In this study, hypnotic analgesia in obstetrics is explained in terms of ecosystemic thinking, as opposed to traditional conceptualisations of hypnosis. Five case studies were used. Each case is described in detail, as well as the therapeutic rationale behind each case, in order to present the reader with an understanding for the thinking behind the doing of ecosystemic hypnotherapy. The study utilises a new paradigm approach to research which is explained and is in keeping with ecosystemic epistemology. / Psychology / M.A. (Clinical Psychology)

The aim of this study was to explore the psychological effects of termination of pregnancy by choice amongst adolescents within the ages of 18 to 21 years. Exploratory, contextual, qualitative design was used to determine the psychological effects of termination of pregnancy by choice amongst adolescents. Purposive sampling method as well as snowballing were used to select participants for the study. Data collection was done through in-depth, one-on-one, face-to-face interviews, using a semi-structured interview guide. The study highlighted that adolescents who seek abortion are unmarried and mostly still studying. The results revealed that adolescents experience mental ill health after termination of pregnancy due to feelings of guilt. All participants stated that abortion is murder of a life person and that it is a bad thing to do. The study revealed that counselling that is done before TOP focuses on the procedure of TOP. There is need for a holistic approach to counselling. As a guide, policy makers need to specify the mandatory counselling in the Choice on Termination of Pregnancy Act (Act No 92 of 1996). / Health Studies / M.A. (Nursing Science)

The study described and analysed the self-reported stress burden resulting from occupational exposure to maternal death among professional midwives working in rural health care units, and the effect of the identified stress burden on their physical and psychological well-being in order to recommend coping mechanisms and support for these midwives. Quantitative research using an exploratory, descriptive, and correlation design was used to collect data from midwives working in two rural districts, Mubende and Mityana in Uganda. Data was collected using a self-administered questionnaire which comprised of three standardised scales, and permission was granted by the developers of the scales. The study population comprised of 238 midwives and a response rate of 95.2% was obtained. Simple random sampling was used to select the study sites and the whole target population was studied. Data was analysed using the SPSS version 20. The findings revealed that occupational exposure to maternal death experienced by midwives working in rural districts of Uganda, may result into significant stress burden in the form of moderate to high death anxiety, mild to moderate death obsession and mild death depression. The respondents also experience physical un-wellness because of experiencing maternal death at the workplace, however, their psychological well-being was sustained. Although the midwives were using effective problem focused coping strategies to reduce their stress burden resulting from occupational exposure to maternal death, the study uncovered a number of factors that were non-modifiable that could be preventing this. However, midwifery educators, employers and managers should address the modifiable factors such as: midwives' education, involvement in other health care activities, lack of functional communication and ambulance services, support given at the work place after experiencing a maternal death, and professional training on how to handle death situations which exaggerate the stress burden resulting from occupational exposure to maternal death. Based on the key findings, proposed interventions, responsible persons and recommendations for practice to promote the coping mechanism and well-being of rural midwives in view of occupational exposure to maternal death were suggested. / Health Studies / D. Litt. et Phil. (Health Studies)

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

Using the stress process model, the relationship between pregnancy and depressive symptoms among adolescent girls was investigated. This model posits that stress resulting from social location and related disruptive life events may indirectly affect health by eroding coping, mastery, or social support mechanisms. The effect of low income, minority status and pregnancy on coping processes in adolescent girls was hypothesized and tested. Communication with parents, involvement in activities, and success in school were examined as positive coping strategies. Smoking tobacco, heavy alcohol use, and drug use were examined as negative coping. Data from the National Survey on Drug Use and Health were analyzed. After combining the available cases from the 2006, 2007, and 2008 datasets, selecting girls aged from 12 to 17 years, and removing missing cases; the sample consisted of a total of 22,854 adolescents. A series of binary logistic regression models were estimated. Findings included that coping strategies partially mediate the relationship between pregnancy and depressive symptoms. In particular, success in school, smoking tobacco, and drug abuse played a mediating role. When coping was accounted for, the relationship between pregnancy and depressive symptoms was reduced and became only marginally significant. Implications of the study include a focus on policy that promotes early intervention assisting at-risk adolescents with the development of coping strategies that may help them adjust to unexpected life events, such as pregnancy.

The study described and analysed the self-reported stress burden resulting from occupational exposure to maternal death among professional midwives working in rural health care units, and the effect of the identified stress burden on their physical and psychological well-being in order to recommend coping mechanisms and support for these midwives. Quantitative research using an exploratory, descriptive, and correlation design was used to collect data from midwives working in two rural districts, Mubende and Mityana in Uganda. Data was collected using a self-administered questionnaire which comprised of three standardised scales, and permission was granted by the developers of the scales. The study population comprised of 238 midwives and a response rate of 95.2% was obtained. Simple random sampling was used to select the study sites and the whole target population was studied. Data was analysed using the SPSS version 20. The findings revealed that occupational exposure to maternal death experienced by midwives working in rural districts of Uganda, may result into significant stress burden in the form of moderate to high death anxiety, mild to moderate death obsession and mild death depression. The respondents also experience physical un-wellness because of experiencing maternal death at the workplace, however, their psychological well-being was sustained. Although the midwives were using effective problem focused coping strategies to reduce their stress burden resulting from occupational exposure to maternal death, the study uncovered a number of factors that were non-modifiable that could be preventing this. However, midwifery educators, employers and managers should address the modifiable factors such as: midwives' education, involvement in other health care activities, lack of functional communication and ambulance services, support given at the work place after experiencing a maternal death, and professional training on how to handle death situations which exaggerate the stress burden resulting from occupational exposure to maternal death. Based on the key findings, proposed interventions, responsible persons and recommendations for practice to promote the coping mechanism and well-being of rural midwives in view of occupational exposure to maternal death were suggested. / Health Studies / D. Litt. et Phil. (Health Studies)

In this study, hypnotic analgesia in obstetrics is explained in terms of ecosystemic thinking, as opposed to traditional conceptualisations of hypnosis. Five case studies were used. Each case is described in detail, as well as the therapeutic rationale behind each case, in order to present the reader with an understanding for the thinking behind the doing of ecosystemic hypnotherapy. The study utilises a new paradigm approach to research which is explained and is in keeping with ecosystemic epistemology. / Psychology / M.A. (Clinical Psychology)

The aim of this study was to explore the psychological effects of termination of pregnancy by choice amongst adolescents within the ages of 18 to 21 years. Exploratory, contextual, qualitative design was used to determine the psychological effects of termination of pregnancy by choice amongst adolescents. Purposive sampling method as well as snowballing were used to select participants for the study. Data collection was done through in-depth, one-on-one, face-to-face interviews, using a semi-structured interview guide. The study highlighted that adolescents who seek abortion are unmarried and mostly still studying. The results revealed that adolescents experience mental ill health after termination of pregnancy due to feelings of guilt. All participants stated that abortion is murder of a life person and that it is a bad thing to do. The study revealed that counselling that is done before TOP focuses on the procedure of TOP. There is need for a holistic approach to counselling. As a guide, policy makers need to specify the mandatory counselling in the Choice on Termination of Pregnancy Act (Act No 92 of 1996). / Health Studies / M.A. (Nursing Science)

A família é o primeiro grupo social do indivíduo. Grupo esse que é de grande importância, uma vez que todas as relações sociais futuras o terão como base. A adolescente que se torna mãe vive duas transformações: uma a da própria fase, que lhe possibilita novas conquistas e uma maior independência de sua família de origem; outra, a condição da maternidade que aponta para a formação de um novo núcleo familiar, acarretando responsabilidades para as quais ainda não está devidamente preparada. Este estudo teve por objetivo compreender como a adolescente de baixa renda na condição de mãe recente, representa a família. A nossa pesquisa foi de natureza qualitativa. Participaram doze adolescentes que haviam dado à luz a seus filhos há menos de um ano. Utilizamos dois instrumentos para coleta do material: o primeiro consistiu na aplicação do Teste do Desenho da Família com Estórias (DF-E); e o segundo, a aplicação de uma entrevista semi-estruturada com uma questão disparadora: O que é para você, família?. Com a aplicação do teste e da entrevista foi possível identificar quatro núcleos temáticos: representação de família; configuração de família; o lugar do pai da criança na vida da adolescente e projetos para o futuro. Constatamos que essas adolescentes ainda privilegiam uma representação de família nos moldes da família conjugal tradicional e que há uma associação de sentimentos positivos em relação a ela. Observamos que as adolescentes que contam com o apoio familiar atuam melhor como mães, mesmo que vivam numa configuração de família não tradicional. O lugar do pai continua conservado, idealmente, mesmo que a função se apresente fragilizada. Os planos para o futuro são: voltar a estudar e trabalhar para cuidar melhor do filho. A partir dos resultados obtidos, destacamos a importância de se desenvolver programas junto às escolas, postos de saúde e espaços que trabalhem com adolescentes, com temas voltados à sexualidade, contracepção e família. Assim como, um trabalho com os avós que cuidam de seus netos, no sentido de oferecer orientação e apoio. / The family is the first social group of the individual. Group this that is of great importance, a time that all the future social relations will have it as base. The adolescent who becomes mother lives two transformations: one of the proper phase, that makes possible it new conquests and a bigger independence of its original family; another one, the condition of the maternity that points to the formation of a new familiar nucleus, causing responsibilities for which duly it is still not prepared. This study had for objective to understand how the low income adolescent in the condition of recent mother, represents the family. Our research was of qualitative nature. Twelve adolescents had participated who had given to the light its children have less of one year. We use two instruments for the material collection: the first one considered on the application of Test of the Drawing the Family with histories; and the second one, the application of an interview half-structuralized with an initial question: What family is for you? With the test application and the interview was possible to identify four thematic nucleus: family representation; family configuration; the place of the childs father in the adolescents life and projects for the future. We evidence that these adolescents still privilege a family representation in the molds of the traditional conjugal family and that it has an association of positive feelings in relation to its. We observe that the adolescents who count on the familiar support act better as mother, even that live in a not traditional family configuration. The fathers place continues conserved, ideally, even that the function presents fragile. The plans for the future are: come back to study and work to take care better of the son. From the gotten results, we detach the importance of developing programs together to the schools, healths ranks and spaces the work with adolescents, with subjects directed to the sexuality, contraception and family. As well as, a work with the grandparents who take care of its grandsons, in the direction to offer orientation and support.

Made available in DSpace on 2017-06-01T18:09:04Z (GMT). No. of bitstreams: 1 Marcos Antonio_Confrontado.pdf: 2042514 bytes, checksum: a7de26917b3618235f2709ecbb8f9efd (MD5) Previous issue date: 2007-04-13 / The family is the first social group of the individual. Group this that is of great importance, a time that all the future social relations will have it as base. The adolescent who becomes mother lives two transformations: one of the proper phase, that makes possible it new conquests and a bigger independence of its original family; another one, the condition of the maternity that points to the formation of a new familiar nucleus, causing responsibilities for which duly it is still not prepared. This study had for objective to understand how the low income adolescent in the condition of recent mother, represents the family. Our research was of qualitative nature. Twelve adolescents had participated who had given to the light its children have less of one year. We use two instruments for the material collection: the first one considered on the application of Test of the Drawing the Family with histories; and the second one, the application of an interview half-structuralized with an initial question: What family is for you? With the test application and the interview was possible to identify four thematic nucleus: family representation; family configuration; the place of the child s father in the adolescent s life and projects for the future. We evidence that these adolescents still privilege a family representation in the molds of the traditional conjugal family and that it has an association of positive feelings in relation to its. We observe that the adolescents who count on the familiar support act better as mother, even that live in a not traditional family configuration. The father s place continues conserved, ideally, even that the function presents fragile. The plans for the future are: come back to study and work to take care better of the son. From the gotten results, we detach the importance of developing programs together to the schools, health s ranks and spaces the work with adolescents, with subjects directed to the sexuality, contraception and family. As well as, a work with the grandparents who take care of its grandsons, in the direction to offer orientation and support. / A família é o primeiro grupo social do indivíduo. Grupo esse que é de grande importância, uma vez que todas as relações sociais futuras o terão como base. A adolescente que se torna mãe vive duas transformações: uma a da própria fase, que lhe possibilita novas conquistas e uma maior independência de sua família de origem; outra, a condição da maternidade que aponta para a formação de um novo núcleo familiar, acarretando responsabilidades para as quais ainda não está devidamente preparada. Este estudo teve por objetivo compreender como a adolescente de baixa renda na condição de mãe recente, representa a família. A nossa pesquisa foi de natureza qualitativa. Participaram doze adolescentes que haviam dado à luz a seus filhos há menos de um ano. Utilizamos dois instrumentos para coleta do material: o primeiro consistiu na aplicação do Teste do Desenho da Família com Estórias (DF-E); e o segundo, a aplicação de uma entrevista semi-estruturada com uma questão disparadora: O que é para você, família? . Com a aplicação do teste e da entrevista foi possível identificar quatro núcleos temáticos: representação de família; configuração de família; o lugar do pai da criança na vida da adolescente e projetos para o futuro. Constatamos que essas adolescentes ainda privilegiam uma representação de família nos moldes da família conjugal tradicional e que há uma associação de sentimentos positivos em relação a ela. Observamos que as adolescentes que contam com o apoio familiar atuam melhor como mães, mesmo que vivam numa configuração de família não tradicional. O lugar do pai continua conservado, idealmente, mesmo que a função se apresente fragilizada. Os planos para o futuro são: voltar a estudar e trabalhar para cuidar melhor do filho. A partir dos resultados obtidos, destacamos a importância de se desenvolver programas junto às escolas, postos de saúde e espaços que trabalhem com adolescentes, com temas voltados à sexualidade, contracepção e família. Assim como, um trabalho com os avós que cuidam de seus netos, no sentido de oferecer orientação e apoio.