Submitted in fulfillment of the requirements for the Doctoral Degree in Nursing, Durban University of Technology, Durban, South Africa, 2016. / Background An increase in the world's population of ageing people is occurring not only in developed countries but also in developing countries. In South Africa, the proportion of the population aged 50 and over increased from 14.8% in 2006 to 15% in 2009 and is predicted to be 19% by 2030. This means that the supply of services for the elderly people should match the demand at all times, otherwise the quality of life of these senior citizens will be compromised. This study aimed at developing a model that would improve the quality of life for elderly people living in the uMhlathuze and uMlalazi sub-districts of the uThungulu district, KwaZulu-Natal. Methodology A qualitative, exploratory, descriptive design was applied for this study. A semi-structured interview guide based on the Health Related Quality of Life Theory and Maslow’s hierarchy of needs was used. Random sampling was used to select the elderly participants. Purposive sampling was used for the selection of the chairpersons of non-governmental organisations, and the District Programme Manager. Audits were conducted in the clubs that elderly people with chronic disease participate in. Data analysis followed Tesch’s steps after which themes and categories were formulated. Results Three major themes that emerged from the data analysis were social well-being of elderly people, physiological factors and psychological factors. The results revealed that elderly people experience poor living conditions and suffer poverty due to a number of factors which including the high unemployment rate of their children. Often the children are involved in substance abuse using the elderly person’s money pension money, which leaves them without any food items in the household. According to the District Programme Manager, there was a project on integrated chronic disease management that was conducted at uThungulu district by the Department of Health. The integrated chronic disease management focused on the population in general of all ages, yet in this study the focus has been on elderly people, which is why the researcher developed a model to improve the QoL of elderly people, due to their unique needs. Conclusion This research study gathered information regarding social, economic, health and environmental factors in rural areas which will help in bringing issues of elderly people’s quality of life to awareness. This research will deepen the knowledge and skills of professionals on ageing issues, especially in rural areas/communities. / D

Mobility is an undeniable issue for current and future elderly populations. The increasing popularity for retirees to live in rural communities makes this a particularly important issue in rural towns. When an elderly individual living in a rural community is no longer able to drive, issues that come with living in a rural area may be exacerbated, and the individual may experience a decrease in their quality of life. Although individuals may be able to use public transportation most existing options do not promote an independent lifestyle. Any updated rural transportation system benefiting the elderly would be funded by taxpayers. An understanding of the taxpayers' preferences and willingness-to-pay (WTP) for transportation options, therefore, is essential. Few, if any economic studies have addressed this issue. The objectives of this research are to: (1) estimate economic willingness-to-pay (WTP) for public transportation options by using choice modeling techniques; and (2) better understand opinions related to public transportation for the elderly held by the general population as a whole and within different demographics. To complete these objectives, a choice survey was distributed to samples of three populations: residents of Atascosa County (located in south Texas); residents of Polk County (located in east Texas); and students at Texas A&M University. Respondents were presented with transportation options made of five attributes: addition to annual vehicle registration fee, days of operation, hours of operation, type of route, and senior citizen transportation fare discount. Results show both students and the general public value public transportation options and are willing to pay for specific transportation attributes. Respondents tended to prefer options which are more flexible than the less flexible attribute presented to them; however, respondents did not necessarily prefer the most flexible options. Students, generally, are willing to pay more for transportation attributes than county residents. Overall, both Atascosa and Polk County residents have similar WTP's, indicating both populations value rural public transportation similarly. The effects of socio-demographic variables on residents' decision to choose a transportation option appear to differ between the counties. These findings imply that while the influence of transportation attribute levels are consistent across counties, local input is important in customizing transportation systems to meet local expectations.

Este estudo é dedicado à compreensão de experiências de envelhecimento rural nos municípios de Camaquã e Canguçu na perspectiva do desenvolvimento social ampliado. Insere-se em um Programa Interdisciplinar de Pesquisa que busca integrar enfoques multidisciplinares e interdisciplinares na análise do desenvolvimento rural em municípios da Metade Sul do Estado do Rio Grande do Sul. Analisa as convergências e ou divergências das evidências sociais, os reflexos na vida prática das populações rurais envelhecidas, considerando a transição demográfica no país e a noção de desenvolvimento social ampliado. Trata-se de um estudo de casos múltiplos (multicaso), do tipo qualitativo. A geração dos dados deu-se por meio de pesquisa documental das políticas públicas setoriais que se embasam no envelhecimento populacional e nas dimensões locais dessas políticas e em entrevistas e grupos focais, com 31 gestores e prestadores de serviços dos municípios estudados. Desenvolveram-se dois grupos focais, um em Camaquã e outro em Canguçu, participando em cada grupo oito idosos rurais. A análise considerou o conteúdo temático e as formas como apareceram nas comunicações as dimensões sociopolíticas da problemática estudada. Os resultados mostraram o envelhecimento crescente tanto em Camaquã quanto em Canguçu, com destaque para o rural. Constatou-se que as velhices rurais expressam as incongruências da implementação das políticas públicas referendadas em tratados e políticas nacionais e internacionais. Observaram-se características e limitações próprias do rural, expressas e diferenciadas entre os espaços da agricultura familiar, dos assentamentos rurais e das fazendas, encontrando-se os dois últimos em situação desfavorável se comparados ao primeiro. No plano da vida prática, para suprir a carência da oferta de ações e serviços públicos aos idosos no rural, o Sindicato dos Trabalhadores Rurais de Camaquã e de Canguçu assumem papel importante na vida dessa população. É possível afirmar que, considerando o desenvolvimento social ampliado, tanto em Camaquã quanto em Canguçu os idosos rurais encontram-se “des” (não) envolvidos nas ações e serviços, quer nos limites do rural dos municípios como em termos de inclusão na sociedade mais ampla. / This study is devoted to understanding the experiences of rural aging in the cities of Camaquã and Canguçu from the prospect of expanded social development. It is inserted into an Interdisciplinary Research Program that integrates multidisciplinary and interdisciplinary approaches in the analysis of rural development in cities in the southern half of the state of Rio Grande do Sul. It examines the convergences and or divergences of social evidences, the reflections on the practical life of the aging rural population, considering the demographic transition in the country and the notion of social development expanded. It is a multiple case study (multicase), a qualitative approach. The generation of data was done through desk research of public sector policies that underlie the aging population and local dimensions of these policies and interviews and focus groups, with 31 managers and service providers in the cities studied. Two focus groups were developed, one in Camaquã and another in Canguçu, participating in each group eight rural elderly. The analysis considered the thematic content and the ways communications appeared in the socio-political dimensions of the problem studied. The results showed the growing aging both in Camaquã as in Canguçu, especially rural. It was found that rural old age express inconsistencies of implementation of public policies ratified in treaties and national and international policies. We observed the characteristics of the rural, expressed and differentiated among the spaces of family agriculture, rural settlements and farms, lying the last two at a disadvantage compared to the first. In terms of practical life, to supply the deficiency of actions and services for the elderly in the rural, the Rural Workers Union from Camaquã and Canguçu play an important role in the life of this population. It is possible to say that, considering the wide social development, both in Camaquã as in Canguçu the rural elderly are “un” (not) involved in the actions and services, either within the boundaries of rural cities and in terms of inclusion in wider society.

Este estudo é dedicado à compreensão de experiências de envelhecimento rural nos municípios de Camaquã e Canguçu na perspectiva do desenvolvimento social ampliado. Insere-se em um Programa Interdisciplinar de Pesquisa que busca integrar enfoques multidisciplinares e interdisciplinares na análise do desenvolvimento rural em municípios da Metade Sul do Estado do Rio Grande do Sul. Analisa as convergências e ou divergências das evidências sociais, os reflexos na vida prática das populações rurais envelhecidas, considerando a transição demográfica no país e a noção de desenvolvimento social ampliado. Trata-se de um estudo de casos múltiplos (multicaso), do tipo qualitativo. A geração dos dados deu-se por meio de pesquisa documental das políticas públicas setoriais que se embasam no envelhecimento populacional e nas dimensões locais dessas políticas e em entrevistas e grupos focais, com 31 gestores e prestadores de serviços dos municípios estudados. Desenvolveram-se dois grupos focais, um em Camaquã e outro em Canguçu, participando em cada grupo oito idosos rurais. A análise considerou o conteúdo temático e as formas como apareceram nas comunicações as dimensões sociopolíticas da problemática estudada. Os resultados mostraram o envelhecimento crescente tanto em Camaquã quanto em Canguçu, com destaque para o rural. Constatou-se que as velhices rurais expressam as incongruências da implementação das políticas públicas referendadas em tratados e políticas nacionais e internacionais. Observaram-se características e limitações próprias do rural, expressas e diferenciadas entre os espaços da agricultura familiar, dos assentamentos rurais e das fazendas, encontrando-se os dois últimos em situação desfavorável se comparados ao primeiro. No plano da vida prática, para suprir a carência da oferta de ações e serviços públicos aos idosos no rural, o Sindicato dos Trabalhadores Rurais de Camaquã e de Canguçu assumem papel importante na vida dessa população. É possível afirmar que, considerando o desenvolvimento social ampliado, tanto em Camaquã quanto em Canguçu os idosos rurais encontram-se “des” (não) envolvidos nas ações e serviços, quer nos limites do rural dos municípios como em termos de inclusão na sociedade mais ampla. / This study is devoted to understanding the experiences of rural aging in the cities of Camaquã and Canguçu from the prospect of expanded social development. It is inserted into an Interdisciplinary Research Program that integrates multidisciplinary and interdisciplinary approaches in the analysis of rural development in cities in the southern half of the state of Rio Grande do Sul. It examines the convergences and or divergences of social evidences, the reflections on the practical life of the aging rural population, considering the demographic transition in the country and the notion of social development expanded. It is a multiple case study (multicase), a qualitative approach. The generation of data was done through desk research of public sector policies that underlie the aging population and local dimensions of these policies and interviews and focus groups, with 31 managers and service providers in the cities studied. Two focus groups were developed, one in Camaquã and another in Canguçu, participating in each group eight rural elderly. The analysis considered the thematic content and the ways communications appeared in the socio-political dimensions of the problem studied. The results showed the growing aging both in Camaquã as in Canguçu, especially rural. It was found that rural old age express inconsistencies of implementation of public policies ratified in treaties and national and international policies. We observed the characteristics of the rural, expressed and differentiated among the spaces of family agriculture, rural settlements and farms, lying the last two at a disadvantage compared to the first. In terms of practical life, to supply the deficiency of actions and services for the elderly in the rural, the Rural Workers Union from Camaquã and Canguçu play an important role in the life of this population. It is possible to say that, considering the wide social development, both in Camaquã as in Canguçu the rural elderly are “un” (not) involved in the actions and services, either within the boundaries of rural cities and in terms of inclusion in wider society.

Este estudo é dedicado à compreensão de experiências de envelhecimento rural nos municípios de Camaquã e Canguçu na perspectiva do desenvolvimento social ampliado. Insere-se em um Programa Interdisciplinar de Pesquisa que busca integrar enfoques multidisciplinares e interdisciplinares na análise do desenvolvimento rural em municípios da Metade Sul do Estado do Rio Grande do Sul. Analisa as convergências e ou divergências das evidências sociais, os reflexos na vida prática das populações rurais envelhecidas, considerando a transição demográfica no país e a noção de desenvolvimento social ampliado. Trata-se de um estudo de casos múltiplos (multicaso), do tipo qualitativo. A geração dos dados deu-se por meio de pesquisa documental das políticas públicas setoriais que se embasam no envelhecimento populacional e nas dimensões locais dessas políticas e em entrevistas e grupos focais, com 31 gestores e prestadores de serviços dos municípios estudados. Desenvolveram-se dois grupos focais, um em Camaquã e outro em Canguçu, participando em cada grupo oito idosos rurais. A análise considerou o conteúdo temático e as formas como apareceram nas comunicações as dimensões sociopolíticas da problemática estudada. Os resultados mostraram o envelhecimento crescente tanto em Camaquã quanto em Canguçu, com destaque para o rural. Constatou-se que as velhices rurais expressam as incongruências da implementação das políticas públicas referendadas em tratados e políticas nacionais e internacionais. Observaram-se características e limitações próprias do rural, expressas e diferenciadas entre os espaços da agricultura familiar, dos assentamentos rurais e das fazendas, encontrando-se os dois últimos em situação desfavorável se comparados ao primeiro. No plano da vida prática, para suprir a carência da oferta de ações e serviços públicos aos idosos no rural, o Sindicato dos Trabalhadores Rurais de Camaquã e de Canguçu assumem papel importante na vida dessa população. É possível afirmar que, considerando o desenvolvimento social ampliado, tanto em Camaquã quanto em Canguçu os idosos rurais encontram-se “des” (não) envolvidos nas ações e serviços, quer nos limites do rural dos municípios como em termos de inclusão na sociedade mais ampla. / This study is devoted to understanding the experiences of rural aging in the cities of Camaquã and Canguçu from the prospect of expanded social development. It is inserted into an Interdisciplinary Research Program that integrates multidisciplinary and interdisciplinary approaches in the analysis of rural development in cities in the southern half of the state of Rio Grande do Sul. It examines the convergences and or divergences of social evidences, the reflections on the practical life of the aging rural population, considering the demographic transition in the country and the notion of social development expanded. It is a multiple case study (multicase), a qualitative approach. The generation of data was done through desk research of public sector policies that underlie the aging population and local dimensions of these policies and interviews and focus groups, with 31 managers and service providers in the cities studied. Two focus groups were developed, one in Camaquã and another in Canguçu, participating in each group eight rural elderly. The analysis considered the thematic content and the ways communications appeared in the socio-political dimensions of the problem studied. The results showed the growing aging both in Camaquã as in Canguçu, especially rural. It was found that rural old age express inconsistencies of implementation of public policies ratified in treaties and national and international policies. We observed the characteristics of the rural, expressed and differentiated among the spaces of family agriculture, rural settlements and farms, lying the last two at a disadvantage compared to the first. In terms of practical life, to supply the deficiency of actions and services for the elderly in the rural, the Rural Workers Union from Camaquã and Canguçu play an important role in the life of this population. It is possible to say that, considering the wide social development, both in Camaquã as in Canguçu the rural elderly are “un” (not) involved in the actions and services, either within the boundaries of rural cities and in terms of inclusion in wider society.

M. Tech. Business Information Systems / The South African government provides grants for social assistance as an income. The Social Grant is paid by South African Social Security Agency (SASSA) using the Smartcard System for distribution of funds to beneficiaries who are classified as: Old Age Grant; Child Grant; War Veteran Grant; Foster Care Grant; Disability Grant; Care Dependency Grant; and Grant-in-Aid. Smartcard System was implemented for the developed countries and developing countries, however, in South Africa, the implementation appears to have some deficiencies. The implementation in the rural areas is not the same as the one in the urban areas due to technical infrastructure and training. The main objective of this study is to determine factors that contribute to successful implementation of Smartcard System and to develop an appropriate framework for the implementation of the Smartcard System in rural South Africa. aim of this research.

A qualitative design was used to explore the use of spirituality and prayer by older adults who have chronic illness and reside in a rural community. Thirteen individuals responded to a flyer soliciting participation in a study of the use of spirituality as part of health care. Participants were at least 60 years of age, had at least one chronic illness and resided in North Central Florida. Twelve participants then responded to six open-ended questions based on an adaption of an instrument used by Dr. Shevon Harvey in her doctoral dissertation. The data was analyzed to identify themes and answer four research questions. The four research questions were 1) how do older adults living with chronic illness describe spirituality? 2) how do older adults use spirituality while living with chronic illness? 3) how can health care providers assist older individuals with chronic illness to meet their spiritual needs?, and 4) do patients feel that their spiritual needs are being addressed during their outpatient health care? The interview responses demonstrated that several different practices, including prayer and scripture readings as well as adherence to medication, diet, and exercise recommendations were used as coping mechanisms by study participants. The majority of participants want their health care providers to address spirituality and/or refer them to spiritual advisors for counseling. The study showed that some participants stated that their spiritual needs were met, but there were some who did not want spirituality addressed in the outpatient setting. Four themes were identified, which suggest that 1) spiritual practices were frequently used coping measure for these individual with chronic illness, 2) health care providers are supportive iv of their patients’ spirituality, 3) participants with chronic illness consider adherence to medication, diet, and exercise a coping measure, and 4) participants with chronic illness want their health care providers to recognize their spiritual needs. The findings indicated that individuals who self identify as individuals from whom spiritual life is important and who have chronic illnesses and have spiritual needs that can be addressed in the outpatient setting. The findings also demonstrated use of non spiritual coping measures and the importance of health care provider’s acceptance of spirituality in this specific population. Recommendations for further research are made.