have found that a proportion of this population has marked difficulty adapting psychologically to their new lifestyle and the challenges it poses. It has been found that the SCI population has an increased risk for divorce, substance abuse, self-neglect and suicide. In the mid-1990's, researchers involved in SCI rehabilitation started developing cognitivebehaviour therapy (CBT) interventions to assist individuals with their psychological adjustment to the traumatic injury. Lazarus and Folkman's (1984) cognitive theory of stress and coping has been the theoretical grounding for some of these interventions. The primary objective of this literature review is to ascertain the effectiveness of CBT in assisting individuals with their psychological adjustment to SCI and to make recommendations for future research in this area. / AFRIKAANSE OPSOMMING: Die traumatiese aard van 'n spinale koord besering (SKB) veroorsaak 'n beduidende en permanente lewensverandering, wat fisieke-, sosiale- en werksaanpassing vir die individu verg, asook spanning op die familie plaas. Die belangrikheid van sielkundige aspekte rakende aanpassing en rehabilitasie word toenemend herken as 'n integrale deel in die fasilitering van 'n hoër kwaliteit van lewe vir die individue en hulle families wat lewe met 'n SKB. Alhoewel daar gevind is dat sielkundige versteuring nie 'n noodwendige langtermyn gevolg van 'n SKB is nie, het navorsers wel gevind dat 'n gedeelte van die populasie beduidende sielkundige aanpassingsprobleme ervaar ten opsigte van hul nuwe lewenstyl en uitdagings. Daar is gevind dat die SKB populasie 'n verhoogde risiko loop vir egskeidings, substansmisbruik, self-verwaarlosing en selfmoord. In die middel van die 1990's, het SKB- en rehabilitasie-navorsers kognitiewe-gedragsterapie (KGT) intervensies ontwikkelom individue te help met sielkundige aanpassing na 'n SKB. Lazarus en Folkman's (1984) se kognitiewe teorie oor stres en streshantering, het die teoretiese grondslag gevorm vir sommige van hierdie intervensies. Die primêre doel van hierdie literatuuroorsig is om die effektiwiteit van KGT te bepaal in die ondersteuning van individue met sielkundige aanpassing na SKB, en om voorstelle te maak oor toekomstige navorsing wat met hierdie onderwerp verband hou.

Introduction: After a brain injury there are often long term consequences impacting on QoL. However, this is a complex issue influenced by many factors. As someone recovers and adjusts it is likely that the way in which they evaluate QoL will also change. The theory of response shift suggests people will change the way they evaluate QoL in the face of changes in their life. The aim of this thesis is to investigate what influences a QoL judgement; examining the possibility of response shift. Methods: Quantitative and qualitative methods were used in 4 studies. These were a cross-sectional design utilising an individualised QoL measure (SEIQoL-DW); a longitudinal study utilising a ‘then-test’ approach; a cross-sectional questionnaire study; and a qualitative study using Interpretative Phenomenological Analysis. Study 1 (Ch.3) Results: Correlations between the QoL measures confirm the validity of the SEIQoL-DW; however, correlations were generally stronger for the simpler Hadorn Scale. There was little overall change in mean QoL when current and retrospective judgements were compared. There was evidence for a change in what areas of life were considered most important to QoL following injury. Study 2 (Ch.4) Results: Improvements in reported QoL between baseline and follow-up were small. A then-test indicates that any effect of response shift is small, and non-significant in the current research. There was also little evidence for reprioritisation or re-conceptualisation. Examination of other factors associated with QoL suggest that brain-injury specific factors (BIGI, RBANS) play a role in predicting QoL. Study 3 (Ch.5) Results: QoL was reported as worse post-injury on both Hadorn’s scale and the QOLIBRI-OS; a difference that was more pronounced on the QOLIBRI-OS. Differences were also reported in the importance of different areas of functioning. Change in QoL as measured by the QOLIBRI-OS was significantly influenced by disability as measured by the GOSE, emotional and informational support, and upwards social comparison. Optimism as measured by the LOT, but not upwards social comparison was a significant predictor of change on Hadorn’s scale; GOSE and emotional and informational support remain significant predictors. The GOSE, emotional and informational support, emotional coping styles and optimism were significant predictors of current QoL on the QOLIBRI-OS; and emotional and informational support and optimism were significant predictors of QoL on Hadorn’s scale. Little evidence was found to suggest that the factors proposed in Sprangers and Schwartz’s (1999) model of response shift have predicted relationships with QoL. Two candidate variables were studied: optimism and social support. However neither showed the predicted pattern of relationships. Nonetheless the study supports previous work indicating an influence of optimism and social support on QoL, and indicates that these warrant further study. There were systematic difference between current and retrospective ratings of importance of domains. The level of importance given to the areas of life defined by the QOLIBRI-OS is higher after injury than before, with the exception of “personal and social life” for which there is no significant difference. The areas of life chosen to reflect that which is measured by the GOSE (“work”, “close relationships”, and “social and leisure activities”) are rated as less important with the exception of “close relationships”. These findings provide further support for the idea that QoL domains are re-evaluated after brain injury. Study 4: This was an in depth qualitative investigation of the experience of recovery and adjustment following TBI. Semi-structured interviews and Interpretative Phenomenological Analysis (IPA) were used. Interviews were conducted with 4 men who were 3, 7, 12, and 18 years post injury. Main Outcome and Results: Themes emerging from the analysis were ‘Change: In Self and World’; ‘Reaching a point of realisation’; ‘Support’; ‘Adjusting to change/Coping with day to day life’; and ‘Participation, Goals and Focus’. These themes cover how participants felt both they and their lives had changed as a consequence of their injury; ways they went about coping and adjusting to changes; the importance of support; and the significance of social integration and participation in feeling satisfied with life. Summary and Conclusions: These studies provide evidence for response shift in different ways. There is little evidence for recalibration but there is some indication that reprioritization or reconceptualization may take place. Changes in how important different areas of life are before and after injury suggest that participants are changing the way they view and make evaluations of QoL. Factors identified as being important to QoL judgements were disability, social support (emotional and informational support identified in the questionnaire study and support in the IPA), upwards social comparison, and optimism. The IPA study suggests that functional outcome and participation are important after TBI; while also identifying ways of coping and providing an insight into the experience of recovery from brain injury. The different QoL measures used provides both evidence for their validity, but also evidence for the different conceptualisations of QoL that are measured by different instruments. The findings have implications both for understanding the QoL of the individual and for research on QoL after TBI.

No description available.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Speech and Hearing Sciences / Master / Master of Philosophy