The purpose of this hermeneutic phenomenology study was to explore and describe the meaning employees attribute to the lived experiences of returning to work after cancer treatment. Semi-structured interviews were held with eight participants and a thematic data analysis method was used. The results indicate that cancer survivors experience various challenges that make it difficult to function as they did before the diagnosis when they return to work. A critical hermeneutical reflection against the literature followed the structural analysis and resulted in a contextual framework that incorporated the individual and organisational perspective on the various influences involved in supporting cancer survivors to maintain their wellbeing when they return to work. Four phases, repression, comprehension, activation and reintegration, were identified when they tried to cope/adjust on their return to work. The corresponding forms of organisational support they expected through these phases were labelled motivation, information, navigation and stabilisation. / Industrial and Organisational Psychology / M. Com.

Thesis (PhD (Sport Science))--Stellenbosch University, 2008. / The benefits of exercise training for patients with chronic obstructive pulmonary disease (COPD) are well-documented. In South Africa, exercise programmes for COPD patients are limited and often expensive and inaccessible to the broader community. The purpose of this study was to assess the responses of COPD patients to an exercise programme and to determine if the same results can be obtained through a less costly programme. In the primary programme of the study, 22 subjects were subjected to 12 weeks of exercise training. Each subject underwent comprehensive pre- and post-intervention assessments, which included the measurement of overall health status by a physician, level of dyspnoea, forced expiratory lung function, exercise capacity, body mass index and health-related quality of life. Exercise sessions included aerobic and strength training exercises and involved three, hour-long exercise sessions a week. In the modified programme, 18 subjects were randomly divided into an experimental and control group. Eleven subjects were included in the experimental group and seven subjects in the control group. Subjects had to complete 32, hour-long exercise sessions in a 10-week period. The experimental group’s exercise programme was adapted so that no specialised equipment was used, while the control group exercised in a well-equipped exercise- and rehabilitation centre.

Thesis (MScSportSc)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The purpose of the study was to measure the responses of chronic obstructive pulmonary disease patients to an exercise programme in a South Africa setting. Nine subjects were evaluated before and after aerobic and resistance training three times a week for the total of 12 weeks. Each evaluation measured forced expiratory lung function; health-related quality of life; functional capacity; level of dyspnea; body composition; physician global evaluation; and the patient global evaluation. The exercise programme consisted of one-hour exercise sessions, three times a week for 12 weeks. The exercise sessions included elements of aerobic and resistance training of the upper and lower extremities. Functional capacity improved drastically (p < 0.01), as did the physician and the patient global evaluations (p < 0.01 and p < 0.01, respectively). Levels of dyspnea also improved (p < 0.01). Health-related quality of life improved marginally (p = 0.03). No significant change was noted in lung function and body composition. The study concluded that an exercise programme consisting of aerobic and resistance training improves chronic obstructive pulmonary disease patients' health-related quality of life, functional capacity and levels of dyspnea. Exercise also reduces the symptoms of chronic obstructive pulmonary disease as are perceived by the physician and patient alike. Exercise does not change lung function or body composition of chronic obstructive pulmonary disease patients. Exercise in conjunction with appropriate medical treatment has the potential to benefit all chronic obstructive patients in South Africa. Keywords: COPD, quality oflife, functional capacity, rehabilitation, exercise. / AFRIKAANSE OPSOMMING: Die doel van die studie was om die reaksies te meet van pasiënte met chroniese obstruktiewe pulmonêre siekte op 'n oefenprogram in 'n Suid-Afrikaanse konteks. Nege proefpersone is voor en na aërobiese en weerstandsoefening drie keer per week vir 'n totaal van 12 weke geëvalueer. Elke evaluering het die volgende gemeet: geforseerde ekspiratoriese longfunksie, gesondheidsverwante lewenskwalitiet, funksionele kapasiteit; dispneevlak, liggaamsamestelling; geneesheer algehele evaluering asook pasiënt algehele evaluering. Die oefenprogram het uit een-uur sessies bestaan, wat drie keer per week vir 12 weke plaasgevind het. Die oefensessies het elemente van aërobiese en weerstandsoefeninge van die boonste en onderste ledemate ingesluit. Funksionele kapasiteit het drasties verbeter (p < 0.01), net so ook die geneesheer en pasiënt algehele evaluerings (p < 0.01 en p < 0.01, respektiewelik). Dispneevlakke het ook verbeter (p < 0.01). Gesondheidsverwante lewenskwaliteit het marginaal verbeter (p = 0.03). Geen beduidende veranderinge is in die longfunksie en liggaamsamestelling gevind nie. Die studie het bevind dat 'n oefenprogram wat uit aërobiese en weerstandsoefening bestaan gesondheidsverwante lewenskwaliteit, funksionele kapasiteit asook dispneevlakke van pasiënte met chroniese obstruktiewe pulmonêre siekte verbeter. Oefening verminder ook die simptome van chroniese obstruktiewe pulmonêre siekte soos waargeneem deur beide die geneesheer en pasiënt. Oefening verander ook nie longfunksie of liggaamsamestelling van pasiënte met chroniese obstruktiewe pulmonêre siekte nie. Oefening tesame met die geskikte mediese behandeling kan voordelig wees vir chronies obstruktiewe pasiënte in Suid- Afrika. Keywords: KOPS, lewenskwaliteit, funksionele kapasiteit, rehabilitasie, oefening.

Thesis (MSportSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: There are a growing number of men and women world-wide who are suffering strokes due to poor lifestyle-related habits. While there is evidence of the differences in cerebral haemodynamics between stroke patients and both elderly and young healthy individuals, limited evidence has examined the effect of rehabilitation on cerebral haemodynamics. Furthermore, most studies have examined changes in cerebral haemodynamics during cognitive and functional tasks in isolation, with no literature published on them simultaneously. The primary aim of this study was to examine whether differences in cerebral haemodynamics exist between stroke patients and healthy elderly individuals while performing a simple and complex cognitive task. Thirty two men and women (age 75 ± 8 years) volunteered to participate in the study and were split into an experimental (n = 14) group consisting of stroke patients and a control (n = 18) group consisting of healthy individuals. Each participant was required to attend one testing session where measurements of oxyhaemoglobin (O2Hb), deoxy-haemoglobin (HHb), tissue oxygenation index (TOI) and total haemoglobin index (THI) were obtained. Measurements were obtained with the participants at rest, while performing the Mini Mental State Exam (MMSE) and the modified Stroop Task as cognitive tests, and the Timed Up-and-Go (TuG) and six minute walk test (6MWT) or Toe Taps (TT) as the functional tests. Furthermore, the outcome scores of the various tests were also recorded. Change in O2Hb levels were lower in the experimental group than in the control group, especially in the left prefrontal cortex (LPFC) while HHb values were higher in the right prefrontal cortex (RPFC) (p > 0.05). There were almost no differences in TOI between the two groups in either the LPFC or RPFC, however, statistically significant differences were seen in THI in the RPFC during the MMSE (p = 0.03), rest period 2 (p = 0.03), the first modified Stroop Task (p = 0.04), as well as the TuG (p = 0.02). Furthermore, significant differences were seen between the two groups with respect to the time taken to complete the TuG, with the experimental group completing it much faster (p = 0.04). The experimental group participants who had received regular rehabilitation performed consistently better across most of the testing phases, with a number of practically significant findings. The results show that definite differences exist between stroke patients and healthy elderly individuals when performing a simple and complex task. The positive effect of low intensity exercise on task performance was clearly seen in both groups, and holds a great deal of practical significance for the development of exercise programmes for healthy individuals, as well as stroke patients. Furthermore, rehabilitation following a stroke has obvious benefits as shown by the positive results of the current study, however, limited research exists to validate these findings, highlighting the need for further research in this area. / AFRIKAANSE OPSOMMING: Daar is ʼn wêreld wye toename in die aantal mans en dames wat beroertes ondervind as gevolg van swak lewenstyl-verwante gewoontes. Alhoewel baie navorsing beskikbaar is oor die verskille in serebrale hemodinamika tussen beroerte pasiënte en bejaardes, asook jong gesonde individue, is daar ʼn beperkte aantal studies oor die effek van rehabilitasie op serebrale hemodinamika. Meeste van hierdie studies het die veranderinge in serebrale hemodinamika tydens kognitiewe of funksionele take in isolasie ondersoek, met geen literatuur waar die effek van albei gesamentlik gemeet word nie. Die hoofdoel van hierdie studie was om die verskille in serebrale hemodinamika tussen beroerte pasiënte en gesonde bejaardes, tydens die uitvoering van ʼn eenvoudige en komplekse kognitiewe taak, te ondersoek. Twee-en-dertig mans en vroue (ouderdom 75 ± 8 jaar) het aan die studie deelgeneem. Die eksperimentele groep (n = 14) het bestaan uit die beroerte pasïente en die kontrole groep (n = 18) was gesonde bejaardes. Elke deelnemer het een toets sessie bygewoon waartydens oksihemoglobien (O2Hb), deoksihemoglobien (HHb), weefsel oksigenasie indeks (TOI) en totale hemoglobien indeks (THI) gemeet is. Metings is tydens rus geneem, asook tydens die kognitiewe toetse, die “Mini Mental State Exam” (MMSE) en die gewysigde Stroop taak gemeet, en die funksionele toetse, naamlik die “Timed Up-and-Go” (TuG) en die ses minute loop toets (6MWT) of “Toe Taps” (TT). Die eksperimentele groep se O2Hb was laer as die kontrole groep, veral in die linker voor frontale korteks (LPFC), en die eksperimentele groep se HHb waardes was hoër in die regter voor frontale korteks (RPFC) (p > 0.05). Daar was geen statisties betekenisvolle verskille in TOI tussen die twee groepe nie, maar wel in die THI in die RPFC tydens die MMSE (p = 0.03), rusperiode twee (p = 0.03), die eerste gewysigde Stroop Taak (p = 0.04) en die TuG toets (p = 0.02). Die kontrole groep was statisties betekenisvol vinniger as die eksperimentele groep in die TuG toets (p = 0.04). Deelnemers in die eksperimentele groep wat gereelde rehabilitasie ontvang het, het konsekwent beter gevaar tydens die toets sessie, en ʼn aantal prakties betekenisvolle verskille is in sekere veranderlikes gevind. Die resultate dui aan dat daar wel ʼn verskil in serebrale hemodinamika bestaan tussen beroerte pasiënte en gesonde bejaardes terwyl hulle eenvoudige en komplekse take verrig. Die positiewe effek van lae intensiteit oefening op prestasie was duidelike sigbaar van beide groepe. Hierdie resultate is prakties betekenisvol as dit kom by die ontwikkeling van oefenprogramme vir gesonde individue asook beroerte pasiënte. Rehabilitasie na ʼn beroerte hou ooglopende voordele in soos aangedui deur die positiewe bevindinge van die huidige studie, hoewel daar beperkte navorsing beskikbaar is om hierdie bevindinge te staaf. Daar is dus ʼn behoefte vir verdere navorsing in hierdie gebied.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Social Work / Master / Master of Social Work

Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs&rsquo / assessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel &reg / . Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants&rsquo / suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants&rsquo / health status and ultimate quality of life.

When children have a moderate to severe traumatic brain injury (TBI), they are treated in a continuum of care that includes triage and emergency care, hospitalization, rehabilitation and outpatient therapy. Physical and cognitive recovery from brain injury may take several years. Children’s recovery varies, depending on numerous factors including pre-injury conditions and injury severity. While children and families are eager to return home to familiar activities, there are often significant physical, cognitive, behavioral and emotional changes that challenge families. Successful community reintegration depends on the ability of the family to understand and support the child, dealing with and responding effectively to those challenges. The purpose of this study is to understand how parents manage the care and community reintegration of their child who has experienced a TBI over time. This study utilized a mixed methods approach exploring the dimensions of the health challenge faced by parents caring for a child after a TBI, critical turning points as they face health challenges, and approaches for movement toward resolving health challenges. Story theory and story inquiry method were used to gather stories from 10 parents of children who experienced moderate to severe traumatic brain injury between the ages of 12 and 18, and between 2 and 5 years ago. Parents’ perceptions of their child’s quality of life and their ability to manage their child’s health challenge were explored using the Pediatric Quality of Life Inventory and Family Management Measure. Health challenges identified were: living with overwhelming personal upheaval, navigating the unknown, and struggling with how to support independence/dependence. Turning points were chronological or epiphanies. Approaches for movement toward resolving were continuously re-creating a new normal, being fully engaged in meeting the needs of one’s child, and embracing caring relationships to construct the new normal. Qualitative and quantitative data were analyzed to synthesize the findings. Results include a sense of ease in managing the health condition of the child associated with continuously creating a new normal. Healthcare providers can support and strengthen family management of children after TBI by understanding the health challenge, critical turning points and how parents move toward resolving. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Doctor of Philosophy / Persons with acquired brain injury require continuing support and care in various aspects of their lives many years post-injury. Their care and support are mainly provided by family members. While respite is one of a range of critical support systems for carers and people with life-long disability, very little is known about respite in the area of acquired brain injury. The majority of the research on respite has been undertaken in developmental disability, mental health and in aged care, but there is no research to date about respite from the perspectives of the person with a disability, the carer and respite provider. There is also no research that examines these perspectives in the acquired brain injury literature. This study was aimed to address this gap in the literature by investigating respite from the perspectives of the person with acquired brain injury, the carer and the respite provider. It also examined the profile of respite services being provided in the Australian state of New South Wales as there had not been a comprehensive mapping of respite before. Survey methodology was used to gather information from persons with acquired brain injury and their carers who were members of the New South Wales Brain Injury Association, which is the peak advocacy association of people with brain injury. The same methodology was used to gather similar information from members of Interchange Respite Care New South Wales, which is a peak association representing respite providers in the state. The survey questionnaires were developed and designed after an extensive review of the literature, and were reviewed by experts in the fields of respite, disability and acquired brain injury. The survey questionnaire was also trialled on a sample of families. The survey questionnaires for the three participant groups shared several common sections, such as demographic information; factors influencing respite use; expectations of respite; and satisfaction with respite services used by persons or carers. The responses from the three participant groups were analysed and compared using logistic regression and descriptive statistics. The key findings of the study are (a) several characteristics or factors of the person with acquired brain injury and their carer were significantly associated with the use of respite, (b) there were several common factors that all three participant groups reported to influence respite use, and (c) there were several common expectations of respite among the three participant groups. Some of the characteristics or factors that were significantly associated with respite use included the severity of disability, the high level of dependency of the person with acquired brain injury, and the number of days spent in a coma. Common factors reported by all three participant groups to influence respite use included the stress level of the carer and the severity of disability. Factors reported to influence respite use appear to be consistent with the literature in developmental disability. There were common perspectives regarding the expectations of respite among all three participant groups, such as the need for trained and qualified respite staff; a wider range of respite services and more flexibility of respite service provision. The study also indicated a reported lack of sufficient respite for persons with acquired brain injury and their carers. Some of the findings of the study appeared to be consistent with the research literature on acquired brain injury; such as the majority of carers being mainly female; there is a reliance on informal networks for the care and support of the person with acquired brain injury; and the majority of the persons with acquired brain injury being male. The study also found that many respite providers in New South Wales had extensive experience in running a respite service. The findings of the study have important implications for policy direction and development, practice and service delivery, and research. In terms of policy direction and development, implications explored included: a flexible funding model that is responsive to the needs of carer and person with acquired brain injury, and adequately trained and qualified staff and volunteers play an important role in respite provision. Further research is required to understand empirically the benefits and quality of life outcomes over a period of time, such as what types and extent of respite are more beneficial for certain demographic profiles. The study highlights the perspectives of persons with acquired brain injury, their carers and respite providers. Respite is an important support system to enable persons with acquired brain injury to receive the continuing care and support from their carers. Respite in acquired brain injury is a new field that merits further research as it holds the potential for addressing the needs of people with acquired brain injury and their carers.

Although self-efficacy has long been established as an important variable for psychological wellbeing across a range of contexts, coping self-efficacy, a subtype of self-efficacy specific to the function of coping, has only recently begun to receive research attention. In addition, despite support from both self-efficacy theory and coping theory, the relationship between coping self-efficacy and coping behaviour in the face of stressful events has not previously been considered. This thesis explores the importance of coping self-efficacy for psychological wellbeing in a new context, recovery after stroke, and investigates the relationship between coping self-efficacy and coping behaviour in the face of this stressor. Stroke was selected as a suitable context for this exploration given its high incidence, lengthy recovery period and the prevalence of significant post stroke psychological distress. The thesis explores four key questions: (i) is coping self-efficacy related to psychological wellbeing for people recovering from stroke, (ii) what types of coping behaviours are related to coping self-efficacy during recovery, (iii) does coping behaviour mediate the relationship between coping self-efficacy and psychological outcomes, and (iv) what is the role of individual dispositional traits (optimism and trait anxiety) in these relations. The implications of these relationships for clinical intervention were a secondary focus of the project.