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A narrative study of the illness experience of fibromyalgia in South Africa.Cooper, Silvie 16 July 2014 (has links)
This thesis presents the findings of an exploratory study undertaken to investigate the illness
experience of fibromyalgia in the context of South Africa. It contains the literature review
and conceptual framework that guided the study. The theoretical discussions reflect the
approaches to health and illness, illness experience and narrative study, context, diagnosis,
prognosis, sickness, illness career, treatment, institutional interactions and social support.
Following this, the methodological approaches and tools used in conducting this study are
explained. In-depth interviews and diaries were used to collect narratives from 15 participants
and one practitioner. Additionally, a brief media content analysis was included in order to
assess the public perceptions of fibromyalgia in South African news articles. The themes of
legitimacy, credibility, flexibility, and accommodation are continually developed throughout
the thesis. The Analysis of Findings chapter presents and discusses the evidence gathered
from the investigations undertaken in this study. This chapter shows how the contested and
confusing illness experience of fibromyalgia can be understood, by viewing the interactions
that patients have with their practitioners, families, peers and colleagues. The meanings
ascribed to fibromyalgia as a label, and the uncertain prognosis attached to the diagnosis, as
well as infrequently effective treatment options are explored here. The gains found in
successful practitioner-patient interactions, and the limitations of medical aid coverage for
chronic conditions like fibromyalgia in South Africa are discussed in this chapter. The role of
family and peers, as well as workplaces and colleagues in offering support to those living
with fibromyalgia is analysed. Finally, the conclusions arising from this study are presented,
and recommendations for areas of future engagement and research are offered in order to
attain a better understanding of the experience and impact of fibromyalgia in the South
African context.
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Die maatskaplike werker as ondersteuningsbron vir geneeshere in privaat praktykVogt, Tertia 12 1900 (has links)
Thesis (MSocialWork)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The aim of this study was to compile practical guidelines to assist medical practitioners in
utilizing social work services in their practices. Exploratory, descriptive and applied
research was done to determine and describe medical practitioners' knowledge of
psychosocial problems and their present and potential utilization of social work services.
Results were generalized in respect of the population as a whole.
In the theoretical study social functioning was conceptualized by the description of
micro, mezzo and macro levels of functioning. The approach towards rendering of
services (in the Medical field) and intervention (in the Social Work field) was described,
followed by recommendations for the eclectical utilization of the approaches.
The eclectical application of the intervention approaches requires that social workers
should have certain knowledge, values and skills to interpret certain roles. This occurs
within certain social work areas, with the achievement of the aims and functions of Social
Work as goal. The ethical and value basis of Social Work and Medical Science shows
certain similarities and disparities. The values of Social Work, as contained in the
Behavioural- and Ethical Code for Social Work and the Oath of Hippocrates, in Medical
Science, are described in this study.
In the empirical study qualitative and quantitative information was gathered, inter alia,
about the existence of psychosocial problems of patients in medical practitioners'
practices, how medical practitioners handled them, how well equipped they were to do it,
their present and potential utilization of Social Work services, the role of third parties in
the rendering of services and referral procedures. Thirty nine (39) medical practitioners,
selected by random sampling procedure, were involved in the study and completed selfadministered
questionnaires.
The majority respondents indicated that their undergraduate training was inadequate in
enabling them to handle psychosocial problems of patients. The entire spectrum of
psychosocial problems existed in all the respondents' practices. The majority of
respondents handled such problems themselves, while specialists, psychologists and
psychiatrists were at times used as resources. The majority of respondents indicated that
they could perhaps utilize Social Work services and that there is a great need for such a
resource. Most medical practitioners preferred to send written referrals via patients, with
the responsibility being with the patient for making an appointment with the social
worker. Minimal use was made of third parties in the patients' frame of reference in the
assessment and treatment of patients.
Third parties, within the reference framework of patients, were used minimally by
medical practitioners in the making of assessments and the rendering of services.
Respondents had divergent opinions regarding their competence in the psychosocial field
of service rendering. The majority of respondents indicated the need for training
programs focusing on the handling of patients' psychosocial problems. Limited time for
attending such training programs was however mentioned as the biggest obstacle. These
findings of the empirical study, together with the theoretical framework, were used as a
guideline for the composition of a practical guideline for the referral of services to social
workers in private practice. / AFRIKAANSE OPSOMMING: Die doelstelling van hierdie studie was om praktykriglynne te ontwikkel, waarvolgens
geneeshere in privaat praktyk maatskaplike werkers as ondersteuningshulpbron kan
benut. Verkennende, beskrywende en toegepaste navorsing is gedoen, ten einde
geneeshere se kennis van psigososiale probleme en hul huidige en potensiele benutting
van maatskaplikewerkdienste te bepaal en te beskryf. Bevindinge is ten opsigte van die
populasie as geheel veralgemeen.
In die teoretiese studie is maatskaplike funksionering deur die beskrywing van mikro-,
meso- en makrovlakfunksionering, gekonseptualiseer. Die benaderings tot dienslewering
(in Geneeskunde) en intervensie (in Maatskaplike Werk) is beskryf. Daarna is 'n
aanbeveling vir die eklektiese benutting van die benaderings gedoen.
Die eklektiese benutting van die intervensiebenaderings vereis dat maatskaplike werkers
oor sekere kennis, waardes en vaardighede moet beskik en sekere rolle moet vertolk. Dit
geskied binne sekere maatskaplikewerkvelde en het as mikpunt die verwesenliking van
die doelstellings en funksies van Maatskaplike Werk. Die etiese en waardegrondslag van
Maatskaplike Werk en Geneeskunde toon sekere ooreenkomste en verskille. Die waardes
van Maatskaplike Werk, soos vervat in die Gedrags- en Etiese Kodes vir Maatskaplike
Werk, en van Geneeskunde, soos vervat in die Eed van Hippocrates, word in hierdie
studie bespreek.
In die empiriese studie is kwalitatiewe en kwantitatiewe inligting ingesamel oor, onder
andere, die voorkoms van psigososiale probleme by pasiente in geneeshere se praktyke,
geneeshere se hantering daarvan, hul bekwaamheid om sodanige probleme te hanteer,
hul huidige en potensiele benutting van maatskaplikewerkdienste, die rol van derde
partye by dienslewering en verwysingsprosedures. Nege-en-dertig (39) geneeshere,
geselekteer deur ewekansige steekproeftrekking, is by die ondersoek betrek en het self
die vraelyste ingevul.
Die meeste geneeshere het aangedui dat hul voorgraadse opleiding hulle nie voldoende
toegerus het om psigososiale probleme by pasiente te hanteer nie. Die hele spektrum van
psigososiale probleme het in respondente se praktyke voorgekom. Die meeste
respondente het sodanige probleme self hanteer, terwyl spesialiste, sielkundiges en
psigiaters soms as hulpbronne benut is. Die meeste respondente het aangetoon dat hulle
moontlik van maatskaplike werkers gebruik kan maak en dat daar 'n groot behoefte aan
sodanige hulpbron bestaan. Die verwysingsprosedure wat deur die meeste geneeshere
verkies is, was die stuur van skriftelike verwysings saam met pasiente.
Derde partye, in pasiente se verwysingsraamwerk, is minimaal deur geneeshere by
assessering en dienslewering betrek. Geneeshere het uiteenlopende menings gehad oor
hul bevoegdhede in die psigososiale veld van dienslewering. Die behoefte aan
opleidingsprogramme, wat fokus op die hantering van psigososiale probleme by pasiente,
is deur die meeste respondente aangedui. Beperkte tyd is egter as die grootste struikelblok
vir die bywoning van sodanige opleidingsessies aangevoer. Hierdie bevindinge van die
empiriese studie, saam met die teoretiese raamwerk, is as riglyn benut vir die
ontwikkeling van 'n praktykriglyn vir verwysing van dienste na maatskaplike werkers in
privaat praktyk.
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The medical profession in a transforming South Africa society : ideals, values and roleMahlati, Malixole Percival 04 1900 (has links)
Thesis (MPhil)--Stellenbosch University, 2000. / Some digitised pages may appear illegible due to the condition of the original hard copy. / ENGLISH ABSTRACT: Medicine in our country is under severe stress, brought about by internal and external
forces that need a response from the medical profession. The profession's attempts and
response will fall short unless the profession itself is aligned with the new social ethos and
the responses are based on the profession's inherent values.
Problem Statement:
Medical doctors have always been highly valued in society because of the duty they have
when illness and disease set in. As individuals, doctors have fulfilled other important roles
in the communities where they work. These include giving advice to young people on
career choices, counseling on various matters and provision of material help where there is
need. This profession has for a long time been shrouded in mystery, being a trade learnt by
a few. All these factors contributed to their social standing increasing phenomenally.
There is a view that this has also led to public perceptions that doctors are the rich
untouchable elite who have no interest or are unconcerned about problems faced by
society. The medical profession faces a challenge that is more significant because of the
value placed on it by society. The numerous submissions by the victims of human rights
abuses to the Truth and Reconciliation Commission have cast a shadow of doubt on the
medical profession for its complicity in these acts. The present government has declared
transformation of health care as one of its top priorities. The response of the medical
profession to this initiative has so far not led to any significant changes of public
perception that the profession is unwilling to participate in the transformation of our
society.
The challenge and subject of discussion in this thesis therefore is:
"What is the ideal role of the medical profession in a transforming South African
society?"
The medical profession, being the nerve centre of health care, has a big responsibility in
social transformation. Doctors stand accused as a collective for failing to protect the
human rights of patients and not living up to the standards of ethics required of them when patients' rights were violated. The Truth and Reconciliation Commission record of the
hearings into the role of the professional organisations in health is used in this thesis to
illustrate how serious society views the medical profession's role in the human rights
abuses of the past.
Based on the T. R. C's report and the assumption that society traditionally places high
value on the medical profession, I conducted a survey among South African doctors to test
their attitudes towards a range of policy and transformational issues. The unit of analysis
was the medical doctors who are in active practice in South Africa in whatever mode of
practice. The survey sought to explore the awareness of the respondents about a range of
transformation policy changes and invite their comments on the role that they envisage for
the medical profession in the process of transformation of society. There is unfortunately
scarcity or a lack of applicable South African literature on this topic thus limiting local
material for referencing. The search of international literature only yielded the subject of
the study of professional values and not necessarily the role of a medical profession in a
transforming society.
The medical profession has to re-visit its foundations, analyse its history and map out its
future in the context of the South African realities. It must find a way of aligning itself
with the new ethos and diverse cultures South Africa possesses. Medicine has its own
traditional goals and values derived and adapted from society's diverse cultural value
systems. With its national and international networks, the inherent knowledge and skills
that it possesses, guided by an ethical code, the Hippocratic Oath that serves as a public
promise, it influences policy on the country's health care system - a mechanism that
government uses to provide a basic human need.
The medical profession therefore has to be responsive to the needs of society as much as
society needs to support the profession. This thesis explores the role that the profession
should play in a transforming South African society. The argument is that this can only be
done through the profession examining its values and aligning itself with broader societal
value systems, the moral and social norms. It is further argued that visible realistic
commitment by the profession to public health will lead to an improvement in its public
image. It is the actions or non-actions of the majority that the public notices. The majority
of respondents to the survey have indicated that they approve of the transformation
policies in health but that they may differ in the way they were introduced. / AFRIKAANSE OPSOMMING: Die geneeskunde in ons land is onder geweldige druk as gevolg van interne en eksterne
faktore en dit is nodig dat die mediese beroep reageer. Dit sal die beroep egter nie help
om te reageer indien sy lede hulle nie met die nuwe maatskaplike etos vereenselwig nie en
die reaksie op die inherente waardes van die mediese beroep geskoei word nie.
Probleemstelling
Mediese dokters is nog altyd baie hoog geag deur die gemeenskap as gevolg van die
verpligting wat hulle het om na mense om te sien wanneer hulle siek word. In hulle
individuele hoedanigheid het dokters ook ander belangrike bydraes tot hulle
gemeenskappe gelewer. Dit sluit in: advies aan jong mense oor loopbaankeuses, berading
en die verskaffing van finansiele hulp waar nodig. Die beroep as sulks was egter vir baie
lank ietwat van 'n misterie omdat dit 'n vakrigting is waarin baie min mense hulle kon
bekwaam. Al hierdie faktore het die maatskaplike aansien/waarde van dokters geweldig
verhoog. Daar is ook diegene wat van mening is dat hierdie faktore aanleiding gegee het
tot die openbare mening dat dokters 'n ryk en onaantasbare elite is en glad nie in die
probleme van die gemeenskap belangstel nie. Die etlike voorleggings deur die slagoffers
van menseregtevergrype aan die Waarheids- en Versoeningskommissie het ook vrae
rondom die beroep se betrokkenheid by sodanige gevalle laat ontstaan. Die huidige
regering het die transformasie van gesondheidsorg as een van sy grootste prioriteite
verklaar. Die reaksie van die beroep hierop het tot dusver nie tot enige noemenswaardige
veranderinge in die openbare mening dat dokters nie bereid is om aan die transformasie
van ons gemeenskap deel te neem gelei nie.
Wat is die ideale rol van die mediese beroep in die transformasie van die Suid-
Afrikaanse gemeenskap?
As die senusentrum van gesondheidsorg het die mediese beroep 'n groot
verantwoordelikheid in maatskaplike transformasie. Dokters word kollektief beskuldig
dat hulle nagelaat het om die menseregte van pasiente te beskerm en nie voldoen het aan
die nodige etiese standaarde wat van hulle verwag word in die tyd toe pasienteregte
geskend is nie. Die rekord van die verhore van die Waarheids- en Versoeningskommissie
oor die rol van professionele gesondheidsorganisasies is vir die doeleindes van hierdie
tesis gebruik om te illustreer hoe ernstig die gemeenskap voeloor die mediese beroep se
rol in die menseregte vergrype van die verlede.
Gegrond op die WVK-verslag en die aanname dat die gemeenskap die mediese beroep
hoog ag, het ek 'n meningsopname onder 300 Suid-Afrikaanse dokters gedoen om hulle
houding jeens 'n aantal beleids- en transformasiekwessies te toets. Die eenheid van
analise was mediese dokters wat in die aktiewe praktyk staan, ongeag hulle praktykgebied.
Die opname het gepoog om te bepaal wat die vlak van bewustheid by die respondente oor
'n aantal beleidsveranderinge gerig op transformasie is, en hulle uit te nooi om
kommentaar te lewer op die rol wat hulle meen die mediese beroep behoort in die proses
te speel. Ongelukkig is daar nie toepaslike Suid-Afrikaanse literatuur oor die onderwerp
beskikbaar me. 'n Internasionale literatuursoektog het net studies rondom waardes
opgelewer, en nie oor die rol van 'n mediese beroep in die transformasie van 'n
gemeenskap nie.
Die mediese beroep moet die grondslag van sy wese in oenskou neem, die geskiedenis
analiseer en sy toekoms in die konteks van die Suid-Afrikaanse realiteite uitstippel. Die
beroep moet 'n manier vind om homself met die nuwe etos en uiteenlopende kulture van
Suid-Afrika te vereenselwig. Die geneeskunde het sy eie tradisionele doelwitte en waardes
gekry en aangepas vanuit die uiteenlopende kulturele waardestelsels van die gemeenskap.
Deur middel van sy nasionale en internasionale netwerke, inherente kennis en
vaardighede, die leiding van 'n etiese kode, die Eed van Hippokrates wat as 'n belofte aan
die publiek dien, beinvloed die mediese beroep die land se gesondheidsorgstelsel - 'n
meganisme van die regering om in 'n basiese menslike behoefte te voorsien.
Die mediese beroep moet daarom ingestel wees op die behoeftes van die gemeenskap in
dieselfde mate as wat die gemeenskap die beroep behoort te ondersteun. Hierdie tesis
ondersoek die rol wat die mediese beroep behoort te vervul in 'n Suid-Afrikaanse
gemeenskap waar transformasie besig is om plaas te vind. Daar word geargumenteer dat
dit net gedoen kan word indien die beroep sy waardes ondersoek en hom met die breer
maatskaplike waardestelsels vereenselwig. Daar word verder geargumenteer dat 'n
sigbare realistiese verbintenis van die mediese beroep tot openbare gesondheid tot die
verbetering van sy openbare beeld sal lei. Dit is die optrede of nie-optrede van die
meerderheid wat die publiek raaksien. Die meerderheid respondente in die
meningsopname het aangedui dat hulle die transformasiebeleid vir gesondheid ondersteun,
maar dat hulle verskil van die wyse waarop dit in werking gestel is.
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Die ontwikkeling van 'n assesseringsprogram vir geneeskundige maatskaplike werkersBeytell, Anna-Marie 14 April 2014 (has links)
M.A. (Social Work) / Accountability and competence are two important attributes needed by medical social workers in the changing social, political, economic and organizational situation in South Africa, In order -to be accountable and competent, medical social workers must be in possession of scientific knowledge, skills and the correct attitude regarding assessment, intervention and evaluation. The change in emphasis from long-term to short-term hospitalization and the importance of primary health care, means that within the limitations of the present organization structure, assessment is often the most important and sometimes the only, aspect in the helping process. The knowledge and skills of the medical social workers need to be extended; this study therefore focuses on effective assessment that will equip the medical social worker to render an effective service through linking resources within the patient, hospital and within the community. The aim of this study is the development of a training programme for medical social workers to extend their knowledge and skills in assessment.
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South African traditional healers' organisations in the context of traditionalism and modernityFenyves, Katalin January 1994 (has links)
A Research Report submitted to the Faculty of Arts, Department of Sociology, University
of the Witwatersrand, Johannesburg, in partial fulfillment for the degree of Master of Arts.
Johannesburg, 1994 / This research report seeks to explore the issues surrounding the organisation of traditiional healers and how their world views can be contextualised within tradtionalism and modernity. [Abbreviated Abstract. Open document to view full version] / MT2017
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The ‘obesity epidemic’ : an analysis of representations of obesity in mainstream South African newspapers post-1997Malan, Chantelle Therese January 2015 (has links)
This study of 449 newspaper articles from South Africa from 1997 provides an analysis of the representations of obesity evinced in the corpus. The research argues that obesity is overwhelmingly framed as being diseased and that there are four main refrains within this frame, namely, statistics on obesity, the naturalisation of negative assumptions about fat, the social dysfunction of fat and the use of crisis metaphors to describe fatness. This framing lends itself to representations of obesity which are raced, gendered and classed. Fat bodies are portrayed as being in deficit and fat people as lacking agency. The disproportional focus on black bodies in the corpus can be attributed to assumptions of ‘incivility’ which are premised on racial stereotypes which construct black people as being unintelligent, irrational, lacking agency and being largely dependent on others to survive. This disproportional focus on black bodies can also be understood in the context of emerging markets. This study argues that the medicalisation of obesity has contributed to many oversimplifications and contradictions in the representation of obesity in the corpus, which seem to go unquestioned, such as the conflation of weight and health, something I argue is one of the main contributors to the negative consequences of the dominant framing of obesity. Framing obesity as medicalised also promotes fat shaming and acts as a form of social control which maintains existing power relations through the use of discursive practices for the identification and control of deviants. These representations are problematic chiefly because they promote the dehumanisation of fat people, but also because that they do not promote good health as they claim to do.
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Poverty, health and disease in the era of high apartheid: South Africa, 1948-1976Phatlane, Stephens Ntsoakae 30 November 2006 (has links)
A higher infant mortality rate and shorter life expectancy, coupled with a high prevalence of a variety of diseases commonly associated with malnutrition, are usually a reflection of the social conditions of poverty in a society. By arguing that apartheid formed the basis of inequality and therefore the main underlying cause of an unacceptable burden of the diseases of poverty among black South Africans, this thesis, Poverty, Health and Disease in the Era of High Apartheid: South Africa, 1948-1976, locates these health problems within their social, economic and political context. It further argues that if health and disease are measures of the effectiveness with which human beings, using the available biological and cultural resources, adapt to their environment, then this relationship underpins the convergence of medical and cultural interests. Under the impact of modern technology and society's dependence upon it, profound cultural changes have taken place and issues of health and the etiology of disease are among the areas most affected by these changes. This thesis explains why, in a pluralistic medical setting, where only modern (scientific) medicine was recognised as legitimate medicine by the apartheid government, for the majority of black South Africans the advent of modern medicine was viewed not so much as displacing indigenous (African) medicine but as increasing the medical options available to them. It is therefore contended here that for most black South Africans, indigenous medicine has played a critical role; it has mitigated the impact of apartheid medicine. Since differences that people perceive in these two medical systems are crucial to the medical choices that they make at the onset of illness, this thesis argues that knowing and understanding the reasons for making such choices would not only have practical value for health authorities in their efforts to improve local, regional and national health service delivery, but would also contribute to a general understanding of human therapy-seeking behaviour in this age of the HIV/AIDS pandemic. / History / Thesis (D. Litt. et Phil. (History))
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Poverty, health and disease in the era of high apartheid: South Africa, 1948-1976Phatlane, Stephens Ntsoakae 30 November 2006 (has links)
A higher infant mortality rate and shorter life expectancy, coupled with a high prevalence of a variety of diseases commonly associated with malnutrition, are usually a reflection of the social conditions of poverty in a society. By arguing that apartheid formed the basis of inequality and therefore the main underlying cause of an unacceptable burden of the diseases of poverty among black South Africans, this thesis, Poverty, Health and Disease in the Era of High Apartheid: South Africa, 1948-1976, locates these health problems within their social, economic and political context. It further argues that if health and disease are measures of the effectiveness with which human beings, using the available biological and cultural resources, adapt to their environment, then this relationship underpins the convergence of medical and cultural interests. Under the impact of modern technology and society's dependence upon it, profound cultural changes have taken place and issues of health and the etiology of disease are among the areas most affected by these changes. This thesis explains why, in a pluralistic medical setting, where only modern (scientific) medicine was recognised as legitimate medicine by the apartheid government, for the majority of black South Africans the advent of modern medicine was viewed not so much as displacing indigenous (African) medicine but as increasing the medical options available to them. It is therefore contended here that for most black South Africans, indigenous medicine has played a critical role; it has mitigated the impact of apartheid medicine. Since differences that people perceive in these two medical systems are crucial to the medical choices that they make at the onset of illness, this thesis argues that knowing and understanding the reasons for making such choices would not only have practical value for health authorities in their efforts to improve local, regional and national health service delivery, but would also contribute to a general understanding of human therapy-seeking behaviour in this age of the HIV/AIDS pandemic. / History / Thesis (D. Litt. et Phil. (History))
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