Type I Diabetes Mellitus (T1DM) is a major health problem and a burden for affected young individuals, as well as for society. It is among the most prevalent paediatric disorders, affecting an estimated 1.7 per 100 children and adolescents. Given the complexity of diabetes treatment regimens, it is not surprising that children, adolescents, and their families often have difficulty adhering to these regimens. Studies have found that the overall adherence rate among children and adolescents with diabetes is about 50%. It has also been found that adherence to T1DM often tends to decrease when the adolescent begins to assume most of the responsibility for managing the disease and the parents‟ role starts to decline. However, literature indicates that adolescent patients‟ adherence is poor and an important strategy to improving their metabolic control is to increase self-care. The most common age of onset for T1DM is between 10-14 years. The adolescent population is highly neglected in current research on diabetes, because the focus tends to favour children and not adolescents. It is widely recognised that glycaemic control in adolescents is complex, challenging and dependent on interconnected relationships between numerous inputs at individual, family, community and health service levels. Optimal care of adolescents with diabetes has not been subjected to rigorous scientific studies, and research results related to optimal glycaemic control are conflicting. Development and continuous evaluation of best practices pertaining to diabetes mellitus remains one of the major objectives of diabetes care, possibly allowing a delay in and/or prevention of later complications. Research indicates that adolescence is the one age group where there has been no discernible improvement in health over the last 20 years. A great number of research studies on the subject of diabetes are done globally, but less literature, especially in the South African context, can be found that focuses on and explain the experiences of adolescents with T1DM with regard to their treatment adherence. This qualitative study explored the experiences of adolescents with T1DM. A purposive sample (n=7) of young adolescents between the ages of 13 and 15 willingly participated in the research study to explore and describe their experiences with managing their treatment regimen. In-depth interviews were conducted to collect rich descriptive data, followed by participants‟ verbal reflections once a week for the duration of a month. After the in-depth interviews and weekly reflections, the researcher held a focus group interview with all the participants. Transcribed data were analysed by means of thematic analysis from which themes and subthemes were derived. The participants expressed both positive and negative emotions associated with their diabetes; they experienced a lack of understanding by significant others because of a lack of knowledge, interest or support regarding their diabetes; they mentioned that they continually need age-appropriate support and parental involvement, even though they manage diabetes through their own processes; and lastly, participants struggled with a fear of friends‟ and peers‟ perceptions. From the findings it is clear that in order to cope, the adolescents need not only medical treatment and education about diabetes (T1DM), but emotional support, supervision and repeated reinforcement to achieve effective self-management. The basic suggestion is that diabetes care for children and young people should include routine assessment of the psychological and social pressures on the adolescent and the family so that strategies can be put in place to give support and education as needed and as appropriate. The researcher also recommends that school personnel must be educated about diabetes so that they can understand the changing medical and psychosocial needs of the adolescent and can help him/her to participate fully in all the available work, sport, and leisure activities. Models of legislation and training programmes for school staff specifically addressing the needs of children with diabetes in school have been developed in a number of countries such as Greece, Germany, Italy, Poland, Spain, Sweden, the UK and the USA. These programmes should be considered as an example to other countries. These best practices can serve as a foundation for national improvement. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Pregnancy can be a very difficult time of transition for some women as they have to adapt, change and prepare for the role and responsibility that awaits them after their baby is born. This is especially challenging for first-time mothers as they experience higher levels of anxiety and uncertainty than more experienced mothers. From a fortogenic perspective, pregnancy can be viewed as a developmental opportunity for maturation and growth. With high levels of psychological well-being the new mother will be able achieve optimal functioning by being a sensitive and responsive and confident in her abilities to care for her new-born baby. There is substantial evidence to show that spirituality is strongly associated with psychological well-being, but the lived experiences of first-time mothers have not yet been explored. Therefore this study aims to explore a group of first-time mothers‟ experiences of meaningfulness during their third trimester of pregnancy by focusing on their spirituality. Qualitative research and a phenomenological design were used to gain in-depth understanding of the experiences of first-time mothers. The Mmogo-Method® and reflective journals were used as data-gathering techniques and visual and textual data were captured. The data were analysed by using thematic analysis (textual) and comparing the symbolic values (visual) with the research question. This group of first-time mothers expressed a very personal and intimate relationship with a Divine reality that they rely on and from it they derive a sense of meaningfulness. This sense of meaning stems from their belief that the Divine reality is the giver of life; they were given a responsibility to carry new life. Unconditional trust in the Divine reality makes them willing to surrender control of their lives and accept the responsibility they were given. They find meaning, which potentially has implications for higher levels of psychological well-being. The findings of this research provide the basis for developing interventions for mothers-to-be to make sense of their pregnancy by relying on their pre-existing spiritual frameworks. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Syftet med denna studie är att undersöka och uppmärksamma unga kvinnors uppfattningar och erfarenheter avseende hur sociala medier påverkar deras identitetsutveckling och psykiska välbefinnande. Det är en kvalitativ studie baserad på två fokusgrupper med tre högskole- och universitetsstuderande kvinnor, i åldern 18 - 25. Det genomfördes även en individuell intervju med en professionell som är verksam på en stödmottagning för psykisk ohälsa. Den teoretiska utgångspunkten i analysen är symbolisk interaktionism, social interaktion, stigma och skam. Kvinnorna upplever att sociala medier har positiv och negativ inverkan på deras identitetsutveckling och psykiska välbefinnande. Kvinnorna upplever att sociala medier ökar en medvetenhet om skönhetsideal, att en större omfattning av människor kan döma ens egen presentation av en själv samt att stress och negativ självbild kan försämra det psykiska välbefinnandet och påverka identitetsutvecklingen. / The purpose of this study is to examine and highlight young women’s opinions and experiences of how Social Media affect their identity development and psychological well-being. It’s a qualitative study based on two focus groups, including three women in each group who studies on an academic level and are in the ages 18-25. One individual interview was also conducted with a professional, who works at a support clinic for mental illness amongst youth. The theoretical basis of the analysis is symbolic interactionism, social interaction, stigma and shame. The study is based on a symbolic interactionist perspective which highlights social interaction, stigma and shame. According to the women, Social Media can have both positive and negative impact on their identity development and psychological well-being. The women experiencing that Social Media increases users’ awareness of beauty standards; others judgement of one others’ presentation of themselves; stress caused by constant availability and exposure of information. The study shows that stress and a negative self-image can decrease the psychological well-being and affect the identity development.

Background: Rectal cancer 5-year survival has increased from 58% of those diagnosed in 1987-1989 to 68% of those diagnosed in 2003-2009. Rectal cancer patients commonly receive one of two surgical treatments: permanent ostomy (a resection of tumor following by a stoma) or anastomosis (a resection followed by a reconnection with or without a prior temporary ostomy). The multifaceted consequences of both types of surgery potentially can affect both long-term psychological well-being and financial concerns of patients and their families. The overall goal of this dissertation is to increase the understanding of the impact of depression on the quality of life of rectal cancer survivors. Methods: The research data were based on a quality of life survey conducted in 2010-2011 among long-term survivors (≥ 5 years post-diagnosis) of rectal cancer. Participants were identified through the Kaiser Permanente (KP) health systems in Northern California and Southwest Washington/Oregon. Data included both the 2010/2011 survey data and KP electronic medical records (EMRs). Results: 1) The 24.7% prevalence of self-reported current depression among long-term rectal survivors was observed with a higher prevalence of 31% among those with permanent ostomies. Although average perceived financial burden level was low in this population of insured cancer survivors, 20% still reported moderate-to-high burden. Perceived financial burden was especially high among those who recalled having depression immediately after surgery and reported depression at the time of survey.2) All self-reported measures showed low sensitivity varying from 26% to 56% and high specificity from 77% to 82.7% against either diagnostic scheme from EMRs. Using either diagnostic scheme, the MCS-12 measure, a Mental Composite Summary (MCS) score from the 12-item Short-Form Health Survey with a cut-off point of≤45.6 for a self-reported depression, performed better as compared to the other two self-reported measures. 3) Approximately one in six rectal cancer survivors experienced depression after their surgery of sufficient severity to result in a depression diagnosis. Among survivors with recurrent depression diagnoses, those with a permanent ostomy reported significantly lower psychological well-being than those with an anastomosis. Conclusions: Depression burden is elevated after receiving surgery and remains a problem long after cancer diagnosis and treatment. Types of rectal cancer surgery received and gender of survivors may complicate the extent of depression burden. Among long-term rectal cancer survivors, having depression is associated with higher perceived financial burden. Chronic or recurrent course of depression may exist in this group of rectal cancer survivors and has significant impact on long-term psychological well-being. Self-reported measures for depression, such as MCS-12 measure with a cutoff point≤45.6, have the potential to be utilized for epidemiological studies when common screening instruments, electronic medical records, or administrative databases are not available. Implications: These findings underline the significance of depression assessments after surgery for this population of rectal cancer survivors and the importance of symptoms monitoring throughout the cancer survivorship continuum. Depressive symptoms should be monitored and managed as early as after cancer diagnosis and surgery to optimize survivors' long-term emotional well-being. In addition, depression screening and treatment as well as discussion of financial issues may have important roles in long-term survivorship care planning, particularly for those with permanent ostomies.

The aim of this research study was to explore the relationship between academic work stress, psychological well-being and social life of university master students. It was also examined whether the presence of control variables i.e. gender and living status had an influence on the relationship between the variables mentioned above. A total of 100 participants both male (N=56) and female (N=44) were conveniently drawn from master students pursuing different master programmes in the university and the spearman’s correlation results of how academic work stress is related to psychological well-being showed a significant strong negative correlation between the variables (rs=-.448, p < .001) which suggests that students who experienced a high level academic work stress, experienced a lower level of psychological well-being. In addition, the results on the relationship between academic work stress and social life showed a significant negative correlation between variables (rs=-.293, p < .001) meaning that a high level of academic work stress is negatively correlated with a lower level of social life among students. Also, the inclusion of living status as a control variable did not have an influence on the above relationship but including gender had a positive significant impact. Lastly, theoretical implications of the study as well as the conclusion were presented.

The purpose of this study was to investigate the process of forgiveness and the relationship among state forgiveness, self-compassion, and psychological well-being experienced by Buddhists in the United States. An integral feminist framework was developed for this mixed-method study. For the quantitative component of this study, a convenience sample of 112 adults completed an online survey. Multiple regression analysis was performed to examine: (a) the impact of gender, age, and the years spent in Buddhist practice on state forgiveness and self-compassion; (b) the outcome of psychological well-being in relation to state forgiveness and self-compassion; and (c) self-compassion as a mediator for the relationship between state forgiveness and psychological well-being. Quantitative results indicated: (a) state forgiveness positively predicted psychological well-being; (b) the years spent in Buddhist practice positively predicted self-compassion; (c) self-compassion positively predicted psychological well-being; and (d) self-compassion partially mediated the relationship between state forgiveness and psychological well-being. Age did not predict any of the three primary variables. Gender did not predict state forgiveness. For the qualitative component of this study, this researcher purposefully selected four adults from a local Buddhist community in central Kentucky and conducted two in-depth interviews to explore their subjective experiences of forgiveness within their own contexts. A holistic-content narrative analysis revealed unique features of each interviewee’s forgiveness process interwoven with the socio-cultural, family and relational contexts. From a phenomenological analysis, common themes and elements of the interviewees’ forgiveness processes emerged. Qualitative findings corresponded to the quantitative results concerning state forgiveness as a route to psychological well-being, the positive relationship between Buddhist practice and compassion, and the role of self-compassion in the relationship between state forgiveness and psychological well-being. Qualitative findings also suggested the following. First, two-way compassion toward self and the offender was a facilitating factor for forgiveness that may be unique to Buddhists. Second, one’s actual experience of forgiveness may encompass not only cognitive, affective, and behavioral changes, but also transformation of self and perspective on meaning and purpose in life. Third, Enright and his colleagues’ (1998) stage and process models of forgiveness were useful to understand Buddhists’ experiences and processes of forgiveness.

Women suffer a high prevalence rate of several mental disorders. National U.S. data (N = 9,282) shows that 23.4% of women meet the criteria for an anxiety disorder, 8.6% for depression, and 11.6% for a mood disorder (Kessler et al., 2005). Compared to men, women are two times more likely to be depressed (Lewinsohn, Rhode, Seeley, & Baldwin, 2001) and two to three times more likely to suffer from anxiety disorders such as panic disorders, phobias, obsessive compulsive disorders, and Posttraumatic Stress (Kessler et al., 2005). Due to experiencing a high number of mental disorders, women’s psychological well-being (PWB) has been questioned (OWH, 2009). Considerable research describes the negative influence psychological distress has on women’s lives, but little is understood of what constitutes PWB. Ryff (1989) proposed that existing models of mental health too often focus on illness and disorders, neglecting important aspects of positive functioning. This study was based on Ryff’s (1989) conceptualization that improved PWB would reflect the perception of functioning well in life (Ryff, 1989). The purpose of the present study was to identify factors important in women’s PWB. Factors included: age, household income, education, marital status, race/ethnicity, perceived social support, psychological distress, and PWB. The design of the study was a secondary data analysis based on an existing study, “The Psychological Well-Being of Women Pre- and Post- a Breast Cancer Diagnosis.” Women recalled for a diagnostic mammogram, but not diagnosed, were included in the study (N = 2,746). Measures used included: a demographic questionnaire, Scales of psychological well-being (Ryff, 1989); Depression, Anxiety, and Stress Scales (Lovibond & Lovibond, 1995); and a Visual Analog Scale of Perceived Social Support. Findings showed that income, education, and perceived social support showed statistically significant different PWB scores in the positive direction. Married women scored higher PWB scores than women of other types of marital status, but neither age nor race/ethnicity showed differences in outcome scores. Psychological distress and PWB were strongly and inversely correlated, suggesting that the constructs are more directly related than previously identified. Implications for therapeutic practice and future research are discussed.

The high prevalence of sexual abuse suffered by women as children is well documented, both internationally and in South Africa. The life outcomes of women who had experienced childhood sexual abuse are generally reported as adverse, yet some of these survivors manage to overcome the abusive relationship and experience positive changes in themselves and their lives. Emerging trauma literature thus supports a philosophical shift from a pathogenic to a autogenic paradigm in which the focus is on positive and adaptive post trauma outcomes. Previous trauma models, which were based on a pathogenic model, are now shifting to a positive psychology trend by incorporating a salutary component, which includes a spiritual and existential dimension as well as an area of potential emerging growth. Information on the constructive coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse can lead to the formulation of guidelines with strategies for an intervention programme that can facilitate and enhance coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. This research investigated the coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse. The research was carried out in South Africa in the greater Gauteng Province and surrounding areas, with women who had experienced sexual abuse in childhood. A mixed method research design was used in which: the first phase was quantitative research conducted with validated psychometric instruments measuring coping behaviour, posttraumatic growth and psychological well-being. These instruments were the COPE (Coping Self-efficacy Scale), the Posttraumatic Growth Inventory, the Mental Health Continuum, Rosenberg’s Self-esteem Scale and the General Health Questionnaire. The second phase was of a qualitative nature, and explored the stories and experiences of women identified as coping constructively, manifesting posttraumatic growth and psychological well-being, by using semi-structured interviews. Lastly, the data obtained was used to formulate guidelines with specific strategies, which can be used by helping professionals in a group context to facilitate and enhance constructive coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. The results of this research were as follows: prevalence of constructive coping, posttraumatic growth and psychological well-being was determined, and indicated that 58% of participants manifested constructive coping, 60% manifested posttraumatic growth and 42% manifested psychological well-being. Semi-structured interviews conducted with the women scoring in the upper range of coping constructively, growing after the trauma and emerging psychologically well were transcribed and analysed by means of interpretative phenomenological analysis, and the following broad themes emerged: psycho-socio spiritual resources, the healing process and positive strengths. These themes and sub-themes produced data which could be used in the formulation of guidelines with strategies for an intervention programme aimed at enhancing and facilitating constructive coping, posttraumatic growth and psychological well-being thereby improving the therapeutic services available to childhood sexual abuse survivors. Finally the study was evaluated and conclusions and recommendations were made. / PhD, Psychology, North-West University, Vaal Triangle Campus, 2012

The aim of this study was to explore, from different perspectives, whether obesity related variables are associated with facets of psychological well-being, with a vision to future enhancement of health and the quality of life of people in the African context. This study was undertaken from the perspective of positive psychology and focused on the metabolic syndrome and obesity as biological facets. This research was conducted as part of the multidisciplinary POWIRS (Profiles of Obese Women with Insulin Resistance Syndrome) project. African (n=102) and Caucasian (1 15) women took part in a cross-sectional design. The thesis consists of 3 articles: I) Childhood relationships and bio-psycho-.gocia1 well-being in African women, 2) Psychological well-being and rhe metabolic syndrome in African and Caucasian women, and 3) Psychological wellbeing and (the absence of obesity in African and Caucasian women. In this study psychological well-being was conceptualized and operationalized by means of the General Health Questionnaire (GHQ); Sense of Coherence Scale (SOC-29); Affectometer 2 (AFM) (short form); Fortitude Questionnaire (FORQ); Cognitive Appraisa1 Questionnaire (CAQ); Psychological Well-being Scales (SPWB); Quality of Childhood Relationship Questionnaire (QCR); Satisfaction with Life Scale (SWLS) and the Jarel Spiritual Well-Being Scale (SWS-H). These scales were chosen to include hedonic as well as eudaimonic psychological well-being facets, but also an index of psychological symptoms. As far as possible, scales with acceptable psychometric properties as described in international as well as South African context were selected. The first article focused on whether African women with a recalled higher level of quality of childhood relationships mould differ significantly with regard to biological, psychological and social well-being from women with a recalled lower level of quality of childhood relationships. Body mass index (BMI) was used as objective measure of obesity to operationalize physical health. Findings were that the recalled quality of childhood relationships is linked with obesity and psycho-social well-being in this group of African women. The second article focused on psychological well-being and (the absence of) the metabolic syndrome (MS). It explored the possible association between comprehensive psychological well-being and MS in different cultural contexts, and explored whether African and Caucasian women without MS markers and those with MS differ on specific indices of psychological well-being. The criteria of the NCEP ATPIII mere implemented to determine markers of MS, and the absence of markers of MS was used as measure of physical health. Findings were that an association is found in Caucasian women between comprehensive psychological well-being and the absence of the metabolic syndrome, but not in the case of African women. Caucasian women without metabolic syndrome markers had significantly higher levels of psycho-social wellbeing than uomen with the metabolic syndrome. but a less apparent pattern of differences emerged for African women. MS markers for African women should be further explored. The third article explored facets of psychological well-being as predictors for (the absence of) obesity (measured by BMI and WHR) in African and Caucasian women, and whether similar or different psychological well-being facets will emerge as predictors of obesity in different cultural contexts. Obesity was operationalized in terms of waist-hip-ratio (WHR) and body-mass-index (BMI). The finding was that clusters of psychological well-being facets are practical significant predictors of obesity (measured by BMI and WHR) and that these clusters differ in some respects for African and Caucasian women. It was concluded that, firstly. findings support holistic conceptualizations of health such as proposed by the WHO (1999). Secondly, it may be worthwhile to include facets of psychological well-being in already existing intervention programmes. The development of strengths that focus on life skills and behaviours related to positive interpersonal relationships, optimistic cognitive attributional styles, finding a sense of purpose and meaningfulness in life, may be particularly beneficial. Sensitivity for cultural contexts is indicated. In view of the increase in the occurrence of obesity in childhood and adolescence it is recommended that educational training programmes should be implemented early in life in order to facilitate protective strengths and to promote bio-psycho-social health in individuals and communities. Advocacy for more attention to psycho-social and protective factors in public health is needed. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2006.

Emotional intelligence is a growing area of behavioural research; it recently grabbed the attention of some of the major organisations worldwide. The objective of this study was to determine the relationship between wellness and emotional intelligence in order to develop a structural model of psychological well-being. The following constructs were looked at, Optimism, Sense of Coherence, Life Satisfaction, Emotional Intelligence are all seen as good indicators of Psychological well-being. A cross-sectional design was used for this study. The participants (N=324) were students within the field of economic science. The Schutte Emotional Intelligence Scale, the Life Orientation Test Revised, the Satisfaction with Life Scale and the Orientation to Life scale were administered. Using a principal component analysis, a six-dimension factor structure for emotional intelligence among students emerged, explaining 45,24% of the variance. These factors were labelled positive affect, emotions-others, happy emotions, emotions-own, nonverbal emotions and emotional control. The most significant correlations found in this study was that Sense of Coherence is significantly positively related to Emotions Management and Life Satisfaction and significantly positively related to Emotions-Own, Happy Emotions, Positive Affect and Optimism. Sense of Coherence was negatively related to Pessimism. Emotions Management is significantly positively related to Emotions-Own, Happy Emotions, Positive Affect, Optimism and Life Satisfaction. Positive affect is significantly positively related to Optimism. Pessimism is significantly negatively related to Life Satisfaction. Optimism is significantly positively related to Life Satisfaction. After conducting a second factor analysis on the factors of the SEIS, LOT-R, SOC and SWLS, two factors were extracted, namely interpersonal and intrapersonal mastery. Using these factors, along with the results of the product-moment correlations, a psychological well-being model was designed and compiled. The results showed that Interpersonal mastery consisted of Positive Affect, Emotional Management, Sense of Coherence, Life Satisfaction and Optimism. Intrapersonal mastery consisted of Emotions-Others, Emotions-Own, Happy Emotions and Non-Verbal Emotions. It is evident from the above that the psychological well-being model consisted of intrapersonal mastery and environmental mastery. Recommendations for future research were made. / Thesis (M.A. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2007