D.Ed. (Nursing) / This research aims at the description of a therapeutic approach relevant to the youth suffering from chronic fatigue syndrome and includes his family, school and peer group. According to relevant literature it appears that chronic fatigue impacts negatively upon the total functioning of the youth. The physical demands of the condition leads to continual school-absenteeism, dysfunctional socialising and variable familial relationships. The condition is not easily diagnosed in youth as symptoms are often ascribed to school-phobia, deviant behaviour and/or psychological problems. In view of the fact that the researcher is of the opinion that the condition of the youth is not readily understood by his peers, family and school, the researcher aims at examining the experience of the youth who manifests chronic fatigue syndrome. The youth forms part of a specific system which is also affected by the chronic-fatigue-syndrome. Thus the research is aligned to a systemic approach. The researcher has decided to follow a qualitative research approach, with the deliberate choice of two youths subjected to the utilisation of multiple data-gathering sources. Multiple data-gathering includes interviews, document analysis and observation. The data has been analysed with the assistance of two independent coders and central themes have been established. Case study reports have been complied according to processed data. Hereafter a literature-control was applied to compare the results of this research with other available research and to point out new insights into chronic-fatigue syndrome gained from this research.

M.Cur / The country and education system is after apartheid in a process of renewal and transformation. Adolescents in secondary schools are increasingly in interaction with adolescents who have different values. The media reports that violence and conflict in secondary schools is common. Adolescents find themselves already in a developmental period characterised by physical, emotional, social and intellectual change (Vermaak, 1993: i). It is apparent that today' s adolescent in South Africa is confronted with more than love disappointments and exam stress. This research tells the story of a group of adolescents within a specific public secondary school in Gauteng in an attempt to give the adolescent a voice. The objectives for this research are: 1. To explore and describe the adolescents' experience of interaction between adolescents with different values in a specific public secondary school in Gauteng. 2. To describe guidelines for the advanced psychiatric nurse practitioner to mobilise resources for facilitating interaction between these adolescents in order to promote their mental health. The Theory for Health Promotion in Nursing as applied by the Nursing Department of the Rand Afrikaans University forms the basis of this research. From this perspective, the human is seen as holistically in interaction with the environment in an integrated manner, and are the four central components of this theory, namely the human, nursing, environment and health defined. The purpose of this theory is aimed at enhancing individual, family, group and community health (Rand Afrikaans University; Department of nursing, 2000: 4) and in this case, mental health. A Functional approach to nursing (Botes, 1991: 19-23) is followed, which implies that the research in nursing is mainly applied research that addresses recent health problems of the South-African community and provide solutions to these problems. It is clear that this research addresses a recent problem/trend in the South African school going adolescent community, namely the interaction between adolescents with different values in schools. The research in nursing, as developed by Botes (1995: 1-21), applies. A qualitative (Cresswell, 1994: 162), explorative (Mouton, 1996: 103), descriptive (Mouton, 1996: 102) and contextual (Mouton, 1996: 133) research design was used, and data was gathered through means ofthree focus groups (Folch-Lyon & Trost, 1981: 443; Krueger, 1994: 14,19 ,29) consisting of adolescents who complied with the sampling criteria. The researcher took field notes during and after the focus groups (Wilson, 1989: 434 ). The Gauteng Department of Education, the schools principal, the parents/guardians of the adolescents and the participating adolescents themselves gave their consent for the conducting of the research. The researcher did analyse the data using Tech's (in Cresswell, 1994: 155) descriptive method and did open coding. An independent coder analysed the data with the researcher and they held consensus discussions (Poggenpoel, 1998: 245). After the data was analysed, a literature control was conducted in order to recontextualise the data (Morse & Field, 1996: 106) and to indicate differences and similarities with other research. In phase one of the research, the researcher concluded that the adolescents experienced that certain practises and incidents in the school contribute to the deconstructive atmosphere in the school. These incidents and practises entail aspects related to discipline, respect, disempowerment, communication, expectations relating to academic issues and the confirmation of certain practises. The practises related to the deconstructive atmosphere contribute to the experiencing of emotions like frustration, anxiety, fear of rejection and victimisation, powerlessness, sadness and disappointment, uncertainty and fury. Discipline, caring and support, friendship and taking responsibility for choices made by the adolescent were practises identified that relate to a constructive atmosphere. Guidelines in phase two describe to the advanced psychiatric nurse practitioner how to facilitate interaction between these adolescents in the specific secondary school in order to contribute to the promotion of their mental health. The researcher generated and describes guidelines, within the survey list as suggested by Dickoff, James & Wiedenbach (1968: 423), for a multicultural empowerment program. The researcher discussed conclusions, limitations and practical problems of the research and made suggestions for the nursing practise, education and research.

The aim of this study is to describe the prevalence of high-risk and social behaviors amongst adolescents in the low- and middle-income country (LMIC) of Guyana, in which suicide ideation is not well understood amongst the indicated population and is holds the second highest rate in the world. The analysis was completed alongside an analysis of these same behaviors among adolescents in the United States alongside with the country of Trinidad and Tobago, to identify possible differences in trends and contribute to an understanding of global best practices. The most recent data available from the Global School-Based Student Health Survey (GSHS) for the LMICs stated and the Youth Risk Behavior Survey for the United States was used. Within the LMICs, there exists a lack of laws, policies, and plans to curb rates in poor high-risk and social behaviors noted. The lack of these action plans correlates to the rates notated. In comparison to the United States where more action plans exist; the correlated rates are not as prevalent. It is also important to note that there are limitations of this study, including differences in the datasets used for each country. In addition, the survey collection process itself might have introduced bias due to the sensitive nature of the questions. However even with these limitations, this study is only the second empirical effort to comprehensively understand suicidal behaviors amongst in-school adolescents in Guyana and the first empirical effort to understand suicidal behaviors amongst in-school adolescents in Trinidad and Tobago as data is limited in these countries are limited but especially amongst adolescents. Although it cannot be extrapolated that the lack of these action plans directly causes high rates of risky behaviors and poor social behaviors; it can be theorized that having more action plans might curb rates and therefore be a key protective factor for future implementation of prevention and intervention programs aimed for this population.

Traditional and cyber bullying have been identified as universal problematic issues facing adolescents, and research is needed to understand correlates associated with these phenomena. Structural equation modeling analyses examined associations between attachment to parents, traditional and cyber bullying or victimization, and mental health outcomes among 257 high school students (Average age 15.9 years). Key patterns emerged, including associations between maternal attachment and mental health outcomes; victimization and mental health concerns; and bullying and victimization in both traditional and cyber contexts. The role of attachment to mothers and fathers varied by context. Findings extend the literature by identifying risk factors in adolescence associated with bullying and victimization, as well as suggesting appropriate prevention and intervention strategies to increase adolescent well-being.

M.Cur. / Please refer to full text to view abstract

Child and adolescent mental health represents a key area of concern and public health relevance. Mental health disorders are one of the most prevalent illnesses affecting young people and contribute significantly to the global burden of disease. Childhood and adolescent mental health problems often persist into adulthood and as such frequently result in lifelong negative consequences. Yet despite the growing concern with regards to the mental health needs of children and adolescents, not much research, both internationally and particularly locally, has focused on the provision of mental health services to children and adolescents. Additionally, little has been published on the changes and trends in diagnostic rates and assessment procedures over time. Only a few international studies have investigated mental health trends in children and adolescents; hence, there is a crucial need for South African data to inform preventative and curative services for children in South Africa. This present study therefore investigated the trends and patterns relating to diagnostic rates and assessment practices in children and adolescents over time at a local South African psychological community service centre in Pietermaritzburg. The study was a retrospective chart review and the sample consisted of 679 case files from children and adolescents between 3-17 years of age, who had been seen at a local psychological service centre between 1987-1989, 1997-1999 and 2007-2009. The case files were systematically analysed with regards to diagnosis and assessment practices. It was hypothesised that the years of continuous social and political conflict in the Pietermaritzburg area, namely 1987-1989, had a direct impact on the psychological development and well-being of children and adolescents from this area, and that this would be reflected in the case files from the corresponding years. The research findings with regard to the assessment practices were comparable to the internationally observed trends relating to choice of tests and procedures. In addition, the findings of the current study also showed similar trends with regard to the increasing diagnostic rates for ADD/ADHD, Mood Disorder, and Autism Spectrum Disorders as were observed internationally. Additionally, the reported decreasing diagnostic rates for Mental Retardation and behaviour disorders were also found in this local study. However, the internationally observed increases in Anxiety Disorder diagnoses contrast with the findings of this study, where the results revealed that the rates for Anxiety Disorder and PTSD were considerably higher in the late 1980s and 1990s. This finding supports the initial hypothesis that the violence and social unrest had an effect on children’s psychological well-being. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2012.

The purpose of this study was to explore the lives of overweight/obese adolescent boys. A qualitative case study focused on depth of understanding. Four boys volunteered to participate in the study. Findings further our understanding of the adolescent boys’ lifescapes; viable and non-viable recruitment strategies among this population; ethical obligations of ending research after establishing trust and rapport; and “Avoidance” as an Idiom of Distress among this sample of boys. Suggestions for future research are addressed in the study. / vi, 102 leaves ; 29 cm

M.Cur. / An exploratory descriptive study was undertaken, focusing on sexually transmitted diseases among teenagers. The aim of the study was to explore and describe the possible reasons for the high rate of sexually transmitted diseases in teenagers. The knowledge, attitudes and opinions of teenagers and community nurses involved in the teenage clinic in a specific predominantly black area were assessed. Twenty teenagers and five community nurses in a specific predominantly black area, were participants in the study. Focus group interviews are used. The study is conducted in two phases: teenagers representing phase one (1) and community nurses as phase two (2). It can be concluded that the attitudes of community nurses may have an influence on the high rate of sexually transmitted diseases, and the knowledge of the teenagers about sexually transmitted diseases is based on myths and misconceptions. The recommendations made are that the training standards for all community nurses should be reviewed and adapted to meet the needs of teenagers attending the teenage services. The policy on in-service training must be reviewed and monitored. Community nurses' intensive training on teenage service delivery and sexually transmitted diseases services should be in correlation with the principles of Primary Health Care. Community nurses need to attend intensive courses on interpersonal skills specifically related to teenagers. Selection procedures for recruiting community nurses to attend specifically to teenagers should be researched. The attitude of community nurses and teenagers should be the core of the service delivery. Teenagers should be involved in planning programmes and the teenage clinic should be evaluated frequently to improve the standards. The availability of teenage services should result in a decrease in sexually transmitted diseases among teenagers.

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.

Approximately 2-11% of adolescents report chronic insomnia. The study used an archival data set from ADDHealth that assessed adolescent health and health-related behaviors. Adolescents (N = 4102) provided data at baseline (Time 1) and at 1-year follow-up (Time 2). Participants were excluded if no ethnicity, gender, or insomnia data were given at Time 1 or 2. Females were more likely to report insomnia than males at Times 1 and 2. In addition, adolescents with remitted insomnia were significantly younger than adolescents without insomnia at Times 1 and 2. Analyses found a prevalence of 9.6%, a remittance of 6.2%, an incidence of 4.4%, and a chronicity of 2.9%. At Time 1 and 2, AWI were significantly more likely to have depression, suicidal behaviors, and behavioral problems in school than AWOI. At Time 2, incidence and chronic insomnia increased the risk of depression, suicidal behaviors and behavioral problems in school. Risk and protective factors analyses indicated psychological counseling was associated with both remitted and chronic insomnia and depression was associated with incidence insomnia.