In hierdie studie is die tema: ʼn Pastorale ondersoek na die inrigting van geestelike en emosionele herstel in kontemporêre modelle vir innerlike genesing. Die oogmerk is die uiteindelike formulering van vernuwende insigte en riglyne vir die pastorale begeleiding van emosioneel en geestelik verwonde persone vanuit ʼn innerlike genesingsperspektief. Osmer se pastoraal-teologiese metode word as vertrekpunt geneem en hiervolgens word daar onder die Normatiewe taak in hoofstuk 2 gefokus op sewe kontemporêre innerlike genesing modelle. Onder hierdie selfde afdeling word daar in hoofstuk 3 ʼn Skriftuurlike basis geformuleer vir die tema van innerlike genesing en word daar ook bepaal in watter mate beginsels vanuit die onderskeie innerlike genesingsmodelle wat ondersoek word, voldoen aan die eise van die Skrif. Onder die Interpreterende taak word daar in hoofstuk 4 gefokus op aanvullende riglyne vanuit die aangrensende wetenskappe met betrekking tot beginsels van innerlike genesing. Hier het onder andere geblyk dat diep onderdrukte emosionele pyn sekere liggaamlike probleme kan veroorsaak en ook die immuunsisteem onderdruk. Emosionele vryheid of gebondenheid word ook grootliks bepaal deur faktore soos disfunksionele gedragspatrone, traumatiese drome, die verlede te konfronteer, kompulsiewe gedrag te staak, vergifnis te bied/ontvang en op positiewe aspekte soos sterkpunte en prestasies van die verlede te fokus. Vanuit die Beskrywende empiriese taak in hoofstuk 5 word die resultate van drie gevallestudies aan die orde gestel. Tydens gebedsessies is daar telkens saam met die begeleidendes onder leiding van die Heilige Gees as’t ware ‘terug beweeg’ na die oorspronklike traumatiese situasies. Insiggewende waarnemings is gemaak ten opsigte van die begeleidendes se belewenisse van emosionele en geestelike genesing tydens hierdie sessies. Praktyk-teoretiese riglyne ten opsigte van die formulering van ʼn eie innerlike genesingsmodel kom aan die orde in hoofstuk 6 onder die Pragmatiese taak. Die model wat voorgestel word bestaan uit ses fases waarvan die gebedsessie die kern gedeelte vorm. / PhD (Pastoral Studies), North-West University, Potchefstroom Campus, 2015

In hierdie studie is die tema: ʼn Pastorale ondersoek na die inrigting van geestelike en emosionele herstel in kontemporêre modelle vir innerlike genesing. Die oogmerk is die uiteindelike formulering van vernuwende insigte en riglyne vir die pastorale begeleiding van emosioneel en geestelik verwonde persone vanuit ʼn innerlike genesingsperspektief. Osmer se pastoraal-teologiese metode word as vertrekpunt geneem en hiervolgens word daar onder die Normatiewe taak in hoofstuk 2 gefokus op sewe kontemporêre innerlike genesing modelle. Onder hierdie selfde afdeling word daar in hoofstuk 3 ʼn Skriftuurlike basis geformuleer vir die tema van innerlike genesing en word daar ook bepaal in watter mate beginsels vanuit die onderskeie innerlike genesingsmodelle wat ondersoek word, voldoen aan die eise van die Skrif. Onder die Interpreterende taak word daar in hoofstuk 4 gefokus op aanvullende riglyne vanuit die aangrensende wetenskappe met betrekking tot beginsels van innerlike genesing. Hier het onder andere geblyk dat diep onderdrukte emosionele pyn sekere liggaamlike probleme kan veroorsaak en ook die immuunsisteem onderdruk. Emosionele vryheid of gebondenheid word ook grootliks bepaal deur faktore soos disfunksionele gedragspatrone, traumatiese drome, die verlede te konfronteer, kompulsiewe gedrag te staak, vergifnis te bied/ontvang en op positiewe aspekte soos sterkpunte en prestasies van die verlede te fokus. Vanuit die Beskrywende empiriese taak in hoofstuk 5 word die resultate van drie gevallestudies aan die orde gestel. Tydens gebedsessies is daar telkens saam met die begeleidendes onder leiding van die Heilige Gees as’t ware ‘terug beweeg’ na die oorspronklike traumatiese situasies. Insiggewende waarnemings is gemaak ten opsigte van die begeleidendes se belewenisse van emosionele en geestelike genesing tydens hierdie sessies. Praktyk-teoretiese riglyne ten opsigte van die formulering van ʼn eie innerlike genesingsmodel kom aan die orde in hoofstuk 6 onder die Pragmatiese taak. Die model wat voorgestel word bestaan uit ses fases waarvan die gebedsessie die kern gedeelte vorm. / PhD (Pastoral Studies), North-West University, Potchefstroom Campus, 2015

Introduction Alternative medicine has been employed in the treatment of several diseases. Listening to music after minor surgery has been beneficial regarding pain control. Aim The aim of this study was to determine the effect of music on intravenous patient-controlled (PCA) morphine consumption after hip or knee replacement. Methods This was an open label, randomized controlled trial. Forty (twenty per group) consecutive patients scheduled for arthroplasty were included. A standardized anaesthetic technique was used, consisting of propofol, sufentanil, rocuronium, and isoflurane. Postoperatively patients were allocated to one of two groups: Group M listened to music during the first 24 postoperative hours, while Group C did not listen to music. The PCA dose consisted of morphine 1.5 mg and droperidol 83.3 ìg with a lockout time on seven minutes. Rescue doses of morphine 15 ìg/kg intravenously every one-minute until the patient was pain free was administered by a nurse according to a visual descriptive pain score. Both groups received paracetamol 1 g intravenously six hourly. After 24 hours the total (PCA plus rescue) morphine dose was recorded. Morphine consumption in groups was analysed using the one-sided Student two-sample t test. The significance level was 0.05 and the power 0.95. Results Neither the PCA usage (p = 0.4138) nor the rescue doses of morphine (p = 0.9163) differed significantly between the groups. Conclusion Although a statistical difference could not be shown in this study, music during the postoperative period does offer a pleasant distraction from this overall undesirable experience. AFRIKAANS : Inleiding Alternatiewe medisyne word dikwels gebruik vir die hantering van verskeie siektetoestande. Daar is al aangetoon dat deur na musiek te luister voordelig is na geringer chirurgie ten opsigte van pynbeheer. Doel Die studie het ten doel gehad om die effek van musiek na heup- of knievervanging op intraveneuse pasiënt- beheerde morfienverbruik (PBA) te bepaal. Metodes Hierdie was ʼn enkel-blinde gerandomiseerde gekontroleerde studie. Veertig (twintig per groep) agtereenvolgende pasiënte geskeduleer vir gewrigsvervanging is by die studie ingesluit. ʼn Standaard narkosetegniek is gebruik, bestaande uit propofol, sufentaniel, rokuronium en isofluraan. Die pasiënte is postoperatief aan een van twee groepe toegedeel: Groep M het gedurende die eerste postoperatiewe 24 uur na musiek geluister terwyl Groep K nie na musiek geluister het nie. Die PBA-dosis het bestaan uit morfien 1.5 mg en droperidol 83.3 μg met ‘n uitsluitingstyd van sewe minute. Addisionele dosisse morfien is toegelaat. Dit is intraveneus deur die verpleegkundige volgens ʼn verbaal beskrewe pynskaal toegedien en het bestaan uit 15 μg/kg IV elke een minuut totdat die pasiënt volgens haar oordeel pynvry was. Beide groepe het ook sesuurliks parasetamol 1 g intraveneus ontvang. Vier en twintig uur na die operasie is die totale morfienverbruik (PBA plus bykomende dosisse) aangeteken. Die morfienverbruik in groepe is geanaliseer met behulp van die eenkantige tweesteekproef-t-toets. Die beduidenheidspeil was 0.05 en die onderskeidingsvermoë 0.90. Resultate Daar was tussen groepe geen beduidende verskil ten opsigte van die PBA (p = 0.4138) en die bykomende dosisse (p = 0.9613) morfien nie. Gevolgtrekking Alhoewel daar geen statisties beduidende verskil tussen groepe aangetoon is nie, bied musiek gedurende die postoperatiewe fase ʼn aangename afleiding van die andersins onaangename ondervinding. Copyright / Dissertation (MMed)--University of Pretoria, 2010. / Anaesthesiology / unrestricted

Pain is a very common problem experienced by the general population and children in particular. It goes beyond personal suffering and affects all dimensions of the quality of life and general functioning of both adults and children, be it the physiological, psychological or financial aspects. Children may suffer from pain that may either be chronic or acute, depending on the diagnosis. Assessment of pain in children is equally important as that of adults, except that they lack the verbal fluency and cognitive development to communicate their pain. Children’s experience of pain is similar to that of adults. Pain assessment is a key aspect in the nursing management of children and delivery of care within the Primary Health Care (PHC) setting. Effective pain assessment is thus reliant on comprehensive assessment of the child and his or her pain. The aim of this research was to explore and describe practices and perceptions of professional nurses working in a PHC facility regarding pain assessment of children under five years in the Mangaung Metropolitan Municipality and to formulate recommendations for professional nurses in PHC facilities to facilitate pain assessment in PHC settings. A qualitative study design was used and data was collected with the use of focus groups. A purposive sampling was conducted to select participants who represent the target population. The sample used for the study included all the professional nurses working in PHC facilities registered with the South African Nursing Council and that have at least one year of experience. The practical training of the researcher to conduct an interview was done prior to the actual research. A pilot focus group was conducted and the interview schedule was finalised. Semi-structured focus groups were used to obtain data from the participants. The researcher conducted 6 focus group interviews attended by 32 professional nurses. Data was collected until data saturation was achieved. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Data was captured on a digital voice recorder and transcribed verbatim. Field notes were taken during each focus group. Data analysis was done by means of content analysis by the researcher and an independent co-coder. After consensus and saturation, three major themes emerged. Each theme was identified and divided into sub-themes and was consequently discussed together with the relevant data obtained from literature. The findings indicated that professional nurses perceive the assessment of pain in children under five years as a challenge. The combination of signs and symptoms to make decisions with pain assessment was identified as an area of concern. The participants further p erceived the history provided by the parent as important in the process of pain assessment. The conclusions drawn are that the professional nurses acknowledge that they don’t take sufficient notice of pain in children under five, which means that children with pain are neglected. Professional nurses maintain that there is a need for sufficient pain assessment and the need for guidelines and tools to assess pain in children under five, especially in the PHC setting. These professional nurses support the availability of guidelines to assist them to conduct effective and comprehensive pain assessment. The research report concluded with the researcher’s recommendations for nursing education, nursing research and nursing practice with specific formulation of guidelines for the facilitation of professional nurses to truly render effective and comprehensive pain assessment in PHC settings. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Pain is a very common problem experienced by the general population and children in particular. It goes beyond personal suffering and affects all dimensions of the quality of life and general functioning of both adults and children, be it the physiological, psychological or financial aspects. Children may suffer from pain that may either be chronic or acute, depending on the diagnosis. Assessment of pain in children is equally important as that of adults, except that they lack the verbal fluency and cognitive development to communicate their pain. Children’s experience of pain is similar to that of adults. Pain assessment is a key aspect in the nursing management of children and delivery of care within the Primary Health Care (PHC) setting. Effective pain assessment is thus reliant on comprehensive assessment of the child and his or her pain. The aim of this research was to explore and describe practices and perceptions of professional nurses working in a PHC facility regarding pain assessment of children under five years in the Mangaung Metropolitan Municipality and to formulate recommendations for professional nurses in PHC facilities to facilitate pain assessment in PHC settings. A qualitative study design was used and data was collected with the use of focus groups. A purposive sampling was conducted to select participants who represent the target population. The sample used for the study included all the professional nurses working in PHC facilities registered with the South African Nursing Council and that have at least one year of experience. The practical training of the researcher to conduct an interview was done prior to the actual research. A pilot focus group was conducted and the interview schedule was finalised. Semi-structured focus groups were used to obtain data from the participants. The researcher conducted 6 focus group interviews attended by 32 professional nurses. Data was collected until data saturation was achieved. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Data was captured on a digital voice recorder and transcribed verbatim. Field notes were taken during each focus group. Data analysis was done by means of content analysis by the researcher and an independent co-coder. After consensus and saturation, three major themes emerged. Each theme was identified and divided into sub-themes and was consequently discussed together with the relevant data obtained from literature. The findings indicated that professional nurses perceive the assessment of pain in children under five years as a challenge. The combination of signs and symptoms to make decisions with pain assessment was identified as an area of concern. The participants further p erceived the history provided by the parent as important in the process of pain assessment. The conclusions drawn are that the professional nurses acknowledge that they don’t take sufficient notice of pain in children under five, which means that children with pain are neglected. Professional nurses maintain that there is a need for sufficient pain assessment and the need for guidelines and tools to assess pain in children under five, especially in the PHC setting. These professional nurses support the availability of guidelines to assist them to conduct effective and comprehensive pain assessment. The research report concluded with the researcher’s recommendations for nursing education, nursing research and nursing practice with specific formulation of guidelines for the facilitation of professional nurses to truly render effective and comprehensive pain assessment in PHC settings. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Low back pain has become one of the most influential musculoskeletal diseases of modern society. It is one of most expensive diseases in terms of medical costs and increased worker absenteeism, which can lead to permanent disability and places strain on the economy as a whole. Pain has been recognised as a disease in itself, which has certain consequences when it becomes chronic. Many kinds of treatment options exist with varying degrees of success. The question is thus which treatment option is the most favourable and cost-effective. Conservative treatment is the most recommended form of treatment when no serious underlying diseases are present. Exercise has been shown to be very effective in the treatment of chronic low back pain but there are still questions regarding the use of exercise therapy. The predetermined goal of the study was to ascertain whether an aggressiveprogressive exercise programme, and specifically what kind of exercises, would be more effective in the treatment of chronic low back pain. This was achieved through a number of steps, which included an extensive literature review, the identification of an appropriate test battery with related minimum physical requirements and cut scores, subject recruitment and screening of subjects, the implementation of the intervention and the subsequent re-testing of the subjects. Once the data was completed, the next step was to make use of two case studies to assist in illustrating the effectiveness of individual patients compared to the sample as a whole. These case studies were of patients who completed the entire programme but one took longer to complete the programme. This assists in illustrating the value of maintaining exercise protocol. The results from the present study are extremely positive. The two case studies provided a glimpse of the potential value that could be added through the implementation of more aggressive-progressive exercise interventions in the treatment of chronic low back pain. The final product will greatly assist exercise therapists concerned with the treatment of chronic low back pain along with cognitive-behavioural techniques. Hopefully this study will provide insight into managing chronic low back pain in South Africa from an exercise standpoint. Secondly the study will provide practical techniques to implement in an era in which economic difficulties are rife.AFRIKAANS: Laerugpyn het een van die invloedrykste muskuloskeletale siektes van die moderne samelewing geword. Dit is een van die duurste siektes in terme van mediese koste en verhoogde siekverlof deur werkers, wat kan lei tot permanente ongeskiktheid en ’n verhoogde las plaas op die ekonomie as ’n geheel. Pyn word erken as ’n siekte op sy eie wat sekere gevolge het wanneer dit chronies begin raak. Verskeie soorte behandelingsopsies is beskikbaar met variërende grade van sukses. Die vraag is dus watter behandelingsopsie is die bruikbaarste en koste-doeltreffendste. Konserwatiewe behandeling is die mees aanbevole metode van behandeling wanneer daar geen ernstige onderliggende siektetoestande teenwoordig is nie. Dit is reeds bewys dat oefening baie doeltreffend is in die behandeling van chroniese laerugpyn. Daar bestaan egter steeds vrae rondom die gebruik van oefening as terapie.Die vooropgestelde doelwit van die studie was om te bepaal of ’n aggressiewe-progressiewe inoefeningsprogram doeltreffend sal wees in die behandeling van chroniese laerugpyn, en meer spesifiek watter tipe oefening die doeltreffendste sal wees. Die navorsing het bestaan uit ’n paar stappe wat ingesluit het ’n intensiewe literatuursoektog, die identifisering van ’n gepaste toetsbattery met verwante minimum fisieke vereistes en afsnytellings, die verkryging en evaluering van proefpersone, die implementering van die intervensieprogram en die daaropvolgende hertoetsing van die proefpersone.Nadat die invordering van die data en die gepaardgaande analise van die data voltooi is, was die volgende stap om gebruik te maak van twee gevallestudies ten einde die doeltreffendheid van die intervensieprogram vir individuele proefpersone te ilustreer deur dit te vergelyk met die groep as ’n geheel. Die twee gevallestudies was van proefpersone wat die intervensieprogram volledig voltooi het, alhoewel die een proefpersoon langer geneem het om die intervensieprogram te voltooi. Dit help om die navolgingswaarde van ’n inoefeningsprotokol te illustreer. Die resultate van die huidige studie is uiters positief. Die twee gevallestudies gee ’n mate van insig wat betref die potensiële waarde wat verkry kan word deur die implementering van ’n meer aggressiewe-progressiewe inoefeningsintervensie vir die behandeling van chroniese lae rugpyn. Die finale produk sal die nodige ondersteuning aan oefeningsterapeute bied wat onseker is oor die behandeling van chroniese laerugpyn deur middel van aggressiewe-progressiewe inoefeningsintervensies en kognitiewe gedragstegnieke. Hierdie studie sal dus die begrip en insig van die behandeling van chroniese laerugpyn in Suid-Afrika verhoog vanuit ’n oefeningsuitgangspunt. Tweedens sal die studie die gebruik van praktiese oefentegnieke aanmoedig in ’n era waarin ekonomiese tye moeilik is. / Thesis (DPhil)--University of Pretoria, 2011. / Biokinetics, Sport and Leisure Sciences / unrestricted